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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(04): s00451811253
DOI: 10.1055/s-0045-1811253
Original Research

Comparative Evaluation of Wet and Dry Swallowing in Assessing Eustachian Tube Function in Tympanic Membrane Perforation

Authors

  • Suresh Kruthika

    1   JSS Institute of Speech and Hearing, Mysuru, Karnataka, India

  • Jeevan Govindaraju 

    1   JSS Institute of Speech and Hearing, Mysuru, Karnataka, India

  • Hemanth N. Shetty 

    1   JSS Institute of Speech and Hearing, Mysuru, Karnataka, India

Funding The authors declare that they did not receive funding from agencies in the public, private, or non-profit sectors to conduct the present study.
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Abstract

Introduction

The Eustachian tube is a pressure-equalizing structure, also called the auditory tube, connecting the middle ear to the nasopharynx. Eustachian tube dysfunction is a leading cause of middle-ear infections leading to tympanic-membrane perforation. Therefore, it is necessary to assess the Eustachian tube functioning before determining the management to avoid recurrent middle-ear infections.

Objective

To compare the functional assessment of the Eustachian tube by measuring pressure changes in patients with tympanic-membrane perforation, during the Toynbee test. The effectiveness of wet versus dry swallowing, ease of swallowing, and test-retest reliability for both conditions were examined.

Methods

The study included 52 ears with tympanic-membrane perforations. The Toynbee test involved applying positive pressure to the ear canal while participants performed dry and wet swallowing maneuvers to measure the resulting pressure changes (in daPa). Subjective difficulty ratings were obtained using a 10-point Likert-scale for both swallowing conditions. Additionally, test-retest reliability for each swallowing condition was evaluated in 20 ears.

Results

The pressure changes observed between the open and closed phases during both swallowing conditions differed significantly. Wet swallowing exhibited a larger initial pressure change than dry swallowing (p < 0.001). Participants rated wet swallowing as significantly easier in contrast to dry swallowing. Additionally, the test-retest reliability for wet swallowing was good (intraclass correlation coefficient [ICC] = 0.737–0.876), while it was poor for dry swallowing (ICC = 0.282–0.350).

Conclusion

Wet swallowing reliably assesses the Eustachian tube's function in tympanic-membrane perforation cases to aid in informed decision making on the possible method of tympanoplasty.

Keywords

auditory tube - pressure change - perforation - tympanic membrane - ear infection

Authors' Contributions

HNS: conceptualization, data curation, formal analysis, methodology, writing – review & editing, supervision; JG: conceptualization, data curation, methodology, investigation, writing – original draft, writing – review & editing; SK: methodology, investigation, writing – original draft, writing – review & editing.


Data Availability Statement

Data will not be shared due to privacy and institutional policy.




Publikationsverlauf

Eingereicht: 03. Februar 2025

Angenommen: 20. Juni 2025

Artikel online veröffentlicht:
16. Oktober 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Suresh Kruthika, Jeevan Govindaraju, Hemanth N. Shetty. Comparative Evaluation of Wet and Dry Swallowing in Assessing Eustachian Tube Function in Tympanic Membrane Perforation. Int Arch Otorhinolaryngol 2025; 29: s00451811253.
DOI: 10.1055/s-0045-1811253