Comparative preoperative evaluation of eustachian tube function in pathological ears

Area of Science:

• Otolaryngology
• Medical Diagnostics

Background:

• Eustachian tube dysfunction is common in ears with tympanic membrane perforations.
• Accurate assessment of eustachian tube function is crucial for surgical planning, such as myringoplasty and radical surgery.

Purpose of the Study:

• To compare the reliability of sonotubometry and the negative pressure equalization test in evaluating eustachian tube function.
• To determine the most effective method for preoperative assessment of tubal patency in pathological ears.

Main Methods:

• Evaluated 100 pathological ears with tympanic membrane perforations.
• Measured eustachian tube function using both sonotubometry and the negative pressure equalization test.
• Compared the results of both tests, correlating them with the ability to equalize middle ear pressure during swallowing.

Main Results:

• Sonotubometry revealed eustachian tube opening in 85% of the myringoplasty group and 49% of the radical surgery group.
• Many ears that failed the negative pressure equalization test actually had patent tubes according to sonotubometry.
• The negative pressure equalization test showed a high rate of false positives for eustachian tube obstruction.

Conclusions:

• Sonotubometry is a more reliable and physiological method for assessing eustachian tube function compared to the negative pressure equalization test.
• The negative pressure equalization test may be unphysiological, potentially causing a 'locking phenomenon' and leading to inaccurate clinical decisions.
• Sonotubometry provides a more accurate preoperative determination of tubal function in patients with tympanic membrane perforations.