Browsing by Author "Lindfors, Oskari"

Tubomanometry (TMM) is used to investigate Eustachian tube opening by forming a pre-defined pressure (30, 40 or 50 mbar) in the nasopharynx and registering a pressure change in the external ear canal, caused by movement of the tympanic membrane. The objective of this study was to investigate problems in TMM use and interpretation in patients with Eustachian tube dysfunction (ETD) at a tertiary referral center. The secondary goal was to examine whether it would be possible to not use all pre-defined pressures. A retrospective chart review of all patients with a history of ETD treated at the Head and Neck Center of Helsinki University Hospital during 2016 - 2018 was conducted. The primary outcome was proportion of successful TMM measurements, including the reasons for unsuccessful measurements. In addition, the results of successful measurements were evaluated. TMM success rate was 91%, varying between 81 – 95% in different ETD patient groups and between 87 – 94% at different pressures. The reasons for unsuccessful measurements were air-leaks from the external ear canal, pressure changes in the external ear canal prior to changes in nasopharyngeal pressure, and insufficient rises in nasopharyngeal pressure. The results of successful TMM measurements were similar in 88% of cases at 30 and 40 mbars and in 86% of cases at 40 and 50 mbars. TMM is suitable for clinical use in ETD patients. The problems in TMM use and interpretation can be avoided by repeating the unsuccessful measurememts during patient examination. To maximize the amount of diagnostic information achievable, all three pressures should be used.