ABSTRACT
RESUMEN En la actualidad se hace referencia en la bibliografía a una gran variedad de métodos para evaluar la disfunción del conducto faringotimpánico (DCFT), la gran mayoría de ellos requiere de instrumental de alta complejidad y personal altamente capacitado. Pese a lo mencionado, ninguno de dichos métodos ha sido validado como herramienta gold standard para el diagnóstico de esta patología. En este contexto, se presenta una herramienta complementaria para el diagnóstico de la DCFT, el Eustachian Tube Dysfunction Questionnaire -7 ítemes (ETDQ-7); cuestionario autoadministrado que considera 7 preguntas en base a una escala de Likert, fue creado para evaluar la sintomatología asociada a la disfunción del conducto con una puntuación que va desde lo más leve (1 punto) a lo más grave (7 puntos) de acuerdo con los síntomas percibidos, y posee un puntaje máximo de 49 puntos, correspondiente a una disfunción severa. La presente revisión tiene como objetivo buscar, organizar, clasificar y describir la información disponible en publicaciones científicas indexadas sobre el ETDQ-7 como herramienta para el diagnóstico clínico complementario de la DCFT. Se incluyeron 11 artículos científicos que hacen referencia al uso del ETDQ-7 en diferentes países. Los resultados recabados sugieren que el ETDQ-7 sería una valiosa herramienta, de alta sensibilidad, especificidad y validez clínica, que permitiría discriminar la presencia de la DCFT. No se encontró evidencia respecto a la aplicación o validación de este cuestionario en nuestro país.
ABSTRACT At present, great variety of methods are described to evaluate the dysfunction of the pharyngotympanic duct (DCFT), the vast majority of them require highly complex instruments and highly trained personnel. Despite this, none of these methods has been validated as the gold standard for the diagnosis of this pathology. In this context, a complementary tool for the diagnosis of the DCFT is presented. The Eustachian Tube Dysfunction Questionnaire-7 items (ETDQ-7), a self-administered questionnaire that includes 7 questions based on a Likert scale, was created to evaluate the symptomatology associated with the dysfunction of the duet. It is scored ranging from the mildest symptomatology (1 point) to the most severe (7 points), according to the perceived symptoms, with a maximum score of 49 points, corresponding to a severe dysfunction. The present review aims to search, organize, classify and describe the available information in scientific indexed journals about the ETDQ-7 as a tool for complementary diagnosis of the DCFT. Eleven scientific articles were included, referred to the use of ETDQ-7 in different countries, describing it as a valid tool which allows to discriminate the presence of a DCFT.
Subject(s)
Humans , Surveys and Questionnaires , Ear Diseases/diagnosis , Eustachian Tube/physiopathology , Ear Diseases/physiopathology , Self ReportABSTRACT
OBJECTIVES@#To evaluate the efficacy of balloon Eustachian tuboplasty (BET) combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction (CDETD).@*METHODS@#A retrospective study was performed in 19 patients with CDETD who underwent BET at the Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, from October, 2014 to September, 2016. The ages of these patients ranged from 10 to 67 years. All the patients underwent the preoperative assessment of oto-endoscope, tympanometry, pure tone audiometry, fiber nasopharyngeal endoscopy, Eustachian tube pressure measurement (TMM), CT and MRI. These patients had failed to respond to medicine, multiple tympanic membrane puncture and at least 2 times grommet insertion before our study. BET was performed in 5 patients (5 ears), and BET+grommet insertionwas performed in other 14 patients (23 ears). The changes of Eustachian tube function in these patients was assessed using the Eustachian tube score (ETS) and Eustachian tube dysfunction questionnaire-7 (ETDQ-7) preoperatively and 1, 3, 6, 9 and 12 months after surgery, respectively. In addition, subjective symptoms including the difficulty level of valsalva, aural fullness and earache were assessed by visual rating scale (VAS score) preoperatively and at 1, 6, and 12 months after surgery. The mean scores before surgery were compared with that at 1, 3, 6, 9 and 12 months. Postoperative adverse reactions and complications were recorded, such as earache, nosebleeding and so on.@*RESULTS@#Valsalva score and VAS score for aural fullness before surgery were 8.286±0.189 and 8.571±0.221, respectively. Valsalva score and VAS score for aural fullness were 3.714±0.317, 2.393±0.434, respectively, at one month after surgery, which were decreased significantly, as compared with the scores before surgery (<0.05). VAS score at 6 months and 12 months after surgery were statistically significant compared with those before surgery (<0.05). ETS score after surgery was significantly higher than that before surgery (<0.05). ETDQ-7 score after surgery was significantly lower than that before surgery (<0.05). The subjective satisfaction in these patients was 84.2%.@*CONCLUSIONS@#BET is simple and safe, with fewer complications, and effective for the treatment of CDETD combined with grommet insertion.
Subject(s)
Adolescent , Adult , Aged , Child , Humans , Middle Aged , Young Adult , China , Dilatation , Ear Diseases , Eustachian Tube , General Surgery , Middle Ear Ventilation , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVES: Eustachian tube dysfunction has been associated with most cases of middle-ear disease. We aimed to assess the effectiveness of dynamic slow motion video endoscopy (DSVE) as a test of eustachian tube dysfunction. Furthermore, we assessed the correlation of the test with the Valsalva maneuver, the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and intraoperative findings of the eustachian tube. METHODS: We retrospectively reviewed medical records from April to September 2014 to identify patients who were diagnosed with chronic otitis media (COM) at Korea University Ansan Hospital. They all underwent surgery because of COM without cholesteatoma and were assessed via the DSVE and ETDQ-7 to determine eustachian tube function. RESULTS: We reviewed 46 COM patients and examined 46 ears with COM and 46 ears on the contralateral side to COM that were thought to be normal. The mean DSVE grade in COM ears was 1.57±0.96, while the mean DSVE grade in contralateral ears was 1.15±0.94. The difference in DSVE between COM ears and normal ears was statistically significant (P=0.006). In the ETDQ-7, a higher score was related to intraoperative obstruction of the eustachian tube (P=0.012). CONCLUSION: DSVE and ETDQ-7 can provide information regarding preoperative status of eustachian tube dysfunction by measuring dynamic structural changes of the eustachian tube in combination with other diagnostic tests.