Assessment of Nasal-Noise Masking Audiometry as a Diagnostic Test for Patulous Eustachian Tube

作者：Paradis Justin; Bance Manohar^*

来源：Otology & Neurotology, 2015, 36(2): e36-e41.

DOI：10.1097/MAO.0000000000000696

• Eustachian tube dysfunction
• Nasal audiometry
• Nasal-noise masking audiometry
• NNMA
• Patulous Eustachian tube

Objective The primary objective is to assess the validity of nasal-noise masking audiometry (NNMA) as a clinical diagnostic tool in our patient population.
Study Design Retrospective case review.
Setting Tertiary ambulatory referral center.
Patients Patients with patulous Eustachian tube (PET) were identified from referrals to our Eustachian tube disorders clinic primarily with symptoms including autophony, aural fullness, and hearing their own breathing. The healthy subjects had no history of ear disease.
Intervention NNMA was measured in 20 ears of 10 healthy subjects as well as in 42 ears of 21 patients with suspected PET.
Main Outcome Measure NNMA mean auditory thresholds were measured at frequencies ranging from 250 to 8,000 Hz.
Results When stratified as definitive or probable PET based on observed tympanic membrane movement with breathing, both Definitive and Probable PET groups had significantly higher NNMA mean auditory thresholds compared to Normal ears at 250 Hz (p = 0.001, p = 0.003), 1,000 Hz (p = 0.019, p = 0.001), and 6,000 Hz (p = 0.4, p = 0.001). When stratified based on symptoms on the day of testing, both Symptomatic Ears and Non-Symptomatic Ears had significantly higher mean auditory thresholds compared to Normal ears at 250 Hz (p = 0.001, p = 0.015) and at 1,000 Hz (p = 0.002, p = 0.004).
Conclusion Our results demonstrate a larger masking effect in patients with PET compared to normal subjects in the low-frequency region. In clinical practice, the relatively small effect and the wide variability of results between patients have made this test be of little value clinically in our patient population.

• 出版日期2015-2