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

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.