Interpretation of the nine‐step test for Eustachian tube function should consider mastoid cavity volume
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...
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| Veröffentlicht in: | Clinical otolaryngology 2024-09, Vol.49 (5), p.588-594 |
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| creator | Kim, Jun Yup Kim, Dachan Moon, In Seok Han, Ji Hyuk Bae, Seong Hoon |
| description | 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 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 |
| doi_str_mv | 10.1111/coa.14175 |
| format | Article |
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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.</description><identifier>ISSN: 1749-4478</identifier><identifier>ISSN: 1749-4486</identifier><identifier>EISSN: 1749-4486</identifier><identifier>DOI: 10.1111/coa.14175</identifier><identifier>PMID: 38714328</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Eustachian tube ; mastoid ; Middle ear ; Middle ear pressure ; middle ear ventilation ; Parameter modification ; Regression analysis ; Tympanic membrane</subject><ispartof>Clinical otolaryngology, 2024-09, Vol.49 (5), p.588-594</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3135-e345c9e5cf449c3b861e1f0405a599e5dc1794ca04d56f68760f680f8594a4bc3</cites><orcidid>0000-0001-5255-6279 ; 0000-0001-9243-9392 ; 0000-0001-5196-8482 ; 0000-0002-1633-9805 ; 0000-0002-3951-5074</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcoa.14175$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcoa.14175$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38714328$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Jun Yup</creatorcontrib><creatorcontrib>Kim, Dachan</creatorcontrib><creatorcontrib>Moon, In Seok</creatorcontrib><creatorcontrib>Han, Ji Hyuk</creatorcontrib><creatorcontrib>Bae, Seong Hoon</creatorcontrib><title>Interpretation of the nine‐step test for Eustachian tube function should consider mastoid cavity volume</title><title>Clinical otolaryngology</title><addtitle>Clin Otolaryngol</addtitle><description>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.</description><subject>Eustachian tube</subject><subject>mastoid</subject><subject>Middle ear</subject><subject>Middle ear pressure</subject><subject>middle ear ventilation</subject><subject>Parameter modification</subject><subject>Regression analysis</subject><subject>Tympanic membrane</subject><issn>1749-4478</issn><issn>1749-4486</issn><issn>1749-4486</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kMtKQzEQhoMoXqoLX0ACbnRRTZrkXJZS6gWEbnR9SHMmNHJOUnNRuvMRfEafxNjWLgRnMTMM3_wz_AidUnJFc1wrJ68op6XYQYe05PWQ86rY3fZldYCOQnghhDNS0n10wKqScjaqDpF5sBH8wkOU0TiLncZxDtgaC18fnyHCAkcIEWvn8SSFKNXcSItjmgHWyarVUpi71LVYORtMCx73MkRn8kC-mbjEb65LPRyjPS27ACebOkDPt5On8f3wcXr3ML55HCpGmRgC40LVIJTmvFZsVhUUqCacCCnqPG8VLWuuJOGtKHRRlQXJmehK1FzymWIDdLHWXXj3mvLvTW-Cgq6TFlwKDSNiJOqCCJrR8z_oi0ve5u8yVdWFoPlupi7XlPIuBA-6WXjTS79sKGl-_G-y_83K_8yebRTTrId2S_4anoHrNfBuOlj-r9SMpzdryW_n9JBF</recordid><startdate>202409</startdate><enddate>202409</enddate><creator>Kim, Jun Yup</creator><creator>Kim, Dachan</creator><creator>Moon, In Seok</creator><creator>Han, Ji Hyuk</creator><creator>Bae, Seong Hoon</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5255-6279</orcidid><orcidid>https://orcid.org/0000-0001-9243-9392</orcidid><orcidid>https://orcid.org/0000-0001-5196-8482</orcidid><orcidid>https://orcid.org/0000-0002-1633-9805</orcidid><orcidid>https://orcid.org/0000-0002-3951-5074</orcidid></search><sort><creationdate>202409</creationdate><title>Interpretation of the nine‐step test for Eustachian tube function should consider mastoid cavity volume</title><author>Kim, Jun Yup ; Kim, Dachan ; Moon, In Seok ; Han, Ji Hyuk ; Bae, Seong Hoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3135-e345c9e5cf449c3b861e1f0405a599e5dc1794ca04d56f68760f680f8594a4bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Eustachian tube</topic><topic>mastoid</topic><topic>Middle ear</topic><topic>Middle ear pressure</topic><topic>middle ear ventilation</topic><topic>Parameter modification</topic><topic>Regression analysis</topic><topic>Tympanic membrane</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Jun Yup</creatorcontrib><creatorcontrib>Kim, Dachan</creatorcontrib><creatorcontrib>Moon, In Seok</creatorcontrib><creatorcontrib>Han, Ji Hyuk</creatorcontrib><creatorcontrib>Bae, Seong Hoon</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical otolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Jun Yup</au><au>Kim, Dachan</au><au>Moon, In Seok</au><au>Han, Ji Hyuk</au><au>Bae, Seong Hoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interpretation of the nine‐step test for Eustachian tube function should consider mastoid cavity volume</atitle><jtitle>Clinical otolaryngology</jtitle><addtitle>Clin Otolaryngol</addtitle><date>2024-09</date><risdate>2024</risdate><volume>49</volume><issue>5</issue><spage>588</spage><epage>594</epage><pages>588-594</pages><issn>1749-4478</issn><issn>1749-4486</issn><eissn>1749-4486</eissn><abstract>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.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38714328</pmid><doi>10.1111/coa.14175</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5255-6279</orcidid><orcidid>https://orcid.org/0000-0001-9243-9392</orcidid><orcidid>https://orcid.org/0000-0001-5196-8482</orcidid><orcidid>https://orcid.org/0000-0002-1633-9805</orcidid><orcidid>https://orcid.org/0000-0002-3951-5074</orcidid></addata></record> |
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| source | Wiley Online Library All Journals |
| subjects | Eustachian tube mastoid Middle ear Middle ear pressure middle ear ventilation Parameter modification Regression analysis Tympanic membrane |
| title | Interpretation of the nine‐step test for Eustachian tube function should consider mastoid cavity volume |
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