TY - JOUR
T1 - Interpretation of the nine-step test for Eustachian tube function should consider mastoid cavity volume
AU - Kim, Jun Yup
AU - Kim, Dachan
AU - Moon, In Seok
AU - Han, Ji Hyuk
AU - Bae, Seong Hoon
N1 - Publisher Copyright:
© 2024 John Wiley & Sons Ltd.
PY - 2024/9
Y1 - 2024/9
N2 - 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.
AB - 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.
KW - Eustachian tube
KW - mastoid
KW - middle ear
KW - middle ear ventilation
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U2 - 10.1111/coa.14175
DO - 10.1111/coa.14175
M3 - Article
C2 - 38714328
AN - SCOPUS:85192252494
SN - 1749-4478
VL - 49
SP - 588
EP - 594
JO - Clinical Otolaryngology
JF - Clinical Otolaryngology
IS - 5
ER -