DIAGNOSTIC ACCURACY OF THE ETDQ-7 IN ADULTS AT UNIVERSITY OF BENIN TEACHING HOSPITAL

Аннотация

INTRODUCTION cleft anomalies had ETD compared to 2.5% in the Bluestone defined Eustachian tube dysfunction control group, as well as in Aboriginal groups from (ETD) as the abnormal function of the Eustachian Australia and the Americas.3,4 Akpalaba and Ogisi tube, a component of the tubotympanic system of reported ETD in 57.6% of children with cerebral the ear that includes the middle ear cleft and palsy, compared to 14.3% in the control mastoid air cells, without reference to its population.5 aetiopathogenesis, which may involve structural or functional factors.1 Disruption in Eustachian Globally, over 80% of children under three have tube function results in middle ear effusion and its experienced at least one middle ear infection, and sequelae or worsens the prognosis of pre-existing more than 40% have had three or more episodes middle ear disease. of acute otitis media.1,2 Shan et al. estimated ETD prevalence in adults in the United States at 4.6%, As ETD progresses, fluid collects in the middle ear compared to <1% in the UK.6,7 Somefun et al. cleft, causing otitis media with effusion or reported a 2.6% prevalence of otitis media with secretory otitis media, potentially leading to other effusion in a hospital-based survey of adult middle ear pathologies and sequelae.1 Secretory patients.8 otitis media and other middle ear diseases significantly contribute to the global burden of ear In developing nations like Nigeria, all forms of diseases, with substantial economic and social otitis media, including otitis media with effusion, impacts.2 It is more prevalent in children under are significant causes of hearing loss.9 These five and those with craniofacial abnormalities. conditions impair speech development in children Musa reported in 2014 that 8.1% of children with and negatively impact social interaction and https://www.theamericanjournals.com/index.php/tajiir 31 THE USA JOURNALS THE AMERICAN JOURNAL OF INTERDISCIPLINARY INNOVATIONS AND RESEARCH (ISSN- 2642-7478) VOLUME 06 ISSUE12 earning potential in adults. Tympanostomy and mobility, retraction, and prominent malleolar similar interventions can improve speech folds.1 development in children and sustain socio- Assessment of Eustachian tube function includes economic activities in adults, as shown in Alabi et visual inspection of the nasopharyngeal opening al.'s study.10 using indirect mirrors in adults or video Bartolomeus Eustachio (1510–1574) discovered endoscopy (nasopharyngoscopy). Locally, the Eustachian tube in 1553.11 Anatomists refer to immittance tympanometry is the standard it as the auditory or pharyngotympanic tube. Its investigation, estimating middle ear pressure, functions include ventilation, secretion clearance, volume, and eardrum compliance to infer tube and pressure equalisation between the middle ear function. A negative tympanogram curve suggests and the pharynx. ETD. In 2015, Schilder et al. classified ETD into: Subjectivity in diagnosing ETD from history-taking can lead to variability among clinicians. The 1. Dilatory ETD disease-specific Eustachian tube dysfunction 2. Patulous ETD questionnaire-7 (ETDQ-7), introduced by McCoul 3. Baro-challenged ETD12 et al. in 2012, offers a reproducible and validated tool with 100% sensitivity and specificity.15 It The dilatory type was further subdivided into: assesses symptoms like aural fullness, tinnitus, and 1. Functional obstruction an “underwater” sensation, providing a 2. Dynamic subtype (muscular failure) standardised diagnostic approach.16 3. Anatomic obstruction There is limited evidence on the ETDQ-7’s validation in large African populations. However, it Bluestone categorised ETD based on impairments has been translated and tested in several in pressure regulation, protective function, and languages, mostly within Caucasian populations, clearance.13 Impaired pressure regulation stems yielding varied outcomes.17-21 from anatomical or functional obstructions, while loss of protective function involves anomalies like Bartolomeo Eustachio first described the abnormally short or patent tubes. Clearance Eustachian tube in 1553. Valsalva elaborated on its failures result from impaired mucociliary action or anatomy in 1717.1 It originates embryologically muscle activity. from the tubotympanic recess of the first pharyngeal cleft and measures 36–44 mm in These factors promote negative pressure build-up adults.22,23 The tube begins in the anterior in the middle ear, particularly during infections or tympanic recess of the petrous temporal bone allergic inflammation, leading to fluid (Protympanum) and follows a pyriform course, accumulation. Diagnosing ETD relies on patient- narrowing at the junction between its bony reported symptoms like ear fullness, autophony, posterior third and cartilaginous anterior two- blockage, tinnitus, otalgia, and hearing loss, often thirds (tubal isthmus). The tube opens into the combined with physical examination findings.1,2 nasopharynx anterior to the Fossa