Correlation between ETDQ-7 questionnaire scores and objective tests of eustachian tube function in a cohort of screened individuals: a clinical retrospective study

BACKGROUND: The aim of this article is to investigate the correlation between subjective symptom scores obtained using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and objective measures of Eustachian tube (ET) function in a screened cohort of adult patients. METHODS: Ninety-six patients with normal tympanic membrane (TM) function and no ear-related symptoms assessed with the ETDQ-7 questionnaire, were selected and analyzed by undergoing standard routine diagnostic tests for ET function, including basal tympanometry alone and implemented with Valsalva and Toynbee maneuvers. The relationship between ETDQ-7 scores and objective findings was analyzed to determine concordance regarding ET dysfunction. RESULTS: Out of 96 patients, 26 were diagnosed with eustachian tube dysfunction (ETD). Only two of these patients had pathological ETDQ-7 scores, while 24 had normal scores. Among the 70 patients without ETD, 16 showed pathological ETDQ-7 scores, and 54 had normal scores. In our cohort, the ETDQ-7 demonstrated low sensitivity (7.7%) and positive predictive value (11.1%), indicating poor ability to identify ETD patients. Specificity was moderate (77.1%), and negative predictive value was 69.2%, suggesting limited accuracy in recognizing healthy subjects. CONCLUSIONS: The ETDQ-7 questionnaire showed a limited screening performance in reliability and accuracy for ETD in our study cohort. Its low sensitivity and positive predictive value indicate a high rate of false negatives and false positives. Therefore, our data suggests that ETDQ-7 should not be used alone for diagnosing ETD in screening settings, but rather in conjunction with objective assessments. These findings emphasize the need for integrated diagnostic approaches combining subjective and objective measures to improve ETD detection.