Inflation-deflation test as a predictor of aditus patency in patients with chronic suppurative otitis media

Abstract

Aims

To assess eustachian tubal function (ETF) preoperatively in patients with chronic suppurative otitis media (CSOM) with central perforation by performing the inflation-deflation test. To correlate the results of the inflation-deflation test with the finding of aditus patency or block in patients with CSOM

Study design

Prospective, cohort

Setting

Tertiary care hospital

Subjects

Eighty adult patients with chronic suppurative otitis media and central perforation were recruited into the study. There were 45 males and 35 females.

Methods

All patients underwent preoperative inflation-deflation test followed by cortical mastoidectomy and tympanoplasty. The patency of the aditus was assessed intraoperatively.

Main outcome measure

Equalization of pressure on inflation-deflation test and intraoperative assessment of aditus patency

Results

Of a total of 80 patients, 49 patients were found to have discharging ears and 31 had dry ears at the time of surgery. In dry ears the inflation-deflation test had a sensitivity of 93% in predicting aditus patency although the specificity was lower at 67%. In discharging ears the sensitivity in predicting aditus patency was 72% and the specificity was 67%.

Conclusion

The eustachian tube inflation-deflation test is a sensitive test for predicting aditus patency in patients with dry ears but less so in patients with discharging ears. Hence, it could be used in the former to avoid unnecessary exploration of the mastoid.