The Usefulness of ETDQ-7 Score in Assessing ETD.

INTRODUCTION

The ETDQ-7 questionnaire has been validated for diagnosing Eustachian tube dysfunction (ETD) and a minimal clinically important difference (MCID) of > 3.5 has been suggested. We aim to assess the use of ETDQ-7 for assessing ETD and a potential correlation between ETDQ-7 and the Sino-Nasal Outcome Test 22 (SNOT-22).

METHODS

ETD was based on relevant ear symptoms and objective signs of negative middle ear pressure in 75 consecutive adult patients. Ventilation tube insertion (VTi) was performed on affected ears. ETDQ-7 and SNOT-22 scores before and 1 month after VTi were compared to 75 healthy controls.

RESULTS

Mean ETDQ-7 score decreased from 31.9 to 15.8 (p < 0.0001), remained stable on unaffected ears, and was 9.6 in controls. MCID was achieved on all affected ears after VTi. A cut-off score of > 14.5 for diagnosing ETD yielded 100% sensitivity and 94.2% specificity for ETDQ-7. Spearman's ρ for total score test-retest was 0.878 (p = 0.000). Cronbach alpha for total score varied from 0.6807 to 0.7266. SNOT-22 and ETDQ-7 were correlated at baseline (0.12, p = 0.012). ETD patients scored significantly higher in the nasal, otologic and sleep domains in SNOT-22 compared to controls.

CONCLUSION

ETDQ-7 is a very valid tool for ETD diagnostics and assessing the ear-related effects of VTi. ETDQ-7 scores reveal residual symptoms after VTi, indicating symptom relief but no cure for the underlying pathophysiology. For future investigation, we suggest assessing ETDQ-7 scores for each ear separately, higher MCID values, and integration of quality of life measures.

TRIAL REGISTRATION: ClinicalTrials.gov: NCT05055115.