Validating the clinical assessment of eustachian tube dysfunction: The eustachian tube dysfunction questionnaire (ETDQ-7)


  • Presented at the Spring Scientific Meeting of the American Rhinologic Society in Chicago, Illinois, U.S.A., April 28, 2011.

  • Dr. Paul Christos was partially supported by the following grant: Clinical Translational Science Center (CTSC) (UL1-RR024996). The authors have no other funding, financial relationships, or conflicts of interest to disclose.



Eustachian tube dysfunction (ETD) is a common condition that is associated with otologic and rhinologic symptoms. The complete assessment of ETD is limited without a valid symptom score. We developed and conducted initial validation of the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), a disease-specific instrument to assess symptoms with respect to ETD.

Study Design:

Validation study.


The ETDQ-7 was developed using standard survey methodology. The ETDQ-7 was completed by a group of 50 consecutive adult patients diagnosed with ETD and 25 non-ETD patients who served as a control group. Tympanometry was used as a criterion standard to distinguish the two groups. A subset of respondents repeated the ETDQ-7 at a time point 4 weeks later.


Content validity for the ETDQ-7 was established by focus group and review of the literature. Reliability testing indicated acceptable internal consistency for the entire instrument (Cronbach α = .71). The test–retest reliability indicated good correlation between the two questionnaires completed by the same patient 4 weeks apart (r = 0.78). The ETDQ-7 was able to discriminate between patients with ETD and those without (P < .001), indicating excellent discriminant validity.


The ETDQ-7 is a valid and reliable symptom score for use in adult patients with ETD that may facilitate clinical practice by highlighting the impact of ETD. Further testing is needed to determine its usefulness in assessing treatment response.