European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 10, pp 3109–3115 | Cite as

Detection of eustachian tube openings by tubomanometry in adult otitis media with effusion

  • Panpan Liu
  • Kaiming Su
  • Bijun Zhu
  • Yaqin Wu
  • Haibo Shi
  • Shankai Yin


Otitis media with effusion (OME) is a common disease and eustachian tube (ET) dysfunction is widely known to be related to the incidence of OME; however, objective evaluation tools for ET function are lacking. To evaluate ET openings by tubomanometry (TMM) in adult patients with otitis media with effusion (OME), the ET patency of 123 ears, including 63 ears of OME patients and 60 control ears, were tested using TMM and tympanometry. ET patency was evaluated by the R value and ET score, and was compared to the tympanogram results. The eustachian tube dysfunction questionnaire (ETDQ-7) was used to assess the severity of the symptoms in OME patients. The results showed that the rates of restricted opening or blocked ET under pressures of 30, 40, and 50 mbar by TMM testing were 10, 5, and 0 %, respectively (control group) and 76.19, 66.7, and 57.97 %, respectively (OME group) (p < 0.05 for all pressure groups). However, the rates were 77.42, 71.97, and 61.29 % in the type B tympanogram group, and 75, 62.5, and 46.87 % in the type C tympanogram group; no significant difference was found at each testing pressure (p = 0.821, 0.246, and 0.516; respectively) between these tympanogram groups. The mean ETDQ-7 score in OME patients was 16.40 ± 10.72, which was significantly negatively correlated with the ET score at 30 and 40 mbar (30 mbar: correlation coefficient −0.29, p = 0.025; 40 mbar: correlation coefficient −0.28; p = 0.030), but not at 50 mbar (correlation coefficient −0.013, p = 0.924). These findings showed that ET blockage or delayed opening were found in most adult patients with OME when evaluated by this innovative and semi objective TMM, testing pressures should be considered when assessing the results of TMM in OME patients.


Otitis media with effusion (OME) Eustachian tube (ET) Tubomanometry (TMM) Tympanogram Tympanometry 



This study was supported by the State Key Development Program for Basic Research of China (Grant No. 2014CB541705), the Project of the Shanghai Committee of Science and Technology (14DZ1940704), the National Natural Science Foundation (81570910) and the Excellent academic leader training program of Shanghai municipal health system (XBR2013085).


  1. 1.
    Holmquist CA, Gregory JH, Baker MN, Rich ED, Greeley SA (1926) Standard specifications and tests for municipal refuse incinerators. Am J Public Health (NY) 16:393–395CrossRefGoogle Scholar
  2. 2.
    Patel MM, Eisenberg L, Witsell D, Schulz KA (2008) Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices. Otolaryngol Head Neck Surg 139:490–494CrossRefPubMedGoogle Scholar
  3. 3.
    Fujita A, Honjo I, Kurata K, Gan I, Takahashi H (1993) Refractory otitis media with effusion from viewpoints of eustachian tube dysfunction and nasal sinusitis. Am J Otolaryngol 14:187–190CrossRefPubMedGoogle Scholar
  4. 4.
    Doyle WJ, Mandel EM, Seroky JT, Swarts JD, Casselbrant ML (2013) Reproducibility of the forced response test in children with chronic otitis media with effusion. Otol Neurotol 34:16–21CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Prasad KC, Hegde MC, Prasad SC, Meyappan H (2009) Assessment of eustachian tube function in tympanoplasty. Otolaryngol Head Neck Surg 140:889–893CrossRefPubMedGoogle Scholar
  6. 6.
    Falk B, Magnuson B (1984) Eustachian tube closing failure in children with persistent middle ear effusion. Int J Pediatr Otorhinolaryngol 7:97–106CrossRefPubMedGoogle Scholar
  7. 7.
    Swarts, JD, Teixeira MS, Banks J, El-Wagaa J, Doyle WJ (2014) A method to assess the accuracy of sonotubometry for detecting Eustachian tube openings. Eur Arch OtorhinolaryngolGoogle Scholar
  8. 8.
    Esteve D, Martin C, Dubreuil C (1999) Tubomanometrie: aspects de la function equipressive de la trompe auditive: cas cliniques. J Fr ORL 48:6Google Scholar
  9. 9.
    Collin M, Coulange M, Deveze A, Montava M, Esteve D, Lavieille JP (2012) Middle ear barotraumas due to rhinopharyngeal scar tissue: tubomanometry diagnostic and therapeutic contribution. Rev Laryngol Otol Rhinol (Bord) 133:157–161Google Scholar
  10. 10.
    Sudhoff H, Ockermann T, Mikolajczyk R, Ebmeyer J, Korbmacher D, Garten D, Schreiber S (2009) Clinical and experimental considerations for evaluation of Eustachian tube physiology. HNO 57:428–435CrossRefPubMedGoogle Scholar
  11. 11.
    Silvola J, Kivekas I, Poe DS (2014) Balloon dilation of the cartilaginous portion of the Eustachian tube. Otolaryngol Head Neck Surg 151:125–130CrossRefPubMedGoogle Scholar
  12. 12.
    Gurtler N, Husner A, Flurin H (2015) Balloon dilation of the eustachian tube: early outcome analysis. Otol Neurotol 36:437–443CrossRefPubMedGoogle Scholar
  13. 13.
    Jenckel F, Kappo N, Gliese A, Loewenthal M, Lorincz BB, Knecht R, Dalchow CV (2014) Endonasal dilatation of the Eustachian tube (EET) in children: feasibility and the role of tubomanometry (Esteve) in outcomes measurement. Eur Arch OtorhinolaryngolGoogle Scholar
  14. 14.
    Meyer MF, Mikolajczak S, Korthauer C, Jumah MD, Hahn M, Grosheva M, Luers JC, Huttenbrink KB, Beutner D (2015) Impact of xylomethazoline on Eustachian tube function in healthy participants. Otol NeurotolGoogle Scholar
  15. 15.
    Schroder S, Lehmann M, Sauzet O, Ebmeyer J, Sudhoff H (2015) A novel diagnostic tool for chronic obstructive eustachian tube Dysfunction—the eustachian tube score. Laryngoscope 125:703–708CrossRefPubMedGoogle Scholar
  16. 16.
    Ars B, Dirckx JJ (2003) Fibrocartilaginous Eustachian tube—middle ear cleft. Kugler Publications, The Hague, The Netherlands. pp 151–158Google Scholar
  17. 17.
    McCoul ED, Anand VK, Christos PJ (2012) Validating the clinical assessment of eustachian tube dysfunction: the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope 122:1137–1141CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Jerger J (1970) Clinical experience with impedance audiometry. Arch Otolaryngol 92:311–324CrossRefPubMedGoogle Scholar
  19. 19.
    Ockermann T, Reineke U, Upile T, Ebmeyer J, Sudhoff HH (2010) Balloon dilatation eustachian tuboplasty: a clinical study. Laryngoscope 120:1411–1416CrossRefPubMedGoogle Scholar
  20. 20.
    Esteve D, C. Dubreuil C, Della-Vedova C, Normand B, Martin C (2001) Evaluation by tubomanometry of the eustachian tube opening function and of the tympanic response in normal subjects and in patients with secretory otitis media: result comparison. J Fr ORL 50:223–231Google Scholar
  21. 21.
    Watters GW, Jones JE, Freeland AP (1997) The predictive value of tympanometry in the diagnosis of middle ear effusion. Clin Otolaryngol Allied Sci 22:343–345CrossRefPubMedGoogle Scholar
  22. 22.
    Califano L, Salafia F, Mazzone S, D’Ambrosio G, Malafronte L, Vassallo A (2014) A comparative randomized study on the efficacy of a systemic steroid therapy vs. a thermal therapy in Otitis media with effusion in children. Minerva Pediatr 66:123–125Google Scholar
  23. 23.
    Perez R, Priner R, Cohen D, Freeman S, Sohmer H (2002) An animal model for assessment of amniotic fluid clearance from the middle ear. Otol Neurotol 23:29–33CrossRefPubMedGoogle Scholar
  24. 24.
    Sarkar S, Roychoudhury A, Roychaudhuri BK (2009) Tympanoplasty in children. Eur Arch Otorhinolaryngol 266:627–633CrossRefPubMedGoogle Scholar
  25. 25.
    Kouwen H, van Balen FA, Dejonckere PH (2005) Functional tubal therapy for persistent otitis media with effusion in children: myth or evidence? Int J Pediatr Otorhinolaryngol 69:943–951CrossRefPubMedGoogle Scholar
  26. 26.
    Schroder S, Lehmann M, Sudhoff H, Ebmeyer J (2014) Assessment of chronic obstructive eustachian tube dysfunction: evaluation of the German version of the Eustachian Tube Dysfunction Questionnaire. HNO 62(160):162–164Google Scholar

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© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People’s HospitalOtolaryngology Institute of Shanghai Jiao Tong UniversityShanghaiChina

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