ArticlePloS one2018
Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Balloon dilatation of the Eustachian tube for obstructive Eustachian tube dysfunction in adults.The Cochrane database of systematic reviews · 2025Pooled it
- [Balloon Eustachian tuboplasty for treatment of Eustachian tube dysfunction: A systematic review and Meta-analysis].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2020Pooled it
- Otovent Versus Valsalva: Physiological Insights for Diagnostic and Therapeutic Autoinflation in Eustachian Tube Dysfunction.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- The Global Burden of Eustachian Tube Dysfunction in Older Patients: Pathophysiology, Clinical Consequences, Diagnostic Challenges and Therapeutic Perspectives-A SANRA-Based Study.Healthcare (Basel, Switzerland) · 2026Review
- Functional Assessment Beyond Type A Tympanograms: Pressure-Swallow Testing for Chronic Eustachian Tube Dysfunction in a Taiwanese Cohort.Diagnostics (Basel, Switzerland) · 2026Article
- Interplay Between Rhinosinusitis and Eustachian Tube Dysfunction in Patients Undergoing Functional Endoscopic Sinus Surgery.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Tubomanometry and Symptom Outcomes in Eustachian Tube Dysfunction Associated with Chronic Nasal Disease.Audiology research · 2026Article
- Office-Based LA-BET Without Sedation or Nerve Block: Prospective Evaluation of a Simplified Local Anesthesia Protocol.Journal of clinical medicine · 2026Article
- Prevalence and Interplay of Modifiable and Genetic Determinants of Eustachian Tube Dysfunction Among Saudi Adults: A Nationwide Study.Diagnostics (Basel, Switzerland) · 2025Article
- Evaluating Middle Ear Absorbance and Resonant Frequency in Patulous Eustachian Tube Patients Using Wideband Tympanometry.Otology & neurotology open · 2025Article
- Effect of deviated nasal septum on Eustachian tube dysfunction: a systematic review and meta-analysis.The Journal of laryngology and otology · 2025Review
- Establishment of the Normative Value of Classical Bluestone's Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test.Diagnostics (Basel, Switzerland) · 2024Article
- Chronic Nasal Disease and Eustachian Tube Function: What Is the Role of Tubomanometry?Journal of clinical medicine · 2024Article
- Assessing the usefulness of tubomanometry as a diagnostic tool in Eustachian tube dysfunction.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Article
- Sound and Noise Sources in Sonotubometry: An Investigation of Eustachian Tube Assessment.Annals of biomedical engineering · 2024Article
- Review
- Eustachian Tube Dysfunction Diagnostic Pathway-What Is the Current State of the Art and How Relevant Is Chronic Nasal Disease?Journal of clinical medicine · 2024Review
- Patulous Eustachian Tube and Otitis Media With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis (OMAAV).Cureus · 2024Article
- Results of Eustachian tube balloon dilation measured using the nine-step test.Scientific reports · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsEustachian tube dysfunction (ETD) is a commonly diagnosed disorder of Eustachian tube opening and closure, which may be associated with severe symptoms and middle ear disease. Currently the diagnosis of obstructive and patulous forms of ETD is primarily based on non-specific symptoms or examination findings, rather than measurement of the underlying function of the Eustachian tube. This has proved problematic when selecting patients for treatment, and when designing trial inclusion criteria and outcomes. This study aims to determine the correlation and diagnostic value of various tests of ET opening and patient reported outcome measures (PROMs), in order to generate a recommended diagnostic pathway for ETD.
methodsIndex tests included two PROMs and 14 tests of ET opening (nine for obstructive, five for patulous ETD). In the absence of an accepted reference standard two methods were adopted to establish index test accuracy: expert panel diagnosis and latent class analysis. Index test results were assessed with Pearson correlation and principle component analysis, and test accuracy was determined. Logistic regression models assessed the predictive value of grouped test results.
resultsThe expert panel diagnosis and PROMs results correlated with each other, but not with ET function measured by tests of ET opening. All index tests were found to be feasible in clinic, and acceptable to patients. PROMs had very poor specificity, and no diagnostic value. Combining the results of tests of ET function appeared beneficial. The latent class model suggested tympanometry, sonotubometry and tubomanometry have the best diagnostic performance for obstructive ETD, and these are included in a proposed diagnostic pathway.
conclusionsETD should be diagnosed on the basis of clinical assessment and tests of ET opening, as PROMs have no diagnostic value. Currently diagnostic uncertainty exists for some patients who appear to have intermittent ETD clinically, but have negative index test results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.