Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Development and Preliminary Evaluation of an Endoscopic Eustachian Tube Orifice Patency Score (ETOPS): A Pilot Study

Articles in Press

Document Type : Original

Author
Regin William
Department of Otorhinolaryngology Shri Sathya Sai Medical College and Research Institute Sri Balaji Vidyapeeth (Deemed to be University) Puducherry 607402, India.
10.22038/ijorl.2026.96623.4176
Abstract
Introduction:
Eustachian tube dysfunction (ETD) is a common condition that can lead to middle ear disorders and significantly affect quality of life. This study aimed to develop a novel Endoscopic Eustachian Tube Orifice Patency Score (ETOPS) and explore its potential relationship with ETD.
Materials and Methods:
In this prospective observational study, 40 adult patients presenting with symptoms suggestive of ETD underwent diagnostic nasal endoscopy using a 70° endoscope. The Eustachian tube nasopharyngeal orifice was graded using the newly proposed ETOPS. ETOPS values were compared with ETDQ-7 symptom scores and tympanometric findings.
Results:
A significant positive correlation was observed between ETOPS and ETDQ-7 scores (r = 0.74, p < 0.001). Inter-observer reliability was good (ICC = 0.89). Patients with Type B and Type C tympanograms demonstrated significantly higher ETOPS values than those with Type A tympanograms (p< 0.001).
Conclusion:
The proposed ETOPS may serve as a simple and reproducible endoscopic grading system for evaluating Eustachian tube dysfunction. Further validation using real patient data is required to establish its clinical utility.
Keywords
Eustachian Tube Dysfunction
Nasal Endoscopy
Tympanometry
Subjects
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Iranian Journal of Otorhinolaryngology

Articles in Press, Corrected Proof
Available Online from 26 August 2026