Diagnostic Value of Tubomanometry in Patulous Eustachian Tube

Background: A patulous Eustachian tube (PET) may be challenging to diagnose in cases where objective tympanic membrane movement is absent during physical examination. Objective: The primary aim was to assess the diagnostic usefulness of tubomanometry (TMM) in patients with PET. A secondary aim was to evaluate nasopharyngeal pressure curves as indicators of nasopharyngeal muscle function, given the proposed contribution of muscular dystrophy in PET pathophysiology. Methods: A retrospective study was conducted at a tertiary referral center on adult patients diagnosed with PET who had undergone TMM between August 2016 and May 2024. Ear-symptomatic patients without Eustachian tube dysfunction or sinonasal disease served as healthy controls. The PET group included 27 ears from 20 patients, and the control group included 91 ears from 49 subjects. Results: The nasopharyngeal pressure threshold at which middle ear pressure started to increase was markedly lower in the PET than the control group [7.0 mbar (3.0 to 23) vs. 21 mbar (10 to 25), respectively, P =0.014]. A threshold of ≤4.5 mbar showed 90% specificity for PET. No differences were observed in nasopharyngeal pressure curves between the groups, suggesting similar nasopharyngeal muscle dynamics. Conclusions: TMM showed diagnostic value for PET. No differences in nasopharyngeal muscle dynamics were observed.