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

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.