Endoscopic Evaluation of Pharyngeal End of Eustachian Tube and Eustachian Tube Dysfunction Symptoms Score Among Adult Patients

Authors

  • Adekunle Adeyemo Department of Otorhinolaryngology, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. https://orcid.org/0000-0003-2381-7446
  • Samuel Ayodele Otorhinolaryngology Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria https://orcid.org/0000-0002-1703-6427
  • Ogochukwu Chidi Ejiofor Otorhinolaryngology Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria https://orcid.org/0009-0002-2910-3110
  • Sunday Uhalla Otorhinolaryngology Department, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun, Nigeria.

DOI:

https://doi.org/10.71637/tnhj.v25i2.1071

Keywords:

Eustachian tube dysfunction, Tympanometry, Inflammatory grading system, Nasal endoscopic assessment, Otitis Media with Effusion

Abstract

Background: Eustachian tube dysfunction is central to Otitis Media with Effusion which may occur because of poor ET functions. Nasal endoscopy gives a direct visualization of the pharyngeal orifice of the ET and has the ability to establish, diagnose and assess various pathological causes of ETD. This study addressed gap in knowledge by determining the symptoms scores, endoscopic grading of ET and tympanometric findings among participants.

Methodology: This is a hospital based cross-sectional study. Written informed consent was taken and a study proforma was used to record information from the assessment of recruited individuals. Clinical assessment, Eustachian Tube Dysfunction Questionnaire, ENT examination, tympanometry and nasal endoscopy were carried out. The two grading systems (mucosal inflammatory endoscopic grading and the 3ET endoscopic assessment of the pharyngeal end of the ET) was used to assess the pharyngeal end of the ET orifice. The data collected was analyzed and depicted using prose, tables, and chart.

Results: A total of 54 participants with male to female ratio of 1:1.8 and mean age of 49.98 years ± 19.179. ETDQ-7 was abnormal in 28 (51.9%) of participants. There was a statistically significant difference between ETDQ-7 and tympanometry results. Thirty-five (64.8%) participants were diagnosed with Otitis Media with Effusion while others had Chronic Rhinosinusitis. The relationship between endoscopic grading and tympanometry report was statistically significant.

Conclusion: Combination of the ETDQ-7 scores, endoscopic grading and tympanometry will give a more reliable report of the ET status among patients with OME and CRS.

 

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Author Biography

  • Ogochukwu Chidi Ejiofor, Otorhinolaryngology Department, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria

       

References

1. Schilder A, Bhutta MF, Butler CC, Kvaerner K, Holy C, Levine LH, et al. Eustachian tube dysfunction: Consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol. 2015; 40:407–11.

2. Rennie CE, Gutierrez M, Darby Y, Lund VJ. Investigation of the incidence of Eustachian tube dysfunction in patients with sinonasal disease. Rhinol Online. 2018; 1:85–9.

3. Bluestone CD, Klein JO. Otitis Media and Eustachian Tube Dysfunction. In: Bluestone C, Simons J, Healy G, editors. Pediatric Otolaryngology. 5th ed. Shelton: People’s Medical Publishing House-USA; 2014. p. 633–760.

4. Browning GG, Wormald PJ. Clinical Examination of The Ears and Hearing. In: Watkinson JC, Clarke RW, editors. Scott-Brown’s Otorhinolaryngology Head and Neck Surgery. 8th ed. Boca Raton: CRC Press; 2018. p. 926–8.

5. Vila PM, Thomas T, Liu C, Poe D, Shin JJ. The Burden and Epidemiology of Eustachian Tube Dysfunction in Adults. Otolaryngol Head Neck Surg. 2017; 156:278–84.

6. Choffor-Nchinda E, Siafa AB, Nansseu JR. Otitis media with effusion in Africa-prevalence and associated factors: A systematic review and meta-analysis. Laryngoscope Investig Otolaryngol. 2020; 5:1205–1216.

7. Kivekäs I, Pöyhönen L, Aarnisalo A, Rautiainen M, Poe D. Eustachian Tube Mucosal Inflammation Scale Validation Based on Digital Video Images. Otol Neurotol. 2015;36(10):1748–52.

8. Poe DS, Abou-halawa A, Abdel-razek O. Analysis of the Dysfunctional Eustachian Tube by Video Endoscopy. Otol Neurotol. 2001; 22:590–5.

9. Upadhya I, Datar J. Treatment Options in Otitis Media with Effusion. Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):S191–S197.

10. Stammberger H. Secretion Transportation. In: Hawke M, editor. Functional Endoscopic Sinus Surgery. Philadephia: Decker, BC; 1991. p. 17–47.

11. Patel S, Dasgupta KA, Mustafa A, Sood R. Is Chronic Rhinosinusitis and Status of Pharyngeal End of Eustachian Tube Link-Up: All Smoke No Fire? Int J Contemp Med Res. 2016;3(6):1682–4.

12. Llewellyn A, Norman G, Harden M, Coatesworth A, Kimberling D, Schilder A, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Heal Technol Assess. 2014;18(46):1–204.

13. Menezes AS, Ribeiro, Daniela Correia Guimaras, Joana Rocha Costa I, Moreira F, Dias L. Translation and Validation of the “7-Item Eustachian Tube Dysfunction Questionnaire” to European Portuguese (PT). Acta Med Port. 2020;33(3):191–7.

14. Hunter LL, Sanford CA. Tympanometry and Wideband Acoustic Immittance. In: Katz J, Chasin M, English K, Hood L, Tillery K, editors. Handbook of Clinical Audiology. 7th ed. Philadephia: Wolters Klumer Health; 2015. p. 137–63.

15. Mathew GA, Kuruvilla G, Job A. Dynamic slow motion video endoscopy in eustachian tube assessment. Am J Otolaryngol. 2007;28(2):91–7.

16. Augustine AM, Varghese L, Michael RC, Alber RR, Job A. The efficacy of dynamic slow motion video endoscopy as a test of eustachian tube function. Laryngol Otol. 2013; 127:650–5.

17. McCoul ED, Anand VK, Christos PJ. Validating the Clinical Assessment of Eustachian Tube Dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope. 2012;112(5):1137–1141.

18. McCoul ED, Mayer SI, Tabaee A, Bedrosian JC, Marino MJ. Endoscopic Evaluation of the Eustachian Tube: assessment of a novel tool for grading Eustachian tube inflammation. Int Forum Allergy Rhinol. 2019;9(3):305–10.

19. Fisher A, Stockel J, Townsend J. Sampling and sample size determination. In: Handbook for family planning operations. Research and design. 2nd ed. New York: The population council; 1983. 1–98 p.

20. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl S29):1–464.

21. Daval M, Picard H, Bequignon E, Bedbeder P, Coste A, Ayache D, et al. Chronic otitis media with effusion in chronic sinusitis with polyps. Ear, Nose, Throat J. 2018;97(8):13–8.

22. Hong CK, Park DC, Kim SW, Chang C, Cha S, Yeo SG. Effect of paranasal sinusitis on the development of otitis media with effusion: Influence of Eustachian tube function and adenoid immunity. Int J Pediatr Otorhinolaryngol. 2008; 72:1609–18.

23. Browning GG, Gatehouse S. The prevalence of middle ear disease in the adult British population. Clin Otolaryngol Allied Sci. 1992;17(4):317–21.

24. Finkelstein Y, Ophir D, Talmi YP, Shabtai A, Strauss M, Zohar Y. Adult-Onset Otitis Media with Effusion. Arch Otolaryngol Head Neck Surg. 1994; 120:517–27.

25. Benninger MS, Ferguson BJ, Hadley JA, Hamilos DL, Jacobs M, Kennedy DW, et al. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol neck Surg. 2003;129(3 Suppl):S1-32.

26. Robb PJ, Williamson I. Otitis media with effusion. In: Watkinson JC, Clarke RW, editors. Scott-Brown’s Otorhinolaryngology Head and Neck Surgery. 8th ed. Boca Raton: CRC Press; 2018. p. 115–6.

27. Tangbumrungtham N, Patel VS, Thamboo A, Patel Z, Nayak J V, Ma Y, et al. The prevalence of Eustachian tube dysfunction symptoms in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol. 2018;8(5):620–3.

28. Wu AW, Walgama ES, Higgins TS, Borrelli M, Vardanyan N, Hopp S, et al. Eustachian Tube Quality of Life and Severity of Disease in Patients with Chronic Rhinosinusitis. Am J Rhinol Allergy. 2020;34(4):532–6.

29. Stoikes NFN, Dutton JM. The Effect of Endoscopic Sinus Surgery on Symptoms of Eustachian Tube Dysfunction. Am J Rhinol. 2005; 19:199–202.

30. Yang K-S, Chen W-C, Wu C-N, Wee Y-S, Wang C-S, Wu C-C, et al. Endoscopic Sinus Surgery Significantly Reduces Eustachian Tube Dysfunction Symptoms in Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis. Biomedicines. 2024; 12:2484.

31. Moon S, Lee Y, Jung J, Moon IS, Bae SH. Association Between Eustachian Tube Dysfunction Questionnaire-7 scores and Eustachian Tube Function Test Results in Symptomatic Patients with a Normal Drum. J Audiol Otol. 2022;26(3):142–6.

32. Hsieh C-Y, Lin W-C, Lin C-C, Chou Y-F. Combined balloon Eustachian tuboplasty/endoscopic sinus surgery for patients with chronic rhinosinusitis and Eustachian tube dysfunction. Int Forum Allergy Rhinol. 2024; 14:1327–1336.

33. Takahashi H, Honjo I, Fujita A. Endoscopic findings at the pharyngeal orifice of the Eustachian tube in otitis media with effusion. Eur Arch Otorhinolaryngol. 1996; 253:42–4.

34. Padhya C, Sharma Y, Mishra G. To assess the efficacy of modality slow motion dynamic video endoscopy of eustachian tube in chronic middle ear pathologies. Indian J Otolaryngol Head Neck Surg. 2015;67(1):81–7.

35. Patil N, Jain S, Wadhwa S. Unveiling the Potential: A Comprehensive Review of Dynamic Slow-Motion Video Endoscopy for Eustachian Tube Dysfunction Evaluation. Cureus. 2024;16(7):e63811.

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Published

2025-07-03

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How to Cite

Endoscopic Evaluation of Pharyngeal End of Eustachian Tube and Eustachian Tube Dysfunction Symptoms Score Among Adult Patients. (2025). The Nigerian Health Journal, 25(2), 707-715. https://doi.org/10.71637/tnhj.v25i2.1071

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