Tubomanometry: An effective and promising assessment of Eustachian tube dysfunction in chronic rhinosinusitis patients

Abstract

AimsObstructive eustachian tube (ET) dysfunction involves otologic complications, including cholesteatoma, and requires specific treatment. A causal relationship between obstructive ET dysfunction and chronic rhinosinusitis has only been suspected so far. Tubomanometry (TMM) is a new tool in ET dysfunction diagnosis and description. It has mainly been studied in chronic otitis patients but never in chronic rhinosinusitis (CRS). The aim of this work was to obtain TMM results from a CRS patient population presenting clinical ET dysfunction. Materials and methodsA prospective monocentric non-blinded study was performed between November 1 2015 and February 29 2016, involving all adult patients (>18 years; n=294) suffering from bilateral chronic rhinosinusitis who consulted at the rhinology unit at our referral ENT university center; 129 patients were included. An obstructive ET dysfunction clinical screening questionnaire (ETDQ-7) was obtained from all patients. When the mean ETDQ-7 score was≥2.1, a more extensive clinical assessment was performed including clinical maneuvers, otoscopy, transnasal endoscopy, audiometry, tympanometry and TMM for the diagnosis of ET dysfunction. ResultsForty-seven per cent (n=61) had a positive ETDQ-7, 64% (n=39) of which had pathologic tubomanometric results: thirty-two (52.5%) had obstructive ET dysfunction TMM results and the remaining 7 (11.5%) patients had patulous ET TMM results. ConclusionsTubomanometry is a promising new tool for the evaluation of ET dysfunction and could be added to clinical assessment of chronic rhinosinusitis patients.