Evaluation of Eustachian Tube Function in Cases of Chronic Otitis Media by Dynamic Slow Motion Videoendoscopy and Impeda
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ORIGINAL ARTICLE
Evaluation of Eustachian Tube Function in Cases of Chronic Otitis Media by Dynamic Slow Motion Videoendoscopy and Impedance Audiometry Gunjan Dwivedi1 • Vikas Gupta2
•
Yaduvir Singh3 • Abhijit Basu2 • Kiran Upadhyay2 • Ritika Bhatia2
Received: 13 June 2020 / Accepted: 1 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract Eustachian tube (ET) dysfunction is known to be a cause for various middle ear diseases. Dynamic slow motion videoendoscopy (DSVE) and impedance audiometry (IA) can both be employed to evaluate ET dysfunction. To assess the role of DSVE and IA for diagnosing ET dysfunction in cases of middle ear disorders. It is a prospective case control study. 102 ears with chronic otitis media were taken as cases and 102 healthy ears as controls. IA and DSVE were performed to assess ET function in both the groups. Sensitivity/ specificity of both the diagnostic tests were evaluated in case and control groups. Out of 102 ET of case group exposed to both tests, 87 were found to have ET dysfunction by DSVE and 80 by IA. Among 102 ET of control group 78 were identified as normal by DSVE while 87 by IA. On applying chi square test in both these groups, the associations were significant. (p value \ 0.0001). Patients with grade 2B or higher on DSVE endoscopy had abnormal IA findings, indicating that higher the grade on DSVE, higher the chance of abnormal IA. DSVE and IA are potentially useful tools in evaluation of cases of COM and which provide information regarding functional and pathological factors responsible for ET dysfunction.
& Vikas Gupta [email protected] 1
Department of ENT-HNS, Command Hospital, Armed Forces Medical College, Pune, Maharashtra, India
2
Deparment of ENT-HNS, Command Hospital, Lucknow, Uttar Pradesh, India
3
Community Medicine. Field Hospital, Agra, Uttar Pradesh, India
Keywords Eustachian tube dysfunction Dynamic slow motion video endoscopy (DSVE) Chronic otitis media (COM) Impedance audiometry (IA) Positive pressure equalization tympanometry (PPET)
Introduction Chronic otitis media (COM) is a major health problem and the leading cause of hearing impairment in Indian subcontinent. The etiology of middle ear disease is multifactorial, but abnormal mechanical function and mucociliary dysfunction of ET are considered to be the most important factors in etiopathogenesis of middle ear diseases like otitis media with effusion, tympanic membrane perforation, atelectasis or cholesteotoma [1–3]. Various studies have concluded that in absence of good ET function, tympanoplasty has high chances of failure [4, 5]. ET is a dynamic organ which together with its neighboring structures, plays a vital role in physiological functions (viz ventilation, protection, and clearance) of middle ear [6, 7]. ET dysfunction has been attributed to various factors which can be anatomical obstruction of the ET or dysfunction of motility of the tube. Anatomical factors, functional obstructions, infections, and allergies have been implicated in ET dysfunction, thou
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