The Usefulness of ETDQ-7 Score in Assessing ETD

Abstract

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.