Recent Update in the Diagnosis of Eustachian Tube Dysfunction: A Comprehensive Review of the Eustachian Tube Function Test.
- 1Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
- 2Department of Otorhinolaryngology, Pusan National University School of Medicine, Busan, Korea
Abstract
Eustachian tube dysfunction (ETD) is a prevalent otolaryngologic condition that plays a central role in the pathogenesis of various middle ear diseases; however, there is no universally accepted gold-standard test for its diagnosis. In this narrative review, currently available Eustachian tube (ET) function tests are comprehensively evaluated, encompassing subjective patient-reported outcome measures and objective diagnostic modalities, with an assessment of their diagnostic accuracy, clinical utility, repeatability, and limitations. Patient-reported outcome measures, such as the Eustachian Tube Dysfunction Questionnaire-7, are valuable for symptom quantification, but they correlate poorly with objective ET function, and they cannot reliably differentiate between ETD subtypes. Among the objective tests, sonotubometry, tubomanometry, and the nine-step inflation-deflation test have the highest detected opening rates in healthy ears. Composite scoring systems, such as the Eustachian Tube Score-7, achieve superior diagnostic accuracy by integrating multiple test modalities. Advanced imaging techniques, including sitting computed tomography and dynamic magnetic resonance imaging, provide critical anatomical and functional information, particularly for patulous ETD and surgical planning. No single test provides a complete functional assessment; a combined diagnostic approach integrating validated patient-reported outcomes with objective function tests offers the most accurate characterization of ETD. Standardization of testing protocols, consensus reference standards, and international multicenter validation studies remain urgent priorities.
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BibTeX
@article{na2026recent,
title = {{Recent Update in the Diagnosis of Eustachian Tube Dysfunction: A Comprehensive Review of the Eustachian Tube Function Test.}},
author = {Han-Seul Na and Dong-Hoon Lee and Sung-Won Choi},
journal = {Journal of audiology \& otology},
year = {2026},
month = oct,
doi = {10.7874/jao.2026.00262},
url = {https://europepmc.org/article/MED/42958768},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Recent Update in the Diagnosis of Eustachian Tube Dysfunction: A Comprehensive Review of the Eustachian Tube Function Test.
AU - Han-Seul Na
AU - Dong-Hoon Lee
AU - Sung-Won Choi
PY - 2026
DA - 2026/10/20
JO - Journal of audiology & otology
DO - 10.7874/jao.2026.00262
UR - https://europepmc.org/article/MED/42958768
AB - Eustachian tube dysfunction (ETD) is a prevalent otolaryngologic condition that plays a central role in the pathogenesis of various middle ear diseases; however, there is no universally accepted gold-standard test for its diagnosis. In this narrative review, currently available Eustachian tube (ET) function tests are comprehensively evaluated, encompassing subjective patient-reported outcome measures and objective diagnostic modalities, with an assessment of their diagnostic accuracy, clinical utility, repeatability, and limitations. Patient-reported outcome measures, such as the Eustachian Tube Dysfunction Questionnaire-7, are valuable for symptom quantification, but they correlate poorly with objective ET function, and they cannot reliably differentiate between ETD subtypes. Among the objective tests, sonotubometry, tubomanometry, and the nine-step inflation-deflation test have the highest detected opening rates in healthy ears. Composite scoring systems, such as the Eustachian Tube Score-7, achieve superior diagnostic accuracy by integrating multiple test modalities. Advanced imaging techniques, including sitting computed tomography and dynamic magnetic resonance imaging, provide critical anatomical and functional information, particularly for patulous ETD and surgical planning. No single test provides a complete functional assessment; a combined diagnostic approach integrating validated patient-reported outcomes with objective function tests offers the most accurate characterization of ETD. Standardization of testing protocols, consensus reference standards, and international multicenter validation studies remain urgent priorities.
SN - 2384-1621
SN - 2384-1710
ER -