Dynamic Video Endoscopyin Eustachian tube dysfunction: is it better than impedance audiometry

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S. Jain, M. Gupta, and P. Singh, “Dynamic Video Endoscopyin Eustachian tube dysfunction: is it better than impedance audiometry”, ijmhs, vol. 6, no. 3, Jun. 2016.
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Abstract

Objectives: 1. To find out which among dynamic slow motion video endoscopy (DSVE) and impedance audiometry is a better investigation for diagnosis of Eustachian tube dysfunction in the cases of middle ear disorders. 2. To correlate the Eustachian dysfunction with nasal pathology.

Material and methods:  A case control study done on a total of 84 patients (168 ears) where ear complaints either unilateral or bilateral (total 95 ears) having middle ear disease were taken as cases. Patients without any ear and nasal complaints and  normal ears of the case group were taken as controls (total 73 ears). DSVE was performed in cases and controls to compare the incidence of Eustachian dysfunction in the two groups. Impedance audiometry was performed in all cases by William’s or Toynbee’s test, depending on the presence of perforation. Nasal pathologies were identified by endoscopy or CT-scan.

Results: On comparing DSVE findings with impedance audiometry, a strong association was found by applying Mc Nemar Chi square test. However, no significant correlation was found between results obtained on impedance audiometry with middle ear disease. In the mechanical type of dysfunction, we found nasal, paranasal or nasopharyngeal pathology in all the cases. In unilateral otitis media, the contralateral healthy ear was also associated with Eustachian dysfunction.

Conclusion: DSVE is a better investigation than impedance audiometry for diagnosing Eustachian dysfunction in cases of chronic otitis media, especially the functional type. Nasal, paranasal or nasopharyngeal pathologies should be looked for in all cases of mechanical type of dysfunction and adequately addressed.

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