Tubomanometry

Tubomanometry is a technique for assessing the eustachian tube opening function, and sometimes to determine a treatment plan.^[1] This technique was familiarised by D. Estève et al in 2001.^[2]^[1]

Technique

The individual is asked to perform a swallowing maneuver. During this time, the nasal fossae and the nasopharynx are occluded by the velum. A tympanometry earplug is inserted into the external ear of the studied side to avoid fluctuations in ear pressure due to atmospheric conditions. The tubomanometer then creates a dysbarical situation, where the pressure conditions encountered during a rapid drop in altitude is reproduced. This is done by releasing an air bolus into the nasopharynx through airtight nozzles previously placed on both nostrils. At this point, the tubomanometer is able to make several recordings of the pressure variations in the rhinopharynx and on the eardrum as the eustachian tube opens.^[1]

Interpretation

Immediate opening of the eustachian tube was observed in healthy subjects at 30-50 mbar pressure. In patients with chronic eustachian tube dysfunction, this opening could be registered in only 42% of the patients at 30 mbar and 58% at 50 mbar.^[3] The results are usually interpreted as R values. An R-value less than or equal to one indicates regular eustachian tube function and an R-value greater than 1 indicates a delayed opening of eustachian tube, thereby supporting the diagnosis of chronic eustachian tube dysfunction.^[3]

References

^ ^a ^b ^c Vandersteen, C.; Castillo, L.; Roger, C.; Savoldelli, C.; Guevara, N. (1 January 2021). "Tubomanometry: An effective and promising assessment of Eustachian tube dysfunction in chronic rhinosinusitis patients". European Annals of Otorhinolaryngology, Head and Neck Diseases. 138 (1): 7–12. doi:10.1016/j.anorl.2020.06.012. ISSN 1879-7296. PMID 32620424. S2CID 220336725.
^ Estève, D.; Dubreuil, C.; Vedova, Cl Della; Normand, B.; Martin, C. (2001). "Evaluation par tubomanométrie de la fonction d'ouverture tubaire et de la réponse tympanique chez le sujet normal et chez le sujet porteur d'une otite séro-muqueuse chronique : Comparaison des résultats - 1re partie". Journal Français d'Oto-Rhino-Laryngologie. 50: 223–232. S2CID 162960460.
^ ^a ^b Schröder, S.; Lehmann, M.; Korbmacher, D.; Sauzet, O.; Sudhoff, H.; Ebmeyer, J. (December 2015). "Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction". Clinical Otolaryngology. 40 (6): 691–697. doi:10.1111/coa.12451. ISSN 1749-4486. PMID 25925071. S2CID 784294. Retrieved 27 February 2021.

[els-1] Vandersteen, C.; Castillo, L.; Roger, C.; Savoldelli, C.; Guevara, N. (1 January 2021). "Tubomanometry: An effective and promising assessment of Eustachian tube dysfunction in chronic rhinosinusitis patients". European Annals of Otorhinolaryngology, Head and Neck Diseases. 138 (1): 7–12. doi:10.1016/j.anorl.2020.06.012. ISSN 1879-7296. PMID 32620424. S2CID 220336725.

[2] Estève, D.; Dubreuil, C.; Vedova, Cl Della; Normand, B.; Martin, C. (2001). "Evaluation par tubomanométrie de la fonction d'ouverture tubaire et de la réponse tympanique chez le sujet normal et chez le sujet porteur d'une otite séro-muqueuse chronique : Comparaison des résultats - 1re partie". Journal Français d'Oto-Rhino-Laryngologie. 50: 223–232. S2CID 162960460.

[pub-3] Schröder, S.; Lehmann, M.; Korbmacher, D.; Sauzet, O.; Sudhoff, H.; Ebmeyer, J. (December 2015). "Evaluation of tubomanometry as a routine diagnostic tool for chronic obstructive Eustachian tube dysfunction". Clinical Otolaryngology. 40 (6): 691–697. doi:10.1111/coa.12451. ISSN 1749-4486. PMID 25925071. S2CID 784294. Retrieved 27 February 2021.

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