The Application Of Tubomanotery In Adult Otitis Media With Effusion

BACKGROUND: Otitis media with effusion is a common clinical disease,and its incidence is closely related to eustachian tube dysfunction. There are many kinds of methods to determine the function of eustachian tube,such as the nose blowing, acoustic impedance, endoscopy and imaging and so on. But there is still a lack of reliable method. Tubomanometry is a kind of semiobjective semi- quantitative determination of eustachian tube function recently used in clinical widely abroad,which was used in evaluating the eustachian tube function before and after balloon catheter dilatation.But there is no literature about the comparation between tubomanometry and other detection methods on eustachian tube function, neither tubomanometry's application among patients with secretory otitis media.OBJECTIVE: To evaluate Eustachian tube(ET) openings by tubomanometry(TMM) in adult patients with otitis media with effusion(OME).STUDY DESIGN: Prospective, controlled study.METHODS: The ET patency of 123 ears, including 63 ears of OME patients and 60 control ears, were tested using TMM and tympanometry. ET patency was evaluated by the R value and ET scoring, and was compared to the tympanogram results. The Eustachian Tube Dysfunction Questionnaire(ETDQ-7) was used to assess the severity of the symptoms in OME patients.RESULTS: The abnormal ET opening rates under pressures of 30, 40, and 50 mbar by TMM testing were 10%, 5%, and 0%, respectively(control group) and76.19%, 66.7%, and 57.97%, respectively(OME group)(p<0.05 for all pressure groups). However, the rates were 77.42%, 71.97%, and 61.29% in the type B tympanogram group, and 75%, 62.5%, and 46.87% in the type C tympanogram group;a significant difference was only found at 50 mbar(p=0.477, 0.240, and 0.015,respectively) between these tympanogram groups. The mean ETDQ-7 score in OME patients was 16.40±10.72, which was significantly negatively correlated with the ET score at 30 and 40 mbar(30 mbar: correlation coefficient,-0.29, P=0.025; 40 mbar:correlation coefficient,-0.28;P=0.030 espectively) but not at 50 mbar(correlation coefficient,-0.013, P=0.924).CONCLUSIONS: ET blockage or delayed opening were found in most OME ears, but the results were partly related to the testing pressure, indicating the importance of adopting various pressures to elucidate ET function more precisely when assessing the results of TMM in OME patients.It can be more effetive to combine tympanogram results and results from TMM in reflecting the middle ear diseases in OME.