Accuracy of the ETDQ-7 for Identifying Persons with Eustachian Tube Dysfunction

Abstract

Objective To compare the accuracy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) in identifying people with eustachian tube (ET) dysfunction based on symptoms and an objective ET function test. Study Design Cross-sectional study. ObjSettingective Tertiary referral center. Subjects and Methods Fifty-five subjects with and without symptoms suggestive of ET dysfunction completed the ETDQ-7 and had their ET function evaluated by the percentage of middle ear pressure equilibrated after 5 swallows (PEq5) either during a pressure chamber test (intact tympanic membranes) or by the inflation-deflation test (nonintact tympanic membranes). ETDQ-7 score ≥14.5 and PEq5 <60% were used to define ET dysfunction, and sensitivity, specificity, and receiver operating characteristic curves were used to assess the level of association between ETDQ-7 scores and PEq5. Results Twenty-five asymptomatic subjects (group 1 = 15 females, 15 white; mean ± SD age, 32 ± 12.8 years) and 30 subjects with ET dysfunction symptoms (group 2 = 17 females, 25 white; age, 27 ± 16.3 years) were included in the analysis. ETDQ-7 sensitivity and specificity regarding correct group assignment were 70% and 100%, respectively, and with respect to predicting PEq5<60%, 54% and 78%. An area under the curve (AUC) of 0.68 (95% CI, 0.53-0.83) at the participant level and 0.64 (95% CI, 0.50-0.77) at the ear level indicated a moderate level of association that was lower, though not statistically significant, for nonintact tympanic membranes (AUC = 0.63 at the participant level and AUC = 0.49 at the ear level). Conclusion The ETDQ-7 score had a higher correlation with the ET dysfunction symptoms than with an objective measure of ET function.

Keywords: ETDQ-7; eustachian tube; inflation-deflation test; otitis media; percentage pressure equilibrated; pressure chamber test.

Conflict of interest statement

Conflict of Interest: The authors have no conflicts to disclose.

Figures

Figure 1

Participant level empirical ROC curves for ETDQ-7 with PEq5 as a reference. A. All participants; B. Participants with non-intact tympanic membranes (IDT); C. Participants with intact tympanic membranes (PC test).

Figure 2

Ear level empirical ROC curves for ETDQ-7 with PEq5 as a reference. A. All participants; B. Participants with non-intact tympanic membranes (IDT); C. Participants with intact tympanic membranes (PC test).