Use Of Tubomanometry In Patients With Otitis Media With Effusion

Background and ObjectiveOtitis media with effusion(OME)is a common clinical ear disease,which is characterized by stuffy ear,hearing loss and middle ear effusion.Eustachian tube dysfunction is so closely related to the occurrence,development and prognosis of OME.But the evaluation of eustachian tube function has no gold standard and lack of objective testing tools for clinical application.In 2001,Esteve et al.first introduced Tubomanometry(TMM)in Europe and used it to evaluate the function of the eustachian tube.TMM is a relatively simple and non-invasive objective test tool for eustachian tube function,and its efectiveness in assessing eustachian tube function has been observed and studied in healthy populations.Recently,there have been many reports on the application of TMM in China,but the research methods and perspectives are different,and the comparative research data with common clinical methods are still limited.The purpose of this study was to investigate the value of Tubomanometry(TMM)in the measurement of eustachian tube function in patients with OME,and through this study,to provide a reference for clinical application.Methods36 patients(64 ears)with OME and 35 normal controls(70 ears)were tested by TMM.The results were evaluated by R?1 for normal opening of eustachian tube,R>1 or no sign for delay or obstruction of eustachian tube opening.Subjective Valsalva,impedance audiometry,eustachian tube score(ETS)and eustachian tube dysfunction questionnaire-7(ETDQ-7)were tested at the same time.Results1.Under the pressure of TMM 30,40 and 50mbar,the eustachian tube opening was limited.It was 10%,2.86%and 1.43%in the control group,78.12%,71.83%and 68.75%in the OME group,respectively.there was significant difference between the two groups(30mbar:?2=63.479 P=0.000;40mbar:?2=69.273 P=0.000;50mbar:?2=67.934 P=0.000).There was significant difference between the three pressures in the control group(?2=9.055 P=0.011),but there was no significant difference in the OME group(?2=1.477 P=0.478).2.The Valsalva results of OME patients were consistent with the results of TMM 30mbar test(?2=16.663 P=0.000),but was not with the results of 40 and 50mbar(?2=3.322 P=0.068 and?2=2.167 P=0.141).3.The correlation analysis between ETS score and ETDQ-7 score showed that there was a negative correlation between the two groups(correlation coefficient r=-0.493,P=0.000).Conclusion:1.The results show that TMM can effectively evaluate the eustachian tube function in patients with otitis media with effusion.2.The results of TMM 30mbar are in good agreement with the results of Valsalva.3.The results of ETS are negatively correlated with the results of ETDQ-7 score.