유스타키오관 기능 평가를 위한 발살바 수기의 대안으로서의 Popper 테스트
Evaluation of the Popper Test as an Alternative to the Valsalva Maneuver for Assessing Eustachian Tube Function
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Background and Objectives The Valsalva test, although commonly utilized to assess the Eustachian tube function, is limited by drawbacks such as inconsistent pressure increases in the nasal cavity. Thus we introduced the “Popper test,” a tympanic membrane inflation test using the automatic middle ear inflation device known as middle ear inflation device (MEID), to explore its viability as an alternative to the Valsalva test. Subjects and Method We sampled 80 ears from patients between June 1, 2023, and August 1, 2023. Each patient underwent both the Valsalva and Popper tests using the MEID. Partici- pants were divided into three categories: the “unable” group (patients who could not follow the Valsalva maneuver) and the “successful” and “unsuccessful” groups (patients whose at- tempts at the Valsalva or Popper tests either successed or failed). Success or failure was deter- mined using an otoscope to assess the bulging of the tympanic membrane. Results Of the 68 ears with normal middle ear pressure, 30.9% (21 ears) showed an inability to perform the Valsalva test, 45.6% (31 ears) successfully inflated the tympanic membrane via the Valsalva test, and 23.5% (16 ears) failed. Conversely, the Popper test resulted in an 88.2% (60 ears) success rate for inflating the tympanic membrane, with only 11.8% (8 ears) failing. Conclusion Variability observed in the Valsalva test outcomes may be attributed to individ- ual differences and the instructor’s technique. MEID, as utilized in the Popper test, offers a promising alternative to the Valsalva test, potentially enhancing the reliability by minimizing individual variation. However, the diagnostic performance may be dependent on the proper-ties of the MEID.
Abstract
Background and Objectives The Valsalva test, although commonly utilized to assess the Eustachian tube function, is limited by drawbacks such as inconsistent pressure increases in the nasal cavity. Thus we introduced the “Popper test,” a tympanic membrane inflation test using the automatic middle ear inflation device known as middle ear inflation device (MEID), to explore its viability as an alternative to the Valsalva test. Subjects and Method We sampled 80 ears from patients between June 1, 2023, and August 1, 2023. Each patient underwent both the Valsalva and Popper tests using the MEID. Partici- pants were divided into three categories: the “unable” group (patients who could not follow the Valsalva maneuver) and the “successful” and “unsuccessful” groups (patients whose at- tempts at the Valsalva or Popper tests either successed or failed). Success or failure was deter- mined using an otoscope to assess the bulging of the tympanic membrane. Results Of the 68 ears with normal middle ear pressure, 30.9% (21 ears) showed an inability to perform the Valsalva test, 45.6% (31 ears) successfully inflated the tympanic membrane via the Valsalva test, and 23.5% (16 ears) failed. Conversely, the Popper test resulted in an 88.2% (60 ears) success rate for inflating the tympanic membrane, with only 11.8% (8 ears) failing. Conclusion Variability observed in the Valsalva test outcomes may be attributed to individ- ual differences and the instructor’s technique. MEID, as utilized in the Popper test, offers a promising alternative to the Valsalva test, potentially enhancing the reliability by minimizing individual variation. However, the diagnostic performance may be dependent on the proper-ties of the MEID.