{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:13:54Z","timestamp":1789820034299,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Eustachian tube dysfunction (ETD) is traditionally classified as either patulous or obstructive. Recent evidence suggests that obstructive ETD may comprise a broad array of clinical presentations. This study aimed to define subtypes of obstructive ETD according to common clinical features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study included adults diagnosed with ETD at a single academic medical center between October 2014 and June 2022. Clinical data was recorded, including patient\u2010reported ETDQ\u20107 score, nasal endoscopy findings, tympanometry findings, medical comorbidities, timing of symptoms, symptom laterality and duration of ear fullness. Principle component analysis (PCA) was used to distinguish the most important clinical features and hierarchical cluster analysis was used to delineate symptom cluster groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 490 obstructive ETD patients, seven clinical characteristics were found to be the most important: duration, severity, laterality, constancy, sinusitis symptoms, history of pressure equalization tube, and comorbid reflux disease. Five phenotypic clusters were described by the clinical data, which were predictive of relative risk of comorbidity of sinusitis and GERD, as well as abnormality on endoscopy and tympanometry. Patients with bilateral symptoms had longer mean symptom duration than patients with unilateral symptoms (8.5 vs. 6.1\u2009months;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and patients with sinusitis symptoms were more likely to have bilateral symptoms compared to those without (76.6% vs. 59.1%; OR\u2009=\u20090.442 [95% CI: 0.330, 0.651];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our group has identified five data\u2010driven symptom cluster groups that may be translated into clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70502","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T08:50:30Z","timestamp":1774255830000},"page":"3416-3424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Phenotypic Subtypes of Obstructive Eustachian Tube Dysfunction as Defined by Cluster Analysis"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3853-4545","authenticated-orcid":false,"given":"Jenilkumar H.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan G. J.","family":"Green","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Ochsner Health  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manal S.","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven X.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tulane University School of Medicine  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1812-2105","authenticated-orcid":false,"given":"Edward D.","family":"McCoul","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tulane University School of Medicine  New Orleans Louisiana USA"},{"name":"Department of Otorhinolaryngology Ochsner Health  New Orleans Louisiana USA"},{"name":"Ochsner Clinical School, University of Queensland  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816683342"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819826959"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820932541"},{"key":"e_1_2_11_5_1","volume-title":"StatPearls","author":"Hamrang\u2010Yousefi S.","year":"2023"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2022.07.010"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30436"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820940219"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12475"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819848423"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23223"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22771"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22252"},{"issue":"5","key":"e_1_2_11_14_1","first-page":"1499","article-title":"Cluster Analysis and Prediction of Treatment Outcomes for Chronic Rhinosinusitis","volume":"138","author":"Soler Z. M.","year":"2016","journal-title":"Journal of Allergy and Clinical Immunology"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489419863822"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892420941706"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.12.1324"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13411"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.10.010"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0047287513496475"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0283885"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1945892420912366"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-023-01072-3"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13226731"},{"issue":"1","key":"e_1_2_11_25_1","first-page":"73","article-title":"Eustachian Tube Dysfunction in Chronic Rhinosinusitis: Pre and Post\u2010Operative Results Following Endoscopic Sinus Surgery, a Prospective Study","volume":"57","author":"Bowles P. F. D.","year":"2019","journal-title":"Rhinology"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin17.165"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10204689"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin21.209"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820917396"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200109000-00005"},{"issue":"5","key":"e_1_2_11_31_1","first-page":"602","article-title":"Analysis of Eustachian Tube Function by Video Endoscopy","volume":"21","author":"Poe D. S.","year":"2000","journal-title":"American Journal of Otology"},{"issue":"7","key":"e_1_2_11_32_1","article-title":"Unveiling the Potential: A Comprehensive Review of Dynamic Slow\u2010Motion Video Endoscopy for Eustachian Tube Dysfunction Evaluation","volume":"16","author":"Patil N.","year":"2024","journal-title":"Cureus"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70502","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T01:47:23Z","timestamp":1783907243000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":31,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/lary.70502"],"URL":"https:\/\/doi.org\/10.1002\/lary.70502","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]},"assertion":[{"value":"2025-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}