Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test

Background/Objectives: The nine-step inflation/deflation tympanometric Eustachian tube function test (commonly referred to as the nine-step test) is a widely utilized method for evaluating Eustachian tube function (ETF). This study aimed to establish normative values for the nine-step test to facili...

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Main Authors: Jing-Jie Wang, Rong-San Jiang, Chien-Hsiang Weng
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/24/2810
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author Jing-Jie Wang
Rong-San Jiang
Chien-Hsiang Weng
author_facet Jing-Jie Wang
Rong-San Jiang
Chien-Hsiang Weng
author_sort Jing-Jie Wang
collection DOAJ
description Background/Objectives: The nine-step inflation/deflation tympanometric Eustachian tube function test (commonly referred to as the nine-step test) is a widely utilized method for evaluating Eustachian tube function (ETF). This study aimed to establish normative values for the nine-step test to facilitate the diagnosis of Eustachian tube dysfunction (ETD). Methods: A total of 160 adults, including 70 healthy volunteers and 90 patients with chronic rhinosinusitis (CRS), were recruited for this study. Participants were further categorized into “fair ETF” and “poor ETF” groups based on their scores on the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Eustachian tube function was assessed using both the nine-step test and the ETDQ-7. The diagnostic accuracy of the maximal peak pressure difference (MPD) from the nine-step test was evaluated, using an ETDQ-7 score of ≥14 as the reference standard. Discriminative ability was analyzed using receiver operating characteristic (ROC) curves. Results: An MPD value of ≤4 yielded an area under the ROC curve (AUC) of 0.619, indicating moderate discriminative ability in the Taiwanese population. The median MPD value on the nine-step test was 9.5 (interquartile range [IQR]: 4.5–14.0) in participants with an ETDQ-7 score of <14, compared to a median MPD value of 7.5 (IQR: 2.5–12.0) in those with an ETDQ-7 score of ≥14 (<i>p</i> = 0.033). This finding suggests a potential association between MPD values and ETDQ-7 scores. Conclusions: This study identified an MPD value of 4 as a normative cutoff for screening ETD in a Taiwanese population. However, the diagnostic discriminative power of this parameter was moderate.
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spelling doaj-art-2ca65a5155224aa38ad8458ceefa4af22025-08-20T02:00:37ZengMDPI AGDiagnostics2075-44182024-12-011424281010.3390/diagnostics14242810Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function TestJing-Jie Wang0Rong-San Jiang1Chien-Hsiang Weng2Department of Otolaryngology, Taichung Veterans General Hospital, Taichung 40705, TaiwanDepartment of Otolaryngology, Taichung Veterans General Hospital, Taichung 40705, TaiwanDepartment of Family Medicine, Warren Alpert Medical School, Brown University, Providence, RI 02912, USABackground/Objectives: The nine-step inflation/deflation tympanometric Eustachian tube function test (commonly referred to as the nine-step test) is a widely utilized method for evaluating Eustachian tube function (ETF). This study aimed to establish normative values for the nine-step test to facilitate the diagnosis of Eustachian tube dysfunction (ETD). Methods: A total of 160 adults, including 70 healthy volunteers and 90 patients with chronic rhinosinusitis (CRS), were recruited for this study. Participants were further categorized into “fair ETF” and “poor ETF” groups based on their scores on the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Eustachian tube function was assessed using both the nine-step test and the ETDQ-7. The diagnostic accuracy of the maximal peak pressure difference (MPD) from the nine-step test was evaluated, using an ETDQ-7 score of ≥14 as the reference standard. Discriminative ability was analyzed using receiver operating characteristic (ROC) curves. Results: An MPD value of ≤4 yielded an area under the ROC curve (AUC) of 0.619, indicating moderate discriminative ability in the Taiwanese population. The median MPD value on the nine-step test was 9.5 (interquartile range [IQR]: 4.5–14.0) in participants with an ETDQ-7 score of <14, compared to a median MPD value of 7.5 (IQR: 2.5–12.0) in those with an ETDQ-7 score of ≥14 (<i>p</i> = 0.033). This finding suggests a potential association between MPD values and ETDQ-7 scores. Conclusions: This study identified an MPD value of 4 as a normative cutoff for screening ETD in a Taiwanese population. However, the diagnostic discriminative power of this parameter was moderate.https://www.mdpi.com/2075-4418/14/24/2810Eustachian tube functionEustachian tube dysfunctionnine-step inflation–deflation tympanometric Eustachian tube function testmaximal peak pressure differenceseven-item Eustachian Tube Dysfunction Questionnaire
spellingShingle Jing-Jie Wang
Rong-San Jiang
Chien-Hsiang Weng
Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test
Diagnostics
Eustachian tube function
Eustachian tube dysfunction
nine-step inflation–deflation tympanometric Eustachian tube function test
maximal peak pressure difference
seven-item Eustachian Tube Dysfunction Questionnaire
title Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test
title_full Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test
title_fullStr Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test
title_full_unstemmed Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test
title_short Establishment of the Normative Value of Classical Bluestone’s Nine-Step Inflation/Deflation Tympanometric Eustachian Tube Function Test
title_sort establishment of the normative value of classical bluestone s nine step inflation deflation tympanometric eustachian tube function test
topic Eustachian tube function
Eustachian tube dysfunction
nine-step inflation–deflation tympanometric Eustachian tube function test
maximal peak pressure difference
seven-item Eustachian Tube Dysfunction Questionnaire
url https://www.mdpi.com/2075-4418/14/24/2810
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