Tubomanometry value as an associated factor for medication outcomes in adult acute otitis media with effusion

• DOI: 10.1007/s00405-017-4772-8
• Publication Date: 2017-10-25T22:56:53Z
• Authors: Junbo Zhang; Zhen Zhong; Shuifang Xiao; Yuhe Liu; Zhen Zhen; Lei Ren; Lei Zhang
• Keywords: Adult; Aged, 80 and over; Male; Adolescent; Manometry; Otitis Media with Effusion; Eustachian Tube; Anti-Inflammatory Agents; Histamine Antagonists; Middle Aged; Sensitivity and Specificity; 3. Good health; Drug Combinations; 03 medical and health sciences; 0302 clinical medicine; Acoustic Impedance Tests; ROC Curve; Monoterpenes; Humans; Drug Therapy, Combination; Female; Aged; Retrospective Studies

Tubomanometry (TMM) is a relatively novel method for testing the eustachian tube (ET) function, which is speculated to be closely related to otitis media with effusion (OME). The purpose of this study is to explore the predictive power of TMM value for medication outcomes in adult acute OME. A cohort of 41 adult acute OME patients with 53 affected ears was studied retrospectively. All these patients completed a 2-week treatment including oral Myrtol Standardized Enteric capsules, nasal steroid, and oral antihistamine. The results showed that the response rate was 41.5% (22/53). The ratio of tympanometry C and TMM value differed significantly between responders and non-responders (P < 0.05), and the TMM value is the only predictive variable for treatment outcomes (P < 0.001, odds ratio 1.873). A ROC analysis of the TMM value for the treatment outcome showed that the area under the curve could achieve 0.773 (P < 0.001), while the optimal cutoff value calculated by Youden index was 1.5, with 72.7% sensitivity and 74.2% specificity. The response rate of ears with 2-6 TMM values could reach 66.7% (16/24), which was significantly higher than that of ears with TMM values 0-1, 20.7% (6/29) (P < 0.001). These findings showed that acute OME patients with a high TMM value and tympanometry C of the affected ear could potentially benefit from medication. The TMM value was an independent predictive factor of the treatment outcomes that could guide treatment decisions.