Skip to main content
SpringerLink
Log in

Characteristics of tympanogram in symptomatic Eustachian tube dysfunction

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To identify the characteristics of tympanogram in symptomatic Eustachian tube dysfunction (SETD) patients.

Methods

One hundred and twenty-four unilateral SETD patients presenting with type A tympanograms who underwent balloon dilation of the Eustachian tube (BDET) were recruited and assigned into effective BDET group and ineffective BDET group based on treatment effect. The unaffected ear in the same patient served as normal control. Fifty-one patients with sudden sensorineural hearing loss (SSHL) and 46 patients with Meniere’s disease (MD) were selected for cases of non-ETD ear fullness. Demographics, 7-item Eustachian Tube Dysfunction Questionnaire score (ETDQ-7), and tympanograms were recorded and analyzed preoperatively and postoperatively.

Results

Of the 124 SETD patients included in the study 94 (75.8%) showed good response to BDET based on decreased ETDQ-7 scores. There were no significantly differences in the values of tympanometric peak pressure (TPP) between diseased ears and healthy ears in SETD patients, as well as in SSHL and MD patients. Instead, TPP shifts (the difference between two values of TPP obtained under a Valsalva and Toynbee maneuver) were remarkably reduced in affected ears compared with those in unaffected ears in effective BDET group at baseline. Moreover, TPP shifts in these SETD ears significantly raised and reached the levels in healthy ears postoperatively.

Conclusions

This study demonstrated TPP shifts are decreased in a subset of SETD patients presenting with type A tympanograms and these patients are more likely to show good response to BDET.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Vila PM, Thomas T, Liu C, Poe D, Shin JJ (2017) The burden and epidemiology of eustachian tube dysfunction in adults. Otolaryngol Head Neck Surg 156(2):278–284

    Article  Google Scholar 

  2. Schilder AG, Bhutta MF, Butler CC, Holy C, Levine LH, Kvaerner KJ, Norman G, Pennings RJ, Poe D, Silvola JT, Sudhoff H, Lund VJ (2015) Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol 40(5):407–411

    Article  CAS  Google Scholar 

  3. Tucci DL, McCoul ED, Rosenfeld RM, Tunkel DE, Batra PS, Chandrasekhar SS, Cordes SR, Eshraghi AA, Kaylie D, Lal D, Lee J, Setzen M, Sindwani R, Syms CA 3rd, Bishop C, Poe DS, Corrigan M, Lambie E (2019) Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube. Otolaryngol Head Neck Surg 161(1):6–17

    Article  Google Scholar 

  4. H. Editorial Board of Chinese Journal of Otorhinolaryngology, S. Neck, H. Society of Otorhinolaryngology, C.M.A. Neck Surgery (2018) Expert consensus on Eustachian tube dysfunction. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 53(6):406–409

    Google Scholar 

  5. Poe D, Anand V, Dean M, Roberts WH, Stolovitzky JP, Hoffmann K, Nachlas NE, Light JP, Widick MH, Sugrue JP, Elliott CL, Rosenberg SI, Guillory P, Brown N, Syms CA 3rd, Hilton CW, McElveen JT Jr, Singh A, Weiss RL Jr, Arriaga MA, Leopold JP (2018) Balloon dilation of the eustachian tube for dilatory dysfunction: a randomized controlled trial. Laryngoscope 128(5):1200–1206

    Article  Google Scholar 

  6. Meyer TA, O’Malley EM, Schlosser RJ, Soler ZM, Cai J, Hoy MJ, Slater PW, Cutler JL, Simpson RJ, Clark MJ, Rizk HG, McRackan TR, D’Esposito CF, Nguyen SA (2018) A randomized controlled trial of balloon dilation as a treatment for persistent eustachian tube dysfunction with 1-year follow-up. Otol Neurotol 39(7):894–902

    Article  Google Scholar 

  7. Zeng H, Chen X, Xu Y, Zheng Y, Xiong H (2019) Buteyko breathing technique for obstructive Eustachian tube dysfunction: Preliminary results from a randomized controlled trial. Am J Otolaryngol 40(5):645–649

    Article  Google Scholar 

  8. Chen X, Dang H, Chen Q, Chen Z, Ma Y, Liu X, Lin P, Zou H, Xiong H (2021) Endoscopic sinus surgery improves Eustachian tube function in patients with chronic rhinosinusitis: a multicenter prospective study. Rhinology 59(6):560–566

    Article  CAS  Google Scholar 

  9. Shanks JE (1984) Tympanometry. Ear Hear 5(5):268–280

    Article  CAS  Google Scholar 

  10. Smith ME, Bance ML, Tysome JR (2019) Advances in Eustachian tube function testing. World J Otorhinolaryngol Head Neck Surg 5(3):131–136

    Article  Google Scholar 

  11. Jerger J (1970) Clinical experience with impedance audiometry. Arch Otolaryngol 92(4):311–324

    Article  CAS  Google Scholar 

  12. Parsel SM, Unis GD, Souza SS, Bartley H, Bergeron JM, Master AN, McCoul ED (2021) Interpretation of normal and abnormal tympanogram findings in Eustachian tube dysfunction. Otolaryngol Head Neck Surg 164(6):1272–1279

    Article  Google Scholar 

  13. Xiong H, Liang M, Zhang Z, Xu Y, Ou Y, Chen S, Yang H, Zheng Y (2016) Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction: one year follow-up study. Am J Otolaryngol 37(2):99–102

    Article  Google Scholar 

  14. McCoul ED, Anand VK, Christos PJ (2012) Validating the clinical assessment of eustachian tube dysfunction: the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope 122(5):1137–1141

    Article  Google Scholar 

  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(3):703–708

    Article  Google Scholar 

  16. Teixeira MS, Swarts JD, Alper CM (2018) Accuracy of the ETDQ-7 for identifying persons with Eustachian tube dysfunction. Otolaryngol Head Neck Surg 158(1):83–89

    Article  Google Scholar 

  17. Higgins TS, Cappello ZJ, Wu AW, Ting JY, Sindwani R (2020) Predictors of eustachian tube dysfunction improvement and normalization after endoscopic sinus surgery. Laryngoscope 130(12):E721–E726

    Article  Google Scholar 

  18. Chen X, Xie L, Zeng H, Xu Y, Xiong H (2020) Local versus general anesthesia for balloon dilation of the Eustachian tube: a single-center retrospective study in a Chinese population. Ear Nose Throat J. https://doi.org/10.1177/0145561320923172

    Article  Google Scholar 

  19. Standring RT, O’Malley EM, Greene JB, Russell JL, McCoul ED (2021) Balloon dilation of the Eustachian tube with a seeker-based device: a registry of 169 patients. Laryngoscope Investig Otolaryngol 6(5):975–982

    Article  Google Scholar 

  20. Doyle WJ, Swarts JD, Banks J, Casselbrant ML, Mandel EM, Alper CM (2013) Sensitivity and specificity of Eustachian tube function tests in adults. JAMA Otolaryngol Head Neck Surg 139(7):719–727

    Article  Google Scholar 

  21. Yuceturk AV, Unlu HH, Okumus M, Yildiz T, Filiz U (1997) The evaluation of Eustachian tube function in patients with chronic otitis media. Clin Otolaryngol Allied Sci 22(5):449–452

    Article  CAS  Google Scholar 

  22. Siow JK, Tan JL (2020) Indications for Eustachian tube dilation. Curr Opin Otolaryngol Head Neck Surg 28(1):31–35

    Article  Google Scholar 

  23. Froehlich MH, Le PT, Nguyen SA, McRackan TR, Rizk HG, Meyer TA (2020) Eustachian tube balloon dilation: a systematic review and meta-analysis of treatment outcomes. Otolaryngol Head Neck Surg 163(5):870–882

    Article  Google Scholar 

  24. Aboueisha MA, Attia AS, McCoul ED, Carter J (2022) Efficacy and safety of balloon dilation of eustachian tube in children: systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 154:111048

    Article  Google Scholar 

  25. Bachinger D, Eckhard AH, Roosli C, Veraguth D, Huber A, Dalbert A (2021) Endolymphatic hydrops mimicking obstructive Eustachian tube dysfunction: preliminary experience and literature review. Eur Arch Otorhinolaryngol 278(2):561–565

    Article  Google Scholar 

  26. Commesso EA, Kaylie D, Risoli T Jr, Peskoe SB, Witsell D, Coles T (2022) Screening for Eustachian tube dysfunction in clinical practice using the Eustachian tube dysfunction Questionnaire-7. Laryngoscope. https://doi.org/10.1002/lary.29995

    Article  Google Scholar 

Download references

Acknowledgements

We thank Ms. Yanfang Ye, MPH for assistance in statistical analysis.

Funding

This work was supported by Guangzhou Science and Technology Planning Project (No. 202102010332).

Author information

Author notes

  1. Lingwen Xie and Yaodong Xu contributed equally to this work.

Authors and Affiliations

  1. Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 West Yanjiang Road, Guangzhou, 510120, Guangdong, China

    Lingwen Xie, Yaodong Xu, Ling Chen, Jiahao Liu, Jiahong Li, Yongkang Ou & Hao Xiong

  2. Institute of Hearing and Speech-Language Science, Sun Yat-Sen University, Guangzhou, Guangdong, China

    Yaodong Xu, Ling Chen, Jiahao Liu, Jiahong Li, Yongkang Ou & Hao Xiong

Authors
  1. Lingwen Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yaodong Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ling Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiahao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jiahong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yongkang Ou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hao Xiong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Yongkang Ou or Hao Xiong.

Ethics declarations

Conflict of interest

The authors claim that there are no conflicts of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xie, L., Xu, Y., Chen, L. et al. Characteristics of tympanogram in symptomatic Eustachian tube dysfunction. Eur Arch Otorhinolaryngol 280, 581–587 (2023). https://doi.org/10.1007/s00405-022-07503-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-022-07503-7

Keywords

Search

Navigation