Impact of eustachian tube function assessed by saccharin clearance test on surgical outcome of type-1 endoscopic tympanoplasty.

backgroundThe saccharin clearance test is a simple and cost-effective method for assessing eustachian tube (ET) function and may help predict surgical outcomes in tympanoplasty. In this study we aimed to assess ET function using the saccharin clearance test and correlate it with surgical outcomes of type-1 endoscopic tympanoplasty.

methodsA prospective observational study was conducted on 67 patients with inactive mucosal chronic otitis media undergoing type-1 endoscopic tympanoplasty. ET function was evaluated pre-operatively using the saccharin clearance test. The time at which sweet taste is reported after placement of a saccharine particle in the middle ear under endoscopic control was recorded as saccharin perception time (SPT). Patients were categorized as having normal ET function (SPT < 20 min), partial dysfunction (20-45 min), or gross dysfunction (> 45 min). Postoperative outcomes were assessed up to 6 months and classified as successful graft uptake or failure.

resultsThe overall graft uptake rate was 71.6%. Graft uptake was significantly higher in patients with normal ET function (88.9%) compared to partial (57.7%) and gross dysfunction (20%) (p = 0.01). Mean SPT was significantly lower in patients with successful graft uptake than in those with graft failure (18.5 ± 10.8 vs. 33.4 ± 12.8 min; p < 0.001). Logistic regression revealed that prolonged SPT was an independent predictor of graft failure (p < 0.001). ROC analysis demonstrated good predictive value for SPT (AUC: 0.825), with an SPT > 30 min strongly associated with graft failure.

conclusionAssessment of ET function by saccharin clearance test can be a valuable predictor of surgical outcome in type-1 endoscopic tympanoplasty. Future multicentric studies with larger sample sizes and longer follow-up are required to validate these findings and establish their clinical utility.