Interpretation of the nine-step test for Eustachian tube function should consider mastoid cavity volume

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-05-07 DOI:10.1111/coa.14175

Jun Yup Kim, Dachan Kim, In Seok Moon, Ji Hyuk Han, Seong Hoon Bae

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Abstract

Introduction

The modified nine-step test is a classical method for evaluating Eustachian tube function. However, clinical interpretation of the increased maximal difference in middle ear pressure (mdMEP) in the modified nine-step test is unknown. We hypothesised that the different reservoir effects of the mastoid cavity can bias the results of the modified nine-step test.

Methods

A total of 108 consecutive participants (216 ears) were retrospectively screened. Of these, 55 participants (82 ears) who met the inclusion/exclusion criteria were enrolled. The volumetric results of the mastoid cavity, parameters of the modified nine-step test (mdMEP, middle ear pressure, tympanic membrane compliance), and demographic data were analysed.

Results

A significant negative correlation was found between mdMEP and mastoid cavity volume (R = .467, p < .001). Ears with mdMEP >70 daPa showed poor pneumatization in the mastoid cavity, with volumes less than 3000 mm³ (10th percentile of all ears analysed). Ears with mastoid cavity volumes lower than the 25th percentile showed a significantly higher mdMEP (p < .001). Patients with mastoid cavity volumes higher than the 75th percentile were significantly younger (p < .001). Multivariate regression analysis for mdMEP showed a good fit (R = .854) using factors including middle ear pressure, admittance and, most importantly, the reciprocal of mastoid volume (Beta = 0.752, p < .001).

Conclusions

The mdMEP, the main parameter of the modified nine-step test, was negatively correlated with the mastoid cavity volume. Therefore, the results of the modified nine-step test should be interpreted with consideration of mastoid cavity volume.

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咽鼓管功能九步测试的解释应考虑乳突腔容积。

简介改良九步测试是评估咽鼓管功能的经典方法。然而，改良九步测试中中耳最大压差（mdMEP）增加的临床解释尚不清楚。我们假设乳突腔的不同储库效应会使改良九步测试的结果产生偏差：方法：我们对 108 名连续参与者（216 耳）进行了回顾性筛选。方法：对 108 名连续参与者（216 耳）进行了回顾性筛选，其中 55 名参与者（82 耳）符合纳入/排除标准。对乳突腔的体积测量结果、改良九步测试的参数（mdMEP、中耳压、鼓膜顺应性）和人口统计学数据进行了分析：结果发现，mdMEP 与乳突腔容积之间存在明显的负相关（R = .467，p 70 daPa），表明乳突腔气化不良，容积小于 3000 立方毫米（所有分析耳朵的第 10 百分位数）。乳突腔容积小于第 25 百分位数的耳朵的 mdMEP 明显更高（p 结论）：改良九步测试的主要参数 mdMEP 与乳突腔容积呈负相关。因此，在解释改良九步测试结果时应考虑乳突腔容积。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.