The characteristic of patulous eustachian tube patients diagnosed by the JOS diagnostic criteria


Autoři: Yoshinobu Kawamura aff001;  Ryoukichi Ikeda aff001;  Toshiaki Kikuchi aff001;  Hiromitsu Miyazaki aff001;  Tetsuaki Kawase aff001;  Yukio Katori aff001;  Toshimitsu Kobayashi aff001
Působiště autorů: Department of Otolaryngology-Head and Neck Surgery, Tohoku University, Graduate School of Medicine, Sendai, Miyagi, Japan aff001;  Sen-En Rifu Otologic Surgery Center, Rifu, Miyagi, Japan aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226908

Souhrn

Objective

The objective is to describe characteristics of patients diagnosed with patulous Eustachian tube (PET) using the Diagnostic Criteria proposed by Japan Otological Society, and to evaluate the efficiency of objective tests to determine patent Eustachian tube.

Study design

Retrospective.

Setting

Tertiary referral center.

Subjects

A retrospective survey of medical records in Sen-En Rifu Hospital identified 78 ears of 56 patients with “Definite PET” diagnosed by the JOS Diagnostic Criteria between January 2017 and December 2017.

Method

Initial diagnosis, aural symptoms (voice autophony, aural fullness and breathing autophony), tubal obstruction procedures (posture change and pharyngeal orifice obstruction) and objective findings (tympanic membrane movement, Tubo-Tympano-Aerodynamic Graphy (TTAG) and sonotubometry) were evaluated. In addition, sonotubometry with postural change (Ohta’s method), sitting CT and a newly devised PHI-10 score were also examined.

Results

Voice autophony, aural fullness, and breathing autophony were observed in 93.6%, 87.2%, 78.2%, respectively. In 91% of the ears, PET symptoms improved by postural change from sitting to the lying / forward-bending position. Synchronous movement of the TM upon respiration was observed in 69.1% of the ears. Positive findings of TTAG were observed in 75.6% of ears. Positive findings of sonotubometry were found in 55.1% of ears. Sonotubometry with postural change (Ohta’s method), when the cut-off value of over 10dB was used, was positive in 45.2% of ears. Newly devised PHI-10 score representing severity of subjective symptoms classifying patients into no handicap, mild handicap, moderate handicap and severe handicap were observed in 12.2%, 10.8%, 18.9% and 58.1% of ears, respectively. The evaluation of the extent of patency of the ET by sitting CT indicated completely open, closed-short, and closed-long, in 68.6%, 11.4% and 21.4% of ears, respectively. Compared to the closed group, the completely open group had a significantly higher frequency of positive breathing autophony, positive sonotubometry, and positive Ohta’s method.

Conclusion

The characteristics of main symptoms and the efficiency of various tests in PET diagnosis were analyzed based on data obtained from “Definite PET” patients diagnosed by the JOS Diagnostic Criteria. The greater the availability of tests to evaluate PET, the greater the opportunities to diagnose “Definite PET”. In particular, tests measuring pressure transmission between the nasopharynx and middle ear, such as TM observation and TTAG, are more sensitive than sonotubometry measuring sound transmission.

Klíčová slova:

Breathing – Diagnostic medicine – Ears – Musculoskeletal system – Nasopharynx – Otology – Positron emission tomography – Sound pressure


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Článek vyšel v časopise

PLOS One


2019 Číslo 12