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Reliability of manometric eustachian tube function tests in children
N van Heerbeek1, K J Ingels, A F Snik
1Department of Otorhinolaryngology, University Medical Center St. Radboud, Nijmegen, The Netherlands.
Insights
Manometric eustachian tube function tests show good reproducibility in children with ventilation tubes. A single measurement or the mean of three is sufficient for assessing tubal function.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Medical Engineering
Background:
- Persistent otitis media with effusion (OME) in children often necessitates ventilation tube insertion.
- Accurate assessment of eustachian tube function is crucial for managing OME and guiding treatment.
- Manometric tests offer a quantitative method to evaluate eustachian tube patency.
Purpose of the Study:
- To evaluate the reliability and reproducibility of manometric eustachian tube function tests in pediatric patients with ventilation tubes.
- To determine the optimal number of measurements for accurate assessment of tubal function.
Main Methods:
- Manometric eustachian tube function tests, including opening pressure (Po) and closing pressure (Pc), were performed repeatedly within a single session.
- Ninety-nine children with ventilation tubes in situ due to persistent OME participated.
- Tests were conducted at secondary and tertiary referral hospitals.
Main Results:
- Analysis revealed a statistically significant decrease in both Po and Pc with repeated measurements (p < 0.001).
- The reduction in Po was more pronounced than in Pc upon repeated testing.
- Excellent agreement (99%) was observed between the first and second pressure equilibration tests.
Conclusions:
- The categorized results of the pressure equilibration test demonstrate good reproducibility in children with ventilation tubes.
- The forced-response test showed lower reproducibility and a downward shift with repeated measurements.
- A single measurement or the mean of the first three Po and Pc measurements is adequate for determining tubal function.
Objective:
To assess the reliability of manometric eustachian tube function tests in children with ventilation tubes in situ.
Study Design:
Repeated manometric eustachian tube function tests during one session.
Setting:
The study took place at a secondary referral hospital and a tertiary referral hospital.
Patients:
Ninety-nine children with ventilation tubes in situ because of persistent otitis media with effusion.
Main Outcome Measures:
Opening pressure (Po), closing pressure (Pc), and tubal function group.
Results:
Analysis of Po and Pc showed a decrease with repeated measurement (p = 0.0001 and p = 0.001, respectively). The effect of repeated measurement on Po was more pronounced than the effect on Pc. The results of the first and second pressure equilibration tests showed 99% agreement.
Conclusions:
This study showed good reproducibility of the categorized results of the pressure equilibration test, whereas the results of the forced-response test seemed to be less reproducible and showed a downward shift with repeated measurement. A single measurement using wet swallowing and starting pressures of 100 and -100 daPa and the mean of the first three measurements of the Po and Pc are sufficient to determine tubal function. Further studies are needed to determine the discriminative power of these tests in children with different degrees of middle ear disease.
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