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Cited by 70Ear Surgery and Otitis MediaVestibular and auditory disordersHearing Loss and Rehabilitation

Sensitivity and Specificity of Eustachian Tube Function Tests in Adults

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Doyle, William J., Swarts, J. Douglas, Banks, Julianne, Casselbrant, Margaretha L., Mandel, Ellen M., Alper, Cuneyt M.·2013·JAMA Otolaryngology–Head & Neck Surgery
DOI 10.1001/jamaoto.2013.3559PMC PMC3792585
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Abstract

IMPORTANCE: The study demonstrates the utility of eustachian tube (ET) function (ETF) test results for accurately assigning ears to disease state. OBJECTIVES: To determine if ETF tests can identify ears with physician-diagnosed ET dysfunction (ETD) in a mixed population at high sensitivity and specificity and to define the interrelatedness of ETF test parameters. DESIGN, SETTING, AND PARTICIPANTS: Through use of the forced-response, inflation-deflation, Valsalva, and sniffing tests, ETF was evaluated in 15 control ears of adult subjects after unilateral myringotomy (group 1) and in 23 ears of 19 adult subjects with ventilation tubes inserted for ETD (group 2). Data were analyzed using logistic regression including each parameter independently and then a step-down discriminant analysis including all ETF test parameters to predict group assignment. Factor analysis operating over all parameters was used to explore relatedness. EXPOSURES: ETF testing. MAIN OUTCOMES AND MEASURES: ETF parameters for the forced response, inflation-deflation, Valsalva, and sniffing tests measured in 15 control ears of adult subjects after unilateral myringotomy (group 1) and in 23 ears of 19 adult subjects with ventilation tubes inserted for ETD (group 2). RESULTS: The discriminant analysis identified 4 ETF test parameters (Valsalva, ET opening pressure, dilatory efficiency, and percentage of positive pressure equilibrated) that together correctly assigned ears to group 2 at a sensitivity of 95% and a specificity of 83%. Individual parameters representing the efficiency of ET opening during swallowing showed moderately accurate assignments of ears to their respective groups. Three factors captured approximately 98% of the variance among parameters: the first had negative loadings of the ETF structural parameters; the second had positive loadings of the muscle-assisted ET opening parameters; and the third had negative loadings of the muscle-assisted ET opening parameters and positive loadings of the structural parameters. CONCLUSIONS AND RELEVANCE: These results show that ETF tests can correctly assign individual ears to physician-diagnosed ETD with high sensitivity and specificity and that ETF test parameters can be grouped into structural-functional categories.

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  • Tests of ventilatory function of the Eustachian tube (tubomanometry, sonotubometry, nine-step inflation-deflation test, pressure chamber tests) have unclear accuracy and validity.

    “At the current time, the equipment these tests require is not widely available, and their accuracy and validity is unclear,5 but they can be useful research tools.”

    From Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis (2015) · cites this paper as [5]

    The Discussion (page unavailable) says interpretations of Eustachian tube function tests lack a strong empirical foundation, supporting uncertainty about validity. It identifies sonotubometry and the 9-step test, but does not establish that the accuracy of all the named tests is unclear; the Results instead quantify accuracy for a different set of tests. (LLM, conf=0.82)

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Cites

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Research works printed but not linked: 25

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  15. [16]Falk B Magnuson B Evacuation of the middle ear by sniffing: a cause of high negative pressure and development of middle ear disease Otolaryngol Head Neck Surg 6 1984 92 3 312 318 6431372
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Authors
Doyle, W. J., Swarts, J. D., Banks, J., Casselbrant, M. L., Mandel, E. M., & Alper, C. M.
Affiliations
  • University of Pittsburgh (US)
  • Division of Pediatric Otolaryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Corresponding author
Doyle, William J.
ORCID
Venue
JAMA Otolaryngology–Head & Neck Surgery
Publisher
American Medical Association (AMA)
Published
2013-07-01
Volume
139
Issue
7
Pages
719
ISSN
2168-6181 (ISSN-L)
DOI
10.1001/jamaoto.2013.3559
PMC
PMC3792585
OpenAlex
W2044613880
Cited by
70
References
1
Citations by year
2026: 10 · 2025: 5 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 7 · 2019: 7 · 2018: 5 · 2017: 8 · 2016: 2 · 2015: 5 · 2014: 3 · 2013: 1
FWCI
3.33
Type
journal article
Language
en
Open access
Locations
  • JAMA Otolaryngology–Head & Neck Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000005)
  • National Institute on Deafness and Other Communication Disorders (P50DC007667)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Otorhinolaryngology › Ear Surgery and Otitis Media
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
Keywords
Eustachian tube dysfunction, sensitivity and specificity, Valsalva maneuver, myringotomy, tympanostomy tubes, discriminant analysis
MeSH terms
Adolescent, Adult, Ear Diseases, Eustachian Tube, Female, Humans, Male, Middle Aged, Middle Ear Ventilation, Risk Factors, Sensitivity and Specificity, Discriminant Analysis

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