Chronic Nasal Disease and Eustachian Tube Function: What Is the Role of Tubomanometry?

Background/objectives: Eustachian tube dysfunction (ETD) presents complex diagnostic challenges in otolaryngology, compounded by concurrent chronic nasal disease. Patient-reported outcome measures (PROMs) often assess ETD severity due to its elusive diagnosis. Tubomanometry (TMM) emerges as a promising diagnostic tool, yet its application alongside chronic nasal disease remains unclear. Our study aims to elucidate TMM's role in ETD diagnosis within the context of chronic nasal diseases, integrating subjective assessments, clinical examination, and TMM results. Methods: A prospective observational study was conducted with patients suffering from ETD and chronic nasal disease allocated in three different groups according to their nasal pathology. Clinical examination, PROMs in the form of ETDQ-7, and NOSE questionnaires as well as TMM were performed. Results of the above subjective and objective measurements were analysed and correlated statistically to determine the value of TMM in chronic nasal disease patients. Results: All recruited patients suffered from ETD and chronic nasal disease, with similarly affected ETDQ-7 scores across all groups, while NOSE scores differed significantly based on the underground nasal pathology. TMM values confirm the presence of ETD in all three groups, confirming the role of TMM within this cohort. Interestingly, TMM values can still confirm the presence of ETD in patients with chronic nasal disease but cannot discriminate among chronic nasal pathology patients, making TMM a diagnostic tool with uniformity among the chronic nasal pathologies. Conclusions: ETD in individuals with chronic nasal disease presents distinct complexities, requiring a tailored diagnostic approach. In this context, a thorough clinical assessment, integrating ETDQ-7 and NOSE questionnaires, supplemented by TMM where accessible, is crucial to confirm diagnosis. This study confirms that TMM can diagnose ETD in all nasal pathology patients without being influenced by the nature of the disease. This research endeavours to refine diagnostic strategies, enriching clinical decision-making, and enhancing ETD management in patients suffering with chronic nasal diseases.