Comparison of wideband acoustic immittance in Chinese infants under three months of age with normal and abnormal middle ear function.

OBJECTIVES: This study aims to compare the characteristics of Wideband Acoustic Immittance (WAI) in Chinese infants under three months of age, with either normal or abnormal middle ear function. METHODS: We recruited 98 infants with either normal or abnormal middle ear function, and subsequently divided them into four groups based on their middle ear function and chronological age. The absorbances at tympanometric peak pressure (TPP) were collected across 1/3rd octave frequencies ranging from 226 to 8000 Hz. RESULTS: Among infants with normal middle ear function, no significant differences were observed concerning ear laterality. However, significant differences were noted at 3364 Hz and 4000 Hz with respect to age. For infants with either normal or abnormal middle ear function, we found significant differences at the majority of frequencies. Additionally, the receiver operating characteristic (ROC) curves and maxima Youden index indicated that absorbances at 1682 Hz and 1297 Hz could be employed to evaluate the middle ear function of infants at 1 and 2 months of age. CONCLUSION: This study demonstrates that WAI holds promise as a valuable tool for assessing the middle ear condition of infants at 1 and 2 months of age. Infants aged 1 and 2 years, having absorbance values equal to or greater than 0.7470 at 1682 Hz and 0.6775 at 1297 Hz respectively, may indicate normal middle ear function. Furthermore, it underscores the necessity of establishing ethnicity- and age-specific norms for WAI in infants under 3 months of age.

Relapsing polychondritis: state-of-the-art review with three case presentations.

BACKGROUND: Relapsing polychondritis (RPC) is a complex immune-mediated systemic disease affecting cartilaginous tissue and proteoglycan-rich organs. The most common and earliest clinical features are intermittent inflammation involving the auricular and nasal regions, although all cartilage types can be potentially affected. The life-threatening effects of rpc involve the tracheobronchial tree and cardiac connective components. Rpc is difficult to identify among other autoimmune comorbidities; diagnosis is usually delayed and based on nonspecific clinical symptoms with limited laboratory aid and investigations. Medications can vary, from steroids, immunosuppressants, and biologics, including anti-tnf alpha antagonist drugs. METHOD: Information on updated etiology, clinical symptoms, diagnosis, and treatment of rpc has been obtained via extensive research of electronic literature published between 1976 and 2019 using PubMed and medline databases. English was the language of use. Search inputs included 'relapsing polychondritis,' 'polychondritis,' 'relapsing polychondritis symptoms,' and 'treatment of relapsing polychondritis.' Published articles in English that outlined and reported rpc's clinical manifestations and treatment ultimately met the inclusion criteria. Articles that failed to report the above and reported on other cartilaginous diseases met the exclusion criteria. RESULT: Utilizing an extensive overview of work undertaken in critical areas of RPC research, this review intends to further explore and educate the approach to this disease in all dimensions from pathophysiology, diagnosis, and management. CONCLUSION: RPC is a rare multi-systemic autoimmune disease and possibly fatal. The management remains empiric and is identified based on the severity of the disease per case. The optimal way to advance is to continue sharing data on RPC from reference centers; furthermore, clinical trials in randomized control groups must provide evidence-based treatment and management. Acquiring such information will refine the current knowledge of RPC, which will improve not only treatment but also diagnostic methods, including imaging and biological markers.

Erythematous ear with drainage.

This case reminded us that not every moist, erythematous, crusting eruption is purely infectious.

Functional aspects of the Eustachian tube by means of 3D-modeling.

The extent of dysfunction of the Eustachian tube (ET) is relevant in understanding the pathogenesis of secondary otological diseases such as acute or chronic otitis media. The underlying mechanism of ET dysfunction remains poorly understood except for an apparent genesis such as a nasopharyngeal tumor or cleft palate. To better describe the ET, its functional anatomy, and the biomechanical valve mechanism and subsequent development of diagnostic and interventional tools, a three-dimensional model based on thin-layer histology was created from an ET in this study. Blackface sheep was chosen as a donor. The 3-D model was generated by the coherent alignment of the sections. It was then compared with the cone-beam computed tomography dataset of the complete embedded specimen taken before slicing. The model shows the topographic relation of the individual components, such as the bone and cartilage, the muscles and connective tissue, as well as the lining epithelium with the lumen. It indicates a limited spiraling rotation of the cartilaginous tube over its length and relevant positional relationships of the tensor and levator veli palatine muscles.

Unlearning the ABCs of Tympanometry.

Interpretation of tympanometry commonly relies on the historical convention of classifying findings according to large and arbitrary threshold shifts of tympanometric peak pressure (TPP). This convention had value for prior generations of otolaryngologists in diagnosing severe, chronic middle ear disease requiring surgical intervention but may not be well suited for the present-day evaluation of less severe disease. The existing definition of a type C curve (less than -100 daPa) is likely insensitive to detect subtle abnormalities, including some presentations of obstructive eustachian tube dysfunction. The accuracy of clinical diagnosis may be improved by reporting the absolute values of TPP and moving beyond classification according to arbitrary thresholds.

Can the negative pressures found in obstructive sleep apnea and Eustachian tube dysfunction be related?

OBJECTIVE: The association between obstructive sleep apnea (OSA) and Eustachian tube dysfunction (ETD) is well known. When both exist in a single pediatric patient, one of the expected culprits is adenoid enlargement. We hypothesize, in contrast, that the negative pharyngeal pressure found in OSA may be transmitted to the middle ear as negative middle ear pressure (MEP), which subsequently results in pathology. The objective of this study was to determine whether the degree of OSA and MEP are associated while using MEP as a quantifiable measurement of ETD. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary academic center (Jan 2000-Jan 2018). SUBJECTS AND METHODS: The relationship between apnea-hypopnea index (AHI) and MEP was examined. A non-anatomic model was utilized to support causality. RESULTS: Thirty-four pediatric patients and twenty-three adult patients were included in the analysis. REM AHI showed a moderate negative correlation with MEP in children (r = -0.265), and a weak positive correlation with MEP in adults (r = 0.171). Children with an AHI in the severe OSA category had a more negative mean MEP than those in the mild category (p = 0.36). Adults with an AHI in the severe OSA category had a more positive mean MEP than those in the mild category (p = 0.11). CONCLUSION: In children, increasing severity of OSA is associated with a negative MEP, suggesting that negative pressure associated with OSA may be transmitted to the middle ear. In adults, increasing severity of OSA is associated with a more positive MEP.

Objective assessment of autophony during phonation in the diagnosis of patulous Eustachian tube patients.

OBJECTIVE: A system enabling the objective assessment of the transmission of voice sounds to the external auditory canal (EAC) during phonation has recently been revised. Our aim was to evaluate the effectiveness of this new system in the diagnosis of patulous Eustachian tube (PET) patients by comparing the results obtained using this method with those obtained from conventional objective tests to diagnose PET. METHODS: A prospective survey of medical records was included with definite PET, possible PET, and sensorineural hearing loss as control. The measurement system consists of a personal computer, an AD/DA converter (NI 6361, National Instruments), a probe microphone system for recording voice sound (ER-10C, Etymotic Research) and two microphones for measuring noise sound in the EAC (ER-10B+, Etymotic Research). Pronouncing the "Ni" sound for 5 s were recorded with these three microphones. The ratio of the maximum sound pressure of voice sound and noise sound in EAC (EAC/Voice) was simultaneously calculated, and results were displayed on a personal computer for diagnosing. RESULTS: Thirty-one patients of 42 ears with definite PET, 26 patients of 38 ears with possible PET, and 12 patients of 24 ears with sensorineural hearing loss as control were included. The EAC/Voice were 8.63 ± 5.43, 25.41 ± 32.63, and 25.87 ± 24.93 in the control, definite PET, and possible PET group respectively. The control group was significantly different from the definite PET (p < 0.05) and possible PET group (p < 0.05). ROC curve analysis confirmed 14.7 as the best diagnostic cut-off value of EAC/Voice (area under the curve=0.782, 95% CI 0.671-0.894). By adopting this cut-off point, 25 (56.8%) and 22 (61.1%) ears were determined as positive findings in the definite PET and possible PET group, respectively. There was no significant correlation between the positive findings judged by the current method and that of sonotubometry in the control (r = -0.63, p = 0.769), definite PET (r = 0.12, p = 0.451), and possible PET group (r = 0.12, p = 0.451). CONCLUSION: The current system is more useful in the objective assessment of autophony during phonation by calculating the ratio of voice sound and elicited noise sound transmitted in the EAC (EAC/Voice). This method seems promising because it is able to detect cases eluding conventionally used test methods such as sonotubometry performed without phonation, thereby increasing the accuracy of PET diagnoses.

Interpretation of Normal and Abnormal Tympanogram Findings in Eustachian Tube Dysfunction.

OBJECTIVE: To characterize the relationship between objective tympanogram values and patient-reported symptoms and associations with common comorbid conditions. STUDY DESIGN: Cross-sectional study with prospective data collection. SETTING: Tertiary medical center. METHODS: Patients undergoing routine audiometric evaluation between October 2018 and June 2019 were included. Participants with temporomandibular joint dysfunction, inner ear hydrops, and similar conditions were excluded. Symptoms were assessed with the 7-item Eustachian Tube Dysfunction Questionnaire. Demographics and medical comorbidities were recorded from the medical record. Analysis of tympanometric peak pressure (TPP), demographics, and comorbidities was performed to determine associations with clinically significant eustachian tube dysfunction (ETD) symptoms. RESULTS: A total of 250 patients were included with similar demographics: 101 (40.4%) in the asymptomatic group and 149 (59.6%) in the symptomatic group. The median (interquartile range) TPP was -10 (20) daPa and -25 (100) daPa in the asymptomatic and symptomatic groups, respectively. A diagnosis of rhinitis was more likely to be associated with significant ETD symptoms (adjusted odds ratio, 2.61; 95% CI, 1.23-5.63). A subgroup analysis revealed that symptomatic patients with normal TPP values were negatively skewed as compared with asymptomatic patients. This symptomatic group had a higher prevalence of rhinitis and chronic rhinosinusitis than the asymptomatic group. CONCLUSION: Patients with symptoms of ETD may have a TPP within a range typically considered normal per conventional standards. This suggests that the currently accepted interpretation of tympanometry findings may be insensitive for the diagnosis of less severe cases of ETD.

The Infratemporal Fossa Sign: Pilot Study of a Potential Clue to Eustachian Salpingitis.

Aural discomfort may be the result of obstructive eustachian tube (ET) dysfunction, temporomandibular joint dysfunction, or other causes. The infratemporal fossa (ITF) sign, in which a patient points to a characteristic location below the auricle, is proposed as an indicator of nonobstructive eustachian salpingitis. A preliminary study included patients with a complaint of aural discomfort who were prompted to localize symptoms using a single finger. Group 1 localized by using the ITF sign; group 2 localized deep within the external ear canal (suggesting ET dysfunction); and group 3 localized to the preauricular region (suggesting temporomandibular joint dysfunction). Findings of ET inflammation recorded during nasal endoscopy were greater in groups 1 and 2. Tympanometry and otoscopy were uniformly abnormal for group 2 and uniformly normal for groups 1 and 3. The ITF sign may help to identify eustachian salpingitis as a phenotype of ET disease characterized by symptomatic inflammation without abnormal middle ear pressure.

Gastroesophageal Reflux Disease: A Cause for Eustachian Tube Dysfunction in Obstructive Sleep Apnea.

OBJECTIVES: To explore the effect of gastroesophageal reflux disease (GERD) on Eustachian tube function in patients with obstructive sleep apnea (OSA). METHODS: This was a cross-sectional study. The patients were divided into 4 groups according to OSA and GERD: OSA+GERD group; OSA-only group; GERD-only group; and normal control group. RESULTS: There were no differences among the 4 groups regarding age, sex, smoking history, and alcohol history (all P > .05). The patients in the OSA and OSA+GERD groups had a significantly larger body mass index than those in the control and GERD-only groups (all P < .05). The proportions of patients with abnormal ETS-7 and ETD-Q results were higher in the GERD and OSA+GERD groups compared to the control group (P < .008). There were no significant differences in ETS-7 and ETD-Q between the control and the OSA-only groups (P > .008). The multivariable analysis showed that only GERD was independently associated with abnormal ETS-7 results (odds ratio = 3.090, 95% CI: 1.332-7.169, P = .009). CONCLUSION: Given the high concomitance rate in patients with OSA, GERD might be an important association factor of Eustachian tube dysfunction in patients with OSA.

Wideband absorbance pattern in adults with otosclerosis and ossicular chain discontinuity.

OBJECTIVES: Evidence from previous literature had shown that the use of a single frequency probe tone is not sensitive enough to detect middle ear pathologies, especially related to the ossicles, which hinders accurate diagnosis. The goal of the present study was to compare the outcome of wideband absorbance (WBA) tympanometry and to determine the difference in WBA pattern in adults with otosclerosis and ossicular chain discontinuity. MATERIALS AND METHODS: Estimated adult cases of otosclerosis (10 ears) and ossicular chain discontinuity (06 ears) along with healthy individuals (10 ears) in the age range of 24 to 48 years (mean age: 38.6 years) were considered for the study. WBA was measured at peak and ambient pressure along with resonance frequency and compared with the data obtained from the healthy individuals to determine the WBA pattern. RESULTS: Data analysis revealed a distinct WBA pattern showing high absorbance at 750 Hz for ossicular chain discontinuity compared to healthy individuals, whereas the otosclerosis group showed reduced absorbance (p < 0.05) at low frequencies (250 Hz to 1500 Hz). WBA measured at the peak and ambient pressure did not elicit any significant difference across the frequencies. Also, the average WBA tympanogram measured between 375 Hz and 2000 Hz showed a significant difference in ambient pressure only in the otosclerosis group. In comparison to healthy individuals (901 Hz), ossicular chain discontinuity showed a significant reduction in resonance frequency (674 Hz), whereas in cases with otosclerosis had higher resonance frequency (1445 Hz). CONCLUSIONS AND SIGNIFICANCE: The present study showed different WBA patterns between the groups and the absorbance values were significantly different at the low frequencies. This suggests that WBA has the potential to differentiate ossicles related pathologies from normal and also between the ear with otosclerosis and ossicular chain discontinuity.

Role of Allergy in Eustachian Tube Dysfunction.

PURPOSE OF REVIEW: Eustachian tube dysfunction (ETD) presents with symptoms of aural fullness and pressure, muffled hearing, tinnitus, and otalgia. When severe, it can lead to many common ear disorders such as otitis media with effusion, tympanic membrane retraction/perforation, and cholesteatoma. These diseases are prevalent in both the pediatric and adult population and significantly impact quality of life. The pathophysiology of ETD in the absence of an obstructive lesion has long been debated but is thought to be related to functional obstruction (i.e., inefficient tensor veli palatini muscle) and/or nasal cavity and nasopharyngeal inflammation. In the acute setting, the most common cause of nasal inflammation is an upper respiratory infection. When symptoms become chronic, however, the inflammation is thought to be associated with nasal irritants such as nasal allergens, i.e., allergic rhinitis (AR). The purpose of this review is to summarize our current understanding of the relationship between allergy and ETD. RECENT FINDINGS: Past studies are either lacking or have reported equivocal findings regarding the relationship between allergy and ETD, and the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis has deemed the current level of evidence linking AR and ETD as low quality. A more recent study using a large adult population dataset did support an association between AR and ETD, but did not find that all cases of ETD are related to allergies. Furthermore, current evidence suggests that the use of medications that can decrease intranasal inflammation, such as intranasal corticosteroids or oral antihistamines, does not result in significant symptomatic improvement in patients with ETD. However, these studies included all patients with ETD, and evidence is lacking regarding the treatment effect of these medications on the subset of patients with concurrent AR and ETD. Current best evidence does support an association between AR and ETD; however, not all patients with ETD suffer from AR, and vice versa. Further research is necessary to understand the mechanism behind this positive association and to elucidate the cause of chronic ETD in patients without associated allergies.

Diagnostic approaches to and management options for patulous eustachian tube.

OBJECTIVES: To systematically review the literature and to summarize all evidence related to the diagnosis and management of patulous eustachian tube. METHODS: The present study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS: Overall, 59 articles were retrieved and included in the analysis. Studies investigating treatments enrolled 1279 patients collectively, with follow-up duration varying from few days and up to 2 years. Eight studies reported medical treatments with intranasal saline instillation as the most frequently studied option. Other studies reported various surgical treatments varying from simple tympanostomy to invasive procedures targeting the orifice of the ET or the anatomical features surrounding it. In addition, 10 studies including 367 subjects investigated different diagnostic methods. CONCLUSION: Currently, there is a wide spectrum of diagnostic and therapeutic interventions with minimal clinical efficacy, a persistent lack of systematic guidelines, and several gaps in previous research endeavours.

Eustachian Tube Function in Patients with Symptoms on Baro-Challenge.

OBJECTIVES: To explore the relationship between aural symptoms during baro-challenge and the underlying measured Eustachian tube (ET) function. Two key questions were addressed. (1) In patients who have features of obstructive ET dysfunction, is there a measurable underlying difference in ET function between those who experience severe symptoms on baro-challenge and those that do not? (2) What is the diagnostic value of ET function tests in the identification of patients with severe symptoms on baro-challenge? METHODS: Patients with symptoms of obstructive ET dysfunction were recruited, with the presence of aural symptoms on baro-challenge established via the clinical history and analysis of the Cambridge ET Dysfunction Assessment, a patient-reported outcome measure (PROM). ET function tests were assessed in each patient: 9 objective and semi-objective measures of ET opening, and 2 symptom-based PROMs. The tests' results were grouped by type of ET opening assessed, generating passive and active dysfunction scores. Individual test results were assessed for diagnostic accuracy in reference to features in the history or PROM-based evidence of symptoms on baro-challenge. RESULTS: Both passive and active opening of the ET was significantly reduced in ears with a history of pain on baro-challenge. Some patients had apparent severe obstructive ET dysfunction without symptoms on baro-challenge, whilst others had symptoms but normal test results. No individual test of ET opening was of diagnostic value in predicting those ears likely to experience pain or exacerbated symptoms on baro-challenge. CONCLUSION: The relationship between aural pain during baro-challenge and ET function appears more complex than had been assumed, with pain possibly related to factors other than just ET function.

The Relation of Allergy to Eustachian Tube Dysfunction and the Subsequent Need for Insertion of Pressure Equalization Tubes.

INTRODUCTION: The most basic question to be answered in each case in which the choice of using a pressure equalization tube (PET) is being considered is: "what is the underlying pathophysiology of the middle ear disease being addressed?" METHODS: We will evaluate the hypothesis that the Eustachian Tube (ET) may become "dysfunctional" due to allergic mucosal edema and obstruction. We review the literature that evaluates the role of ET, the proposed affect that allergy may contribute to ET dysfunction (ETD), and the relation of allergic rhinitis to otitis. RESULTS: Proof that allergy affects the middle ear was supported by (1) over a dozen investigators using objective immunotherapy demonstrating over the past 70 years that 72% to 100% of the children with otitis media with effusion (OME) are atopic, (2) an association of allergic Th2 immune-mediated histochemical reactivity within the target organ itself, (3) establishment that inflammation within the middle ear is truly allergic in nature, and (4) direct evidence of a dose-response curve and consistency of results, which confirm that OME resolves on allergy immunotherapy. CONCLUSION: Current medical evidence should heighten the awareness of physicians of the physiology that underlies ETD. The evidence supports the link between allergy and OME. The middle ear behaves like the rest of the respiratory tract, and what has been learned about the atopic response in the sinuses and lungs may be applied to the study of the immunologic mechanisms within the middle ear that lead to ETD requiring the use of PET.

Audiometric Outcomes and Middle Ear Disease following Cerebrospinal Fluid Leak Repair.

OBJECTIVE: To investigate audiometric outcomes and incidence of chronic ear disease following lateral skull base repair (LSBR) of cerebrospinal fluid (CSF) leaks. STUDY DESIGN: Retrospective review. SETTING: Tertiary skull base center. SUBJECTS AND METHODS: Consecutive adults undergoing LSBR of CSF leaks between 2012 and 2018 were reviewed. Audiometric data included mean air conduction pure-tone average (PTA), air-bone gap (ABG), speech recognition threshold (SRT), and word recognition score (WRS). The incidence and management of the following were collected: effusion, retraction, otitis media and externa, perforation, and cholesteatoma. RESULTS: Seventy-three patients underwent transmastoid (n = 5), middle cranial fossa (n = 2), or combined approach (n = 67) for repair of spontaneous leaks (sCSFLs, n = 41) and those occurring in the setting of chronic ear disease (ceCSFLs, n = 32). ABG decreased 7.23 dB (P = .01) in sCSFL patients. Perforations (P = .01) were more likely in ceCSFL. No sCSFL patient developed a cholesteatoma, perforation, or infection. Effusions (n = 7) were transient, and retractions (n = 2) were managed conservatively in the sCSFL cohort. Eight ceCSFL patients required tubes, 3 underwent tympanoplasties with (n = 2) and without (n = 1) ossicular chain reconstruction (OCR), and 1 had tympanomastoidectomy with OCR. CONCLUSION: Lateral skull base repair of CSF leaks maintained or improved hearing. Patients with preexisting chronic ear disease were more likely to require additional intervention to sustain adequate middle ear aeration compared to the sCSFL cohort. LSBR of sCSFL does not appear to increase risk for developing chronic ear disease.

Loss-of-function of Endothelin receptor type A results in Oro-Oto-Cardiac syndrome.

Craniofacial morphogenesis is regulated in part by signaling from the Endothelin receptor type A (EDNRA). Pathogenic variants in EDNRA signaling pathway components EDNRA, GNAI3, PCLB4, and EDN1 cause Mandibulofacial Dysostosis with Alopecia (MFDA), Auriculocondylar syndrome (ARCND) 1, 2, and 3, respectively. However, cardiovascular development is normal in MFDA and ARCND individuals, unlike Ednra knockout mice. One explanation may be that partial EDNRA signaling remains in MFDA and ARCND, as mice with reduced, but not absent, EDNRA signaling also lack a cardiovascular phenotype. Here we report an individual with craniofacial and cardiovascular malformations mimicking the Ednra -/- mouse phenotype, including a distinctive micrognathia with microstomia and a hypoplastic aortic arch. Exome sequencing found a novel homozygous missense variant in EDNRA (c.1142A>C; p.Q381P). Bioluminescence resonance energy transfer assays revealed that this amino acid substitution in helix 8 of EDNRA prevents recruitment of G proteins to the receptor, abrogating subsequent receptor activation by its ligand, Endothelin-1. This homozygous variant is thus the first reported loss-of-function EDNRA allele, resulting in a syndrome we have named Oro-Oto-Cardiac Syndrome. Further, our results illustrate that EDNRA signaling is required for both normal human craniofacial and cardiovascular development, and that limited EDNRA signaling is likely retained in ARCND and MFDA individuals. This work illustrates a straightforward approach to identifying the functional consequence of novel genetic variants in signaling molecules associated with malformation syndromes.

Disfunción del conducto faringotimpánico. El ETDQ-7 como herramienta para el diagnóstico clínico / Pharyngothympanic tube dysfunction. The ETDQ-7 as a tool for clinical diagnosis

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.