Publication:

Symptom-based clinical and tympanometric assessment of Eustachian tube dysfunction

Background Eustachian tube dysfunction (ETD) is a clinically important disorder that impairs middle-ear ventilation, pressure equalization, and mucociliary clearance. It contributes to otologic symptoms such as ear fullness, hearing impairment, tinnitus, and pain, and may predispose to chronic middle-ear pathology. Despite its practical importance, the burden of ETD in symptomatic outpatient populations remains under-reported, particularly in hospital-based Indian settings. Aim of the study was to evaluate the clinical profile, tympanometric findings, associated factors, and independent predictors of ETD in symptomatic patients attending a tertiary care ENT outpatient department.

Methods This hospital-based cross-sectional study included 384 symptomatic patients. Clinical history, symptom assessment, ETDQ-7, and tympanometric evaluation were used for assessment. Statistical analysis included descriptive statistics, Chi-square testing, and multivariate logistic regression, with p<0.05 considered significant.

Results ETD was present in 168 of 384 patients (43.8%). The mean age was 28.14±6.80 years, and the largest age group was 21–30 years. Males constituted 60.9% of the study population. Significant symptom associations were observed for aural fullness, hearing loss, tinnitus, and ear pain. Clinical factors significantly associated with ETD included allergic rhinitis, upper respiratory tract infection, chronic sinusitis, deviated nasal septum, smoking, and adenoid hypertrophy, while GERD was not statistically significant. On multivariate analysis, the strongest predictors were type B/C tympanogram (adjusted OR 8.92), hearing loss (adjusted OR 6.48), and aural fullness (adjusted OR 5.12).

Conclusions ETD is highly prevalent among symptomatic ENT outpatients. Aural fullness and hearing loss are the most useful clinical indicators, while abnormal tympanometry provides the strongest objective support for diagnosis. A combined symptom-based and tympanometric approach is essential for early recognition and appropriate management of ETD in routine practice.