Yes. Since the TympStar Pro was introduced, it has been capable of assessing Eustachian tube function for both intact and perforated tympanic membranes, with a work-around for performing patulous testing. With the release of TympStar Pro version 1.2, a patulous Eustachian tube test has been added as its own individual protocol with options to customize testing conditions.
Eustachian tube function can be assessed for the intact TM by obtaining a seal and running a series of three pressure sweeps with the patient drinking water between them. The TympStar Pro guides the user through the test sequence with on-screen instructions. A comparison is then made between the three peaks recorded to determine if there is a difference of 15-20 or more daPa between any of them to establish normal function.
Cases where the tympanogram tracings are nearly identical would be consistent with Eustachian tube dysfunction.
In cases where a patent PE tube or perforation of the TM has been verified, Eustachian tube function can be established by navigating to the ETF-Perforated test protocol. In this test, pressure is now graphed on the y axis, with time on the x axis. Options for recording out to 60 seconds are available in the test setting menu. As with the intact protocol, the TympStar Pro guides the user through the testing sequence. Pressure is established and the patient is instructed to drink water at intervals, while watching for a tracing that looks like a set of stairs to establish normal function.
If the pressure was unchanged during recording it would be consistent with abnormal Eustachian tube function.
With the recent release of firmware version 1.2, the TympStar Pro now has a dedicated test protocol for patulous Eustachian tube testing. Prior to V1.2, TympStar Pro users would navigate to reflex decay testing with contralateral stimulus selected and assess waveform morphology as the patient did a variety of respiration exercises. The contralateral probe is unplugged and/or not placed in the patient’s ear during testing, while the probe is used to establish a seal and record deflections at the level of the TM.
With this new dedicated test protocol, users will have the ability to record deflections under a variety of test conditions including Breathing Normal, Holding Breath, Breathing with one Nostril Closed, and Forced Respirations. These conditions can be customized using the TympStar Pro Configuration Application to suit individual preferences. Up to eight tracings can be recorded, with the ability to record more than one tracing under the same testing condition. Time base options extend out to 60 seconds in 15 second intervals.
Normal function is confirmed by very little change in deflection while the patient is performing the desired respiration during recording.
A rhythmic series of deflections recorded during forced respirations for example, as pictured below, would be consistent with a patulous Eustachian tube.