Objective testing for Eustachian tube dysfunction
Reviewed by Stuart Burrows

Eustachian tube dysfunction (ETD) is typically diagnosed based on subjective symptoms and examination leading to wide variation in its diagnosis and management. The search for an objective test has looked at ways of measuring the passage of air through the Eustachian tube. This published work looks at the reproducibility of tuboimpedance. The paper does not offer conclusions as to the diagnostic criteria, however it starts the process of identifying a reliable, reproducible test. The numbers in the paper are small (20 ears from 10 patients) but the results are encouraging, indicating Eustachian tube opening detection rate of 100% using a nasopharyngeal pressure of 30 mbar or more, compared to 88% to 96% with tubomanometry. Tubomanometry has become increasingly popular in supporting a diagnosis of ETD, however the standardisation of technique and normal values for Eustachian tube function have not been agreed. Eustachian tube dysfunction is a condition where patient subjectivity of symptoms and quality of life may be the best measure of outcome. A move from subjectivity to a more formalised objective test can help improve the diagnostic accuracy of the condition and patient satisfaction with the diagnosis of ETD or the reassurance of normality.

Tuboimpedance: a new test of Eustachian tube function.
Smith ME, Zou CC, Blythe AJC, Tysome JR.
OTOLARYNGOLOGY – HEAD AND NECK SURGERY
2017;156(4):717-21.