Assessment of 7‐Item Eustachian Tube Dysfunction Questionnaire in a Clinical Population

ABSTRACT Objective Eustachian tube dysfunction (ETD) is a common condition among patients presenting to audiology clinics, often accompanied by nonspecific symptoms that complicate diagnosis. The 7‐item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) was developed to aid in identifying ETD; however, despite its widespread clinical use, its diagnostic validity has not been consistently demonstrated across patient populations. We evaluate ETDQ‐7 performance in a diverse group of patients seen in an audiology clinic and compare it to an objective test of ETD based on modified impedance audiometry. Methods This retrospective study analyzed ETDQ‐7 scores, responses to a custom tinnitus quality questionnaire, pure‐tone audiometry, and tympanometry with pressure manipulation in a clinical sample of 300 patients. ETD‐positive cases were identified based on the absence of a significant shift in tympanometric peak pressure during swallowing or the Valsalva maneuver. Results The total ETDQ‐7 score showed low sensitivity and specificity in detecting objectively confirmed ETD, even when the analysis was limited to patients without hearing loss. ETDQ‐7 scores did not differ significantly between patients with normal hearing and those with hearing impairment, regardless of ETD status. However, among patients reporting tinnitus, ETDQ‐7 scores were positively correlated with the reported bothersomeness of tinnitus—even after excluding the “ringing in the ears” item from the total score. Conclusions In patients with tinnitus, ETDQ‐7 scores appear to reflect general subjective discomfort caused by tinnitus rather than the presence or severity of ETD. These findings raise concerns about the ETDQ‐7's utility as a stand‐alone diagnostic tool for ETD in heterogeneous clinical populations. Level of Evidence 3