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Quantitative Eustachian Tube Function Testing in Patulous Eustachian Tube: Case-Control and JOS Subgroup Analyses.

Tae Uk Cheon1, Seon Geum Kim2, Hyun Ji Ahn2

  • 1Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|July 13, 2026
PubMed
Summary

Objective Eustachian tube (ET) function tests reveal significant differences in patulous ET (PET) ears. Tubotympanoaerodynamography opening pressure and probe-tone SPL are key objective measures for diagnosing PET.

Keywords:
Japan otological societyPatulous eustachian tubeSonotubometryTuboimpedancemetryTubotympano-aerodynamography

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Area of Science:

  • Otolaryngology
  • Auditory Physiology
  • Diagnostic Imaging

Background:

  • Patulous Eustachian tube (PET) is a condition where the Eustachian tube remains abnormally open.
  • Objective assessment of Eustachian tube (ET) function is crucial for diagnosing PET.
  • Existing diagnostic methods often lack objective, quantifiable parameters.

Purpose of the Study:

  • To evaluate objective Eustachian tube (ET) function test parameters in patulous ET (PET) ears compared to healthy controls.
  • To examine differences in ET function parameters based on Japan Otological Society (JOS) classification and symptom frequency.
  • To identify reliable objective measures for diagnosing and stratifying PET.

Main Methods:

  • Retrospective analysis of objective ET function test results from adults with suspected PET and healthy controls.
  • Classification of PET ears using Japan Otological Society (JOS) criteria and stratification by symptom frequency (persistent vs. intermittent).
  • Comparison of key ET function parameters including probe-tone sound pressure level (SPL), opening duration, tubotympanoaerodynamography (TTAG) opening pressure, and residual middle-ear volume, followed by receiver operating characteristic (ROC) analysis.

Main Results:

  • Significant differences were observed in probe-tone SPL, opening duration, TTAG opening pressure, and residual middle-ear volume between PET and control ears.
  • TTAG opening pressure and probe-tone SPL varied significantly based on symptom frequency and JOS classification within the PET cohort.
  • ROC analysis demonstrated high diagnostic discrimination for TTAG opening pressure (AUC=0.9565) and probe-tone SPL (AUC=0.8187).

Conclusions:

  • Multiple objective ET function parameters effectively differentiate between PET and control ears.
  • TTAG opening pressure and sonotubometry probe-tone SPL serve as valuable quantitative adjuncts for structured PET assessment.
  • These objective measures support clinical stratification of PET within the JOS framework, enhancing diagnostic accuracy.