Eustachian tube function test
analysis of different conditions and comparison with the ETDQ-7 self-perception questionnaire
DOI:
https://doi.org/10.23925/2176-2724.2026v38i1e72973Keywords:
Eustachian Tube, Valsalva Maneuver, Deglutition, Hearing, Hearing Tests, Sensitivity and SpecificityAbstract
Introduction: In the field of speech therapy, the assessment of Eustachian tube dysfunction (ETD) uses methods such as the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and objective research with the Tubal Function Test (TFT). There is still no clear research investigating the effectiveness of objective tests in comparison with self-perception. Purpose: To analyze the TFT in comparison with the ETDQ-7 and determine the variation in pressure in daPa presented by healthy subjects in each test maneuver. Method: Quantitative, observational, cross-sectional study. Sixty individuals participated, 17 men and 43 women, with normal meatoscopy, tympanometric curve A, with or without complaints related to the Eustachian tube, divided into two groups: G1-individuals with normal self-perception of Eustachian tube function (M=28), and G2-with self-perception of ETD (M=32). The following procedures were performed: visual inspection of the external auditory canal, tympanometry, ETDQ-7, and TFT. Results: Given the different conditions analyzed, the order of swallowing (negative) and after Valsalva (positive) was the test condition that presented the highest percentage of specificity and sensitivity, 46% and 33%, respectively. The other analyses showed high specificity and low sensitivity. The average pressure variation in daPa was 36 daPa for Valsalva and seven daPa for swallowing. Conclusion: When analyzing the TFT, it was observed that performing it in the Swallowing (negative) + Valsalva (positive) condition is most equivalent to the ETDQ-7, when comparing the two. The pressure variation in daPa was established for both conditions, being higher in the Valsalva maneuver.
Downloads
References
1. Szymanski A, Amit A. Anatomy, Head and Neck, Ear Eustachian Tube. StatPearls Publishing; 2023.
2. Su Q, Chen R, Mo J, Li M, Wei J, Weng J, et al. Application progress of Tubomanometry (TMM) in Eustachian tube function evaluation: A Review. Hearing Research. 2025 Jul 18;109370.
3. Casale J, Shumway KR, Hatcher JD. Physiology, Eustachian Tube Function. StatPearls. 2023.
4. Makibara RR, Fukunaga JY, Gil D. Eustachian tube function in adults with intact tympanic membrane Brazilian. Journal of Otorhinolaryngology. 2010 Jun 1 [cited 2023 Apr 12]; 76: 340–6.
5. Schilder AGM, Bhutta MF, Butler CC, Holy C, Levine LH, Kvaerner KJ, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clinical Otolaryngology. 2015 Sep 7; 40(5): 407–11.
6. Malavolta VC, Bruno RS, Oppitz SJ, Pasqualotto B, Didoné DD, Garcia MV. Total remission of pediatric tinnitus: reporting the results of a non-drug approach to tubal dysfunction. Distúrbios da Comunicação. 2023 Aug 2; 35(2): e54780–0.
7. Gallardo FP, Onishi ET, Lira FI, Suzuki FB, Testa JRG. Translation, validation and cultural adaptation of “The Eustachian Tube Dysfunction Questionnaire-7” (ETDQ-7) to Brazilian Portuguese (BR). Brazilian Journal of Otorhinolaryngology. 2019 Jul; 85(4): 456–64.
8. Ikeda R, Ohta S, Yoshioka S, Endo S, Lee K, Kikuchi T, et al. A manual of Eustachian tube function tests–illustration of representative test results obtained from healthy subjects and typical disorders with suggestion of the appropriate test method of choice. Auris, nasus, larynx. 2024 Feb 1; 51(1): 206–13.
9. Teixeira MS. Understanding Eustachian tube function. Brazilian Journal of Otorhinolaryngology. 2020 Sep; 86(5): 523–4.
10. Bal R, Deshmukh P. Management of Eustachian Tube Dysfunction: A Review. Cureus. 2022 Nov 13;14(11).
11. Smith ME, Takwoingi Y, Deeks J, Alper C, Bance ML, Bhutta MF, et al. Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway. Parham K, editor. PLOS ONE. 2018 Nov 8;13(11): e0206946.
12. Anastasiadou S, Polyzois Bountzis, Dimitrios Evangelos Gkogkos, Karkos P, Jannis Constantinidis, Stefanos Triaridis, et al. Eustachian Tube Dysfunction Diagnostic Pathway—What Is the Current State of the Art and How Relevant Is Chronic Nasal Disease? Journal of Clinical Medicine. 2024 Jun 25;13(13): 3700–0.
13. Andresen NS, Sharon JD, Nieman CL, Seal SM, Ward BK. Predictive value of the Eustachian Tube Dysfunction Questionnaire‐7 for identifying obstructive Eustachian tube dysfunction: A systematic review. Laryngoscope Investigative Otolaryngology. 2021 Jun 24; 6(4): 844–51.
14. Moon S, Lee Y, Jung J, Moon IS, Bae SH. Association Between Eustachian Tube Dysfunction Questionnaire-7 Scores and Eustachian Tube Function Test Results in Symptomatic Patients With a Normal Drum. Journal of Audiology and Otology. 2022 May 12.
15. Alkholaiwi F, Alnatheer AM, Theyab RS, Alyousef M, Aldrees T, Dahmash AB, et al. Cross-Cultural Adaptation, Validation, and Arabic Translation of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). International Archives of Otorhinolaryngology. 2022 Feb 22.
16. Lu H, Su J, Chi W, Zou T, Yu M, Wang K. Clinical value of the Eustachian Tube Function Scoring System T-ETDQ: a prospective diagnostic study. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2022 May; 279(5): 2223–30.
17. Commesso EA, Kaylie D, Risoli T, Peskoe SB, Witsell D, Coles T. Screening for Eustachian Tube Dysfunction in Clinical Practice Using the Eustachian Tube Dysfunction Questionnaire‐7. The Laryngoscope. 2022 Jan 3.
18. Ikeda R, Kikuchi T, Miyazaki H, Hidaka H, Kawase T, Katori Y, et al. The efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube patient. Acta Oto-Laryngologica. v. 138, p. 6-9, 2018.
19. Jerger J, Jerger S, Mauldin L. Studies in impedance audiometry. I. Normal and sensorineural ears. Arch Otolaryngol. 1972 Dec; 96(6): 513-23.
20. Teixeira MS, Swarts JD, Alper CM. Accuracy of the ETDQ-7 for Identifying Persons with Eustachian Tube Dysfunction. Otolaryngology–Head and Neck Surgery. 2017 Sep 26;158(1): 83–9.
21. Canali I, Petersen Schmidt Rosito L, Siliprandi B, Giugno C, Selaimen da Costa S. Assessment of Eustachian tube function in patients with tympanic membrane retraction and in normal subjects. Brazilian Journal of Otorhinolaryngology. 2017 Jan; 83(1): 50–8.
22. Lin C, Li Y, Lin X, Zhang S, Tang A, Nong D. Cross-platform data integration of paratubal electromyography and sonotubometry for eustachian tube: a pilot study. Acta oto-laryngologica. 2016 Nov;136(11):1130–6.
23. Bunne M, Falk B, Magnuson B, Hellström S. Variability of Eustachian Tube Function: Comparison of Ears With Retraction Disease and Normal Middle Ears. The Laryngoscope. 2000 Aug;110(8):1389–95.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Fabiana Cristina Toillier, Andriele dos Santos Cavalheiro, Bruna Ribas Maia, Larissa Coradini, Hélinton Goulart Moreira, Vitor Cantele Malavolta, Michele Vargas Garcia
This work is licensed under a Creative Commons Attribution 4.0 International License.
