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Aktueller Stand der Tubenfunktionsdiagnostik

Ein Update

Eustachian tube function tests

An update

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Zusammenfassung

Die Tubenfunktionsdiagnostik ist durch eine Reihe sehr unterschiedlicher Untersuchungsmethoden charakterisiert. In klinischen Studien liegen positive Ergebnisse mit einigen klinischen Tests sowie einer Reihe manometrischer Verfahren wie dem Nine-Step-Test vor. Die Aussagekraft der Tubenmanometrie nach Estève muss weiter abgeklärt werden. Insbesondere die MRT hat die Kenntnisse über die Funktion der Tube deutlich erweitert. Die Endoskopie und das Röntgenbild nach Schüller werden in der klinischen Routine regelmäßig eingesetzt. Die Druckkammer ist hervorragend geeignet, verschiedenste Untersuchungsbedingungen zu simulieren, sie wird jedoch nur experimentell eingesetzt. Die Sonotubometrie hat das Potenzial und die technische Reife zur breiteren klinischen Anwendung. Die Vielzahl der Untersuchungen zeigt, dass es nicht eine allein gültige Methode gibt. Kein Verfahren ist derzeit in der Lage, alle relevanten Aspekte der Tubenfunktion abzubilden. Obwohl sich in der Praxis einige Methoden durchgesetzt haben, muss ein allgemein akzeptierter Goldstandard für die Tubenfunktionsprüfung noch etabliert werden. Weitere klinische Studien sind notwendig, um ein entsprechendes Evidenzniveau für die unterschiedlichen Testverfahren zu erarbeiten.

Abstract

There are many diverse methods for the assessment of Eustachian tube (ET) function. Clinical studies have demonstrated good results for several clinical tests, tympanometry and a number of manometric approaches, such as the nine-step test. The relevance of tubomanometry according to Estève requires further investigation. MRI studies in particular have considerably enhanced our knowledge of ET function. Endoscopy and conventional Schüller radiography are routinely employed in the clinic. The pressure chamber is ideal for simulating the most diverse test conditions, but it is only used experimentally. Sonotubometry has both the potential and the necessary level of technical advancement for a broader clinical application. The majority of investigations have demonstrated that there is no single valid method. There is currently no technique available that is capable of reflecting all aspects of ET function. Although several methods have found clinical application, a commonly accepted golden standard for ET testing still has to be established. Further clinical studies are necessary to generate an adequate amount of data pertaining to the various ET function tests.

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  1. HNO Klinik des DIAKO Hospital Bremen, Gröpelinger Heerstr. 406–8, 28355, Bremen, Deutschland

    E.F.N. Di Martino

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Di Martino, E. Aktueller Stand der Tubenfunktionsdiagnostik. HNO 61, 467–476 (2013). https://doi.org/10.1007/s00106-013-2692-5

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