Skip to main content
Log in

Diagnostic accuracy of tubomanometry R value in detecting the Eustachian tube pressure equalizing function

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Tubomanometry is a relatively novel Eustachian tube (ET) function testing method. A number of recent studies have utilized the R value of Tubomanometry as the main objective measure in reporting their outcome in balloon dilation of ET. There is, however, a lack of evidence concerning the reliability or validity of Tubomanometry measurements. The objectives of this study are to determine the accuracy of Tubomanometry for detecting ET opening as compared to tympanometry and determine its usefulness as a measure of ET function. Healthy subjects between ages 8 and 76 years with an intact tympanic membrane and no middle ear (ME) effusion were prospectively tested. Primary outcomes were the ET opening as determined by the Tubomanometry R value and the increase in ME pressure with tympanometry-measured in relation to a swallow at a nasopharyngeal pressure of 300 daPa. The accuracy of the tubomanometry R value for identifying a successful ET opening was made in reference to the change of ME pressure. A total of 280 measurements were available from 258 ears in 137 subjects. The presence of tubomanometry R value showed high sensitivity of detecting ET opening for the criteria of >5 daPa ME pressure increase (187/202) but low specificity for detecting ET non-opening (34/78). The R value criterion described in the original manuscripts on Tubomanometry is sensitive but not specific for ET opening. The need for validation of the tubomanometry test obviates its use as the main objective outcome measure for the balloon dilation of ET procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bluestone CD (2005) Eustachian tube. Structure, function, role in otitis media. Decker Inc, Hamilton

    Google Scholar 

  2. Ars B (2003) Fibrocartilaginous Eustachian tube—middle ear cleft. Kugler Publications, The Hauge

    Google Scholar 

  3. Ars B, Dirckx JJJ (2003) Tubomanometry, in fibrocartilaginous Eustachian tube—middle ear cleft. In: Ars B (ed). Kugler Publications, The Hauge, pp 151–158

  4. Jenckel F et al (2014) Endonasal dilatation of the Eustachian tube (EET) in children: feasibility and the role of tubomanometry (Esteve) in outcomes measurement. Eur Arch Otorhinolaryngol 272(12):3677–3683

    Article  PubMed  Google Scholar 

  5. Schroder S et al (2015) Balloon Eustachian tuboplasty (BET): our experience of 622 cases. Clin Otolaryngol 40(6):629–638

    Article  CAS  PubMed  Google Scholar 

  6. Schroder S et al (2015) Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction. Clin Otolaryngol 40(6):691–697

    Article  CAS  PubMed  Google Scholar 

  7. Dalchow CV et al (2016) First results of Endonasal dilatation of the Eustachian tube (EET) in patients with chronic obstructive tube dysfunction. Eur Arch Otorhinolaryngol 273(3):607–613

    Article  PubMed  Google Scholar 

  8. Liang M et al (2014) Eustachian tube balloon dilation in eustachian tube dysfunction related diseases. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 28(22):1759–1761, 1764

    PubMed  Google Scholar 

  9. Gurtler N, Husner A, Flurin H (2015) Balloon dilation of the Eustachian tube: early outcome analysis. Otol Neurotol 36(3):437–443

    Article  PubMed  Google Scholar 

  10. Schroder S et al (2015) A novel diagnostic tool for chronic obstructive eustachian tube dysfunction-the eustachian tube score. Laryngoscope 125(3):703–708

    Article  PubMed  Google Scholar 

  11. Di Martino EF (2013) Eustachian tube function tests: an update. HNO 61(6):467–476

    Article  PubMed  Google Scholar 

  12. Collin M et al (2012) Middle ear barotraumas due to rhinopharyngeal scar tissue: tubomanometry diagnostic and therapeutic contribution. Rev Laryngol Otol Rhinol (Bord) 133(3):157–161

    CAS  Google Scholar 

  13. Mink A, Bauer M (1993) Tubomanometry. Values in ears with traumatic and chronic perforations. Clin Otolaryngol Allied Sci 18(4):291–293

    Article  CAS  PubMed  Google Scholar 

  14. Xiong H et al (2016) Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction: one year follow-up study. Am J Otolaryngol 37(2):99–102

    Article  PubMed  Google Scholar 

  15. Esteve D (2003) Tubomanometry and pathology, in fibrocartilaginous Eustachian tube—middle ear cleft. In: Ars B (ed). Kugler Publications, The Hauge pp 159–175

  16. Bluestone CD, Cantekin EI, Douglas GS (1979) Eustachian tube function related to the results of tympanoplasty in children. Laryngoscope 89(3):450–458

    Article  CAS  PubMed  Google Scholar 

  17. Bluestone CD et al (1978) Function of the Eustachian tube related to surgical management of acquired aural cholesteatoma in children. Laryngoscope 88(7 Pt 1):1155–1164

    Article  CAS  PubMed  Google Scholar 

  18. Takahashi H et al (2007) Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. Auris Nasus Larynx 34(2):173–176

    Article  PubMed  Google Scholar 

  19. Manning SC et al (1987) Prognostic value of eustachian tube function in pediatric tympanoplasty. Laryngoscope 97(9):1012–1016

    Article  CAS  PubMed  Google Scholar 

  20. Alper CM et al (2012) Relationship between the electromyographic activity of the paratubal muscles and eustachian tube opening assessed by sonotubometry and videoendoscopy. Arch Otolaryngol Head Neck Surg 138(8):741–746

    Article  PubMed  Google Scholar 

  21. Alper CM et al (2015) Quantitative description of eustachian tube movements during swallowing as visualized by transnasal videoendoscopy. JAMA Otolaryngol Head Neck Surg 141(2):160–168

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Authors thank Ms. Audrey J. N. Lim, Ms. Julianne Banks, Ms. Jenna El-Wagaa and Dr. Selma Cetin-Ferra for assisting with subject recruitment, testing and data entry.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cuneyt M. Alper.

Ethics declarations

Funding

This study was funded in part by National Institute of Health P-50 Grant DC007667, University of Pittsburgh Clinical Scientist Training Program and Clinical and Translational Science Institute Program UL1 TL1TR00000.

Conflict of interest

Authors Cuneyt M. Alper, Miriam S.Teixeira, Jeehong H. Kim and J. Douglas Swarts declare that he/she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alper, C.M., Teixeira, M.S., Kim, J.H. et al. Diagnostic accuracy of tubomanometry R value in detecting the Eustachian tube pressure equalizing function. Eur Arch Otorhinolaryngol 274, 1865–1872 (2017). https://doi.org/10.1007/s00405-016-4430-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-4430-6

Keywords

Navigation