Diagnostic Value And Quantitative Evaluation Of Different Tests Of Eustachian Tube Function For Otitis Media With Effusion In Children

Objective: To investigate the diagnostic value of different eustachian tube function testing methods on the function of the eustachian tube in children with otitis media with effusion and to explore the application value of Tubomanometry(TMM)for quantitative assessment of the functional status of the eustachian tube in children.Methods: From December 2021 to June 2022,a total of 49 ears with otitis media with effusion and 32 healthy ears without otitis media with effusion admitted to the Department of Otolaryngology Head and Neck Surgery of First Affiliated Hospital of Air Force Medical University were collected to evaluate the eustachian tube function respectively using Acoustic immittance measurement(AIM),TMM,Eustachian tube score(ETS),Sonotubometry(STM),Tubo-tympano-aerodynamic graphy(TTAG),and were analyzed and compared them.Results: The AIM results were used as a measure for consistency tests with TMM,ETS,STM and TTAG,with sensitivities of 75.6%,60.0%,82.05% and 53.85%,specificities of 94.4%,97.2%,66.67% and 83.33%,and Youden index of 0.700,0.572,0.487,0.372.The results indicate that TMM has a higher diagnostic value for the function of the eustachian tube in children compared to ETS,STM and TTAG.In the otitis media with effusion group,the percentage of abnormal eustachian tube opening function in TMM at 30,40 and 50 mbar was 77.6%,59.2% and 40.8%,and the percentage of abnormal eustachian tube opening function decreased with increasing pressure in the otitis media with effusion group,with a significant difference(p =0.001).The percentage of abnormal eustachian tube opening function in the B and C tympanograms was statistically different at TMM(50 mbar)(p =0.009)and not at TMM(30,40 mbar)(30 mbar: p =0.678;40 mbar:p =0.185).Multifactorial analysis showed a positive correlation between ETS,TMM values and AIM,but not between TMM values,AIM scores and subjective scores.AIM results based on TMM values for diagnostic cut-off groups were significantly different(p= 0.000).A TMM value of ≤4 is more suggestive of eustachian tube dysfunction,and a TMM value of >4 is more suggestive of good eustachian tube function in children.Conclusion: Various methods of eustasy tube function detection have certain value in the assessment of the state of Eustasy tube function in children with otitis media with effusion.TMM is easy to operate,high accuracy,and can objectively and quantitatively evaluate the function of ET in children.Its diagnostic value in children is higher than ETS,STM,and TTAG.AIM combined with TMM is more helpful to comprehensively understand the function of eustachian tube in children and give timely treatment.