耳管開放症・耳管閉鎖不全の診療の実態ならびに耳鼻咽喉科医の意識に関するアンケート調査 Questionnaire survey regarding the diagnosis and treatment of patulous eustachian tube and insufficient closure of the eustachian tube in Japan
Introduction and methods: The severity of patulous eustachian tube (PET) and insufficient closure of the eustachian tube (ICET) varies in individuals. However, there are no definitions, diagnostic standards, or treatment guidelines for PET and ICET at present. To establish diagnostic standards and treatment guidelines for future use, preliminary research was conducted using a questionnaire sent to otorhinolaryngologists at 1198 clinics and hospitals nationwide.<BR>Results: The number of completed questionnaires recovery was 437, a response rate of 36.5%. 238 hospitals reported less than one new patient with PET or ICET per month. Moreover, 208 hospitals reported no regular outpatients. Only 17 hospitals reported 11 or more outpatients treated for PET or ICET. About 90% of the hospitals listed three symptoms as suggesting PET and ICET: autophony, aural fullness, and tympanophonia. In addition, about 15% listed hearing loss and tinnitus. The most common facts confirmed by physicians when PET or ICET is suspected were: past history of rapid weight loss, symptom changes with changes in posture, and synchronized movement of the eardrum with respiration as shown by microscopic examination. Most physicians made diagnosis on movement of the eardrum synchronized with respiration, and the results of the eustachian tube function test or the SR mode of impedance audiometry. There was no consensus about effective treatment and therapeutic gain in cases of PET. Prognosis of PET was thought to vary depending on each case. Most respondents replied that patients with obstruction of the eustachian tube were examined more often than those with PET or ICET.<BR>Conclusion: Although PET and ICET may be initially identified in many hospitals, treatment tends to be concentrated at certain hospitals due to referral to specialists. And then the eustachian tube function test is carried out at a limited number of hospitals, though symptoms indicating PET or ICET are commonly recognized by otorhinolaryngologists. Therefore, necessities of common diagnostic criteria, and a treatment guideline were highlighted from this questionnaire survey.
- Otology Japan
Otology Japan 17(3), 185-193, 2007-07-25
THE JAPAN OTOLOGICAL SOCIETY