Dynamic Slow Motion Video Endoscopy as an Adjunct to Impedance Audiometry in the Assessment of Eustachian Tube Function
12 December 2016
10 April 2017
16 June 2017 (eFirst)
Introduction Eustachian tube (ET) dysfunction plays an important role not only in the pathophysiology of various middle ear disorders, but also in predicting the outcome of the treatment. As there is no single test that assesses both the anatomic and physiological functions of the ET, a combination of tympanometry and dynamic slow motion video endoscopy may improve the sensitivity of ET function assessment.
Objective To find out if there is any correlation between dynamic slow motion nasal video endoscopy and impedance audiometry in assessing ET function in patients with middle ear diseases.
Methods Ours was a descriptive study performed with 106 patients attending the Ear, Nose and Throat (ENT) Outpatient Department of a tertiary care center in South India with features suggestive of middle ear disease. All patients underwent impedance audiometry and dynamic slow motion nasal video endoscopy, and were graded based on the severity of the ET pathology.
Results A total of 47 out of 97 patients with abnormal endoscopy findings also had abnormal impedance audiometry. The correlation was greater among the patients with higher grades of ET dysfunction. The endoscopy findings of 106 cases, when correlated with middle ear manometry, revealed that 56 cases showed complete agreement, and 50 cases showed disagreement. The nasal endoscopy results, when correlated with middle ear manometry studies by using McNemar's chi-squared (χ2) test, showed a significant association between the 2 tests (p = 0.017).
Conclusion There is a significant alteration in middle ear pressure as the severity of the ET tube dysfunction increases. Impedance audiometry and nasal endoscopy provide a better measure of ET function.
- 1 Pau HW. [Eustachian tube and middle ear mechanics]. HNO 2011; 59 (10) 953-963
- 2 Sato H, Nakamura H, Honjo I, Hayashi M. Eustachian tube function in tympanoplasty. Acta Otolaryngol Suppl 1990; 471: 9-12
- 3 Smith ME, Tysome JR. Tests of Eustachian tube function: a review. Clin Otolaryngol 2015; 40 (04) 300-311
- 4 Poe DS, Pyykkö I. Measurements of Eustachian tube dilation by video endoscopy. Otol Neurotol 2011; 32 (05) 794-798
- 5 Mathew GA, Kuruvilla G, Job A. Dynamic slow motion video endoscopy in eustachian tube assessment. Am J Otolaryngol 2007; 28 (02) 91-97
- 6 Grimmer JF, Poe DS. Update on eustachian tube dysfunction and the patulous eustachian tube. Curr Opin Otolaryngol Head Neck Surg 2005; 13 (05) 277-282
- 7 Poe DS, Abou-Halawa A, Abdel-Razek O. Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 2001; 22 (05) 590-595
- 8 Augustine AM, Varghese L, Michael RC, Albert RR, Job A. The efficacy of dynamic slow motion video endoscopy as a test of eustachian tube function. J Laryngol Otol 2013; 127 (07) 650-655
- 9 Chauhan B, Chauhan K. A comparative study of eustachian tube functions in normal and diseased ears with tympanometry and videonasopharyngoscopy. Indian J Otolaryngol Head Neck Surg 2013; 65 (Suppl. 03) 468-476
- 10 Handzel O, Poe D, Marchbanks RJ. Synchronous endoscopy and sonotubometry of the eustachian tube: a pilot study. Otol Neurotol 2012; 33 (02) 184-191
- 11 Bunne M, Falk B, Magnuson B, Hellström S. Variability of Eustachian tube function: comparison of ears with retraction disease and normal middle ears. Laryngoscope 2000; 110 (08) 1389-1395