Methods of preoperative assessment of function of the auditory tube in patients with chronic tubotympanal purulent otitis media
https://doi.org/10.21518/2079-701X-2020-6-140-147
Abstract
Abstract
Introduction. The purpose of the study was learning diagnostic tools of Eustachian tube pathology and define the highly specific prognostic test. The Eustachian tube is a specific structure that is difficult to visualize and manipulate due to its location and anatomical features. Maintaining adequate aeration and physiological pressure in the tympanic cavity is extremely important for middle ear function. The preoperative assessment of the auditory tube function is still important. A lot of studies demonstrate majority methods of evaluation tube function. However, there is no gold standard for diagnosing tubular dysfunction.
Goal of reserch. The purpose of this review is to analyze methods for studying the function of the auditory tube as a preoperative preparation for hearing-enhancing operations, namely tympanoplasty.
Materials and methods. We analyzed the database related to modern methods of evaluation Eustachian tube function and tympanoplasty outcomes.
Results. Despite a large number of studies, the question of a priority and universal method for the preoperative assessment of the function of the Eustachian tube remains open. Each of the studies presented in this review has its own advantages and disadvantages associated with the complexity of the implementation or limitation of application. Endoscopic examination is the most informative for assessing the anatomical state of the auditory tube and nasopharynx. To assess the physiological function, a group of manometric tests, namely tubomanometry and the ETF-test, turned out to be more accurate, universal, and easily conducted.
Conclusion. The work of the auditory tube is of great prognostic value for conducting auditory-improving operations and determining treatment tactics. Identification of the “gold standard” of diagnosis will help improve the quality and increase the effectiveness of surgical treatment, and therefore, further research in this area is necessary.
About the Authors
K. V. EremeevaRussian Federation
Kseniya V. Eremeeva, Cand. of Sci. (Med.), Associate Professor of the Department of Ear, Throat and Nose Diseases
8, Bldg. 2, Trubetskaya St., Moscow, 119991
E. G. Varosyan
Russian Federation
Egine G. Varosyan, Cand. of Sci. (Med.), Assistant of the Department of Ear, Throat and Nose Diseases
8, Bldg. 2, Trubetskaya St., Moscow, 119991
A. O. Sobolevskaya
Russian Federation
Anastasia O. Sobolevskaya, student
8, Bldg. 2, Trubetskaya St., Moscow, 119991
A. A. Lunicheva
Russian Federation
Anna A. Lunicheva, student
8, Bldg. 2, Trubetskaya St., Moscow, 119991
V. P. Sobolev
Russian Federation
Vasiliy P. Sobolev, Cand. of Sci. (Med.), Associate Professor of the Department of Ear, Throat and Nose Diseases
8, Bldg. 2, Trubetskaya St., Moscow, 119991
References
1. House W.F. The Function of the Eustachian Tube. AMA Arch Otolaryngol. 1960;71(3):405–407. doi: 10.1001/archotol.1960.03770030047010.
2. Pearlman H.B. The eustachian tube: abnormal potency and normal physiological state. Arch Otolaryngol. 1939;30(2):212–238. doi: 10.1001/archotol.1939.00650060232004.
3. Zhang J., Zhong Z., Xiao S. et al. Tubomanometry value as an associated factor for medication outcomes in adult acute otitis media with effusion. Eur Arch OtoRhinoLaryngology. 2018;275(1):53–57. doi: 10.1007/s00405-017-4772-8. Chauhan B., Chauhan K. A Comparative Study of Eustachian Tube Functions in Normal and Diseased Ears with Tympanometry and Videonasopharyngoscopy. Indian J Otolaryngol Head Neck Surg. 2013;65(3):468–476. doi: 10.1007/s12070-011-0312-9.
4. Llewellyn A., Norman G., Harden M. et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Health Technol Assess. 2014;18(46):1–180, v-vi. doi: https://doi.org/10.3310/hta18460.
5. Lin A.C., Messner A.H. Pediatric tympanoplasty: Factors affecting success. Curr Opin Otolaryngol Head Neck Surg. 2008;16(1):64–68. doi: 10.1097/MOO.0b013e3282f43430.
6. Bellucci R.J. Selection of cases and classification of tympanoplasty. Otolaryngologic Clinics of North America. 1989;22(5):911–926. Available at: https://www.ncbi.nlm.nih.gov/pubmed/2694069.
7. Vartiainen E., Nuutinen J. Success and pitfalls in myringoplasty: Follow-up study of 404 cases. Am J Otol. 1993;14(3):301–315. Available at: https://www.ncbi.nlm.nih.gov/pubmed/8372930.
8. Takahashi H., Sato H., Nakamura H., Naito Y., Umeki H. Correlation between middle-ear pressure-regulation functions and outcome of type-I tympanoplasty. Auris Nasus Larynx. 2007;34(2):173–176. doi: 10.1016/j.anl.2006.09.007.
9. Uzun C. Cartilage Palisade Tympanoplasty, Diving and eustachian tube function. Otol Neurotol. 2003;24(2):350. doi: 10.1097/00129492-200303000-00039.
10. Schröder S., Lehmann M., Korbmacher D., Sauzet O., Sudhoff H., Ebmeyer J. Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction. Clin Otolaryngol. 2015;40(6):691– 697. doi: 10.1111/coa.12451.
11. Smith M.E., Tysome J.R. Tests of Eustachian Tube Function: A Review. Clin Otolaryngol. 2015;40(4):300–311. doi: 10.1111/coa.12428.
12. Finkelstein Y., Talmi Y.P., Zohar Y., Laurian N. Study of Toynbee phenomenon by combined intranasopharyngeal and tympanometric measurements. Ann Otol Rhinol Laryngol. 1988;97(2 Pt 1):199–206. doi: 10.1177/000348948809700220.
13. McCoul E.D., Anand V.K., Christos P.J. Validating the clinical assessment of eustachian tube dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7), Laryngoscope. 2012;122(5):1137–1141. doi: 10.1002/lary.23223 .
14. Teixeira M.S., Swarts J.D., Alper C.M. Accuracy of the ETDQ-7 for Identifying Persons with Eustachian Tube Dysfunction. Otolaryngol Head Neck Surg. 2018;158(1):83–89. doi: 10.1177/0194599817731729.
15. Smith M.E., Zou C.C., Blythe A.J.C., Tysome J.R. Tuboimpedance: A New Test of Eustachian Tube Function. Otolaryngol – Head Neck Surg (United States). 2017;156(4):717–721. doi: 10.1177/0194599816686546.
16. Poe D.S., Abou-Halawa A., Abdel-Razek O. Analysis of the dysfunctional eustachian tube by videoendoscopy. Otolo Neurotol. 2001;22(5):590–595. doi: 10.1097/00129492-200109000-00005.
17. Di Martino E., Walther L.E., Westhofen M. Endoscopic Examination of the Eustachian Tube: A Step-by-Step Approach. Otology & Neurotology. 2005;26(6):1112–1117. doi: 10.1097/01.mao.0000176175.71894.98.
18. Smith E., Scoffings D.J., Tysome J.R. Imaging of the Eustachian tube and its function: a systematic review. Neuroradiology. 2016;58(6):543–556. doi: 10.1007/s00234-016-1663-4.
19. Shim H.J., Choi A.Y., Yoon S.W., Kwon K.H., Yeo S.G. The Value of Measuring Eustachian Tube Aeration on Temporal Bone CT in Patients with ChronicOtitis Media. Clin Exp Otorhinolaryngol. 2010;3(2):59–64. doi: 10.3342/ceo.2010.3.2.59.
20. Lükens A., Dimartino E., Günther R.W., Krombach G.A. Department of Diagnostic Radiology. Eur Radiol;22(3):533–538. doi: 10.1007/s00330-011-2303-3.
21. Paludetti G., Di Nardo W., Galli J., De Rossi G., Almadori G. Functional study of the eustachian tube with sequential scintigraphy. ORL J Otorhinolaryngol Relat Spec. 1992;54(2):76–79. doi: 10.1159/000276266.
22. Celen Z., Kanlykama M., Bayazit A.Y., Mumbuc B.S., Zincirkeser S., Ozbay E. Scintigraphic evaluation of the eustachian tubefunctions. Rev Laryngol Otol Rhinol (Bord). 1999;120(2):123–125. Available at: https://www.ncbi. nlm.nih.gov/pubmed/10444987.
23. Virtanen H. Sonotubometry: An acoustical method for objective measurement of auditory tubal opening, Acta Otolaryngol. 1978;86(1–2):93–103. doi: 10.3109/00016487809124724.
24. Borangiu A., Popescu C.R., Purcarea V.L. Sonotubometry, a useful tool for the evaluation of the Eustachian tube ventilatory function. J Med Life. 2014;7(4):604–610. Available at: https://www.ncbi.nlm.nih.gov/pmc/arti- cles/PMC4316148/?report=classic.
25. Jonathan D.A. The predictive value of eustachian tube function (measured with sonotubometry) in the successful outcome of myringoplasty. Clin Otolaryngol. 1990;15:431–434. doi: 10.1111/j.1365-2273.1990.tb00496.x.
26. Palva T., Marttila T., Jauhiainen T. Comparison of pure tones and noise stimuli in sonotubometry. Acta Otolaryngol. 1987;103(5–6):212–216. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21449644.
27. Kurien R., Chrisolyte S., Rupa V. Inflation – deflation test as a predictor of aditus patency in patients with chronic suppurative otitis media. Indian J Oto larnygol Head Neck Surg. 2009;61(3):169–172. doi: 10.1007/s12070-009-0060-2.
28. Бобошко М.Ю., Лопотко А.И. Слуховая труба. СПб.: СпецЛит; 2003. С. 166. Boboshko M., Lopotko A. Tuba Auditiva Eustachii. St. Petersburg: SpecLit; 2003. P. 166. (In Russ.)
29. Ruan K., Li J., Tan S., Liu L., Tang A. Comparison of sonotubometry, impedance, tubo-tympano-aerography, and tubomanometry to test eustachian tube function. Am J Otolaryngol. 2020;41(2):102384. doi: 10.1016/j.amjoto.2019.102384.
30. Liu P., Su K., Zhu B., Wu Y., Shi H., Yin S. Detection of eustachian tube openings by tubomanometry in adult otitis media with effusion. Eur Arch Oto rhinolaryngol. 2016;273(10):3109–3115. doi: 10.1007/s00405-016-3938-0.
31. Alper C.M., Teixeira M.S., Kim J.H., Swarts J.D. Diagnostic accuracy of tubomanometry R value in detecting the Eustachian tube pressure equalizing function. Eur Arch OtoRhinoLaryngology. 2017;274(4):1865–1872. doi: 10.1007/s00405-016-4430-6.
32. Esteve D. Tubomanometry and Pathology. In: Ars B. (ed.). Fibrocartilaginous Eustachian Tube Middle Ear Cleft. The Hauge, The Netherlands: Kugler Publications; 2003, pp. 159–175.
33. Alper C.M., Swarts J.D., Singla A., Banks J., Doyle W.J. Relationship between the electromyographic activity of the paratubal muscles and eustachian tube opening assessed by sonotubometry and videoendoscopy. Arch Otolaryngol – Head Neck Surg. 2012;138(8):741–746. doi: 10.1001/archoto.2012.1293.
34. Alper C.M., Teixeira M.S., Swarts J.D., Doyle W.J. Quantitative description of eustachian tube movements during swallowing as visualized by transnasal videoendoscopy. JAMA Otolaryngol – Head Neck Surg. 2015;141(2):160– 168. doi: 10.1001/jamaoto.2014.3002.
35. Mikolajczak S., Meyer M.F., Hahn M., Korthäuer C. et al. Characterizing the active opening of the eustachian tube in a hypobaric/hyperbaric pressure chamber. Otol Neurotol. 2015;36(1):70–75. doi: 10.1097/MAO.0000000000000575.
36. Bylander A., Tjernström O., Ivarsson A. Pressure opening and closing functions of the eustachian tube in children and adults with normal ears. Acta Otolaryngol. 1983;95(1–2):55–62. doi: 10.3109/00016488309130915.
37. Biswas A. Eustachian tube function test: A new dimension in the management of CSOM. Indian J Otolaryngol Head Neck Surg. 1999; 51(2):14–22. doi: 10.1007/BF02997984.
38. Akyıldız M.Y., Özmen Ö.A., Demir U.L. et al. Should nasal function be considered prior to tympanoplasty? J Int Adv Otol. 2018;14(1):53–57. doi: 10.5152/iao.2017.3624.
39. Choi S.H., Han J.H., Chung J.W. Pre-operative evaluation of Eustachian tube function using a modified pressure equilibration test is predictive of good postoperative hearing and middle ear aeration in type 1 tympanoplasty patients. Clin Exp Otorhinolaryngol. 2009;2(2):61–65. doi: 10.3342/ceo.2009.2.2.61.
40. Feldmann H. The Eustachian tube and its role in the history of otology. Images from the history of otorhinolaryngology, presented by instruments from the collection of the Ingolstadt German History Museum. Laryngorhinootologie. 1996;75(12):783–792. doi: 10.1055/s-2007-997676.
Review
For citations:
Eremeeva KV, Varosyan EG, Sobolevskaya AO, Lunicheva AA, Sobolev VP. Methods of preoperative assessment of function of the auditory tube in patients with chronic tubotympanal purulent otitis media. Meditsinskiy sovet = Medical Council. 2020;(6):140-147. (In Russ.) https://doi.org/10.21518/2079-701X-2020-6-140-147