{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T20:49:51Z","timestamp":1791838191980,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Understanding the distinct subtypes of adhesive otitis media (AdOM) is crucial for appropriate treatment such as balloon Eustachian tuboplasty (BET), particularly in distinguishing between patulous and obstructive Eustachian tube (ET) function. Nevertheless, AdOM caused by patulous Eustachian tube dysfunction (ETD) remains underexplored. This study aims to describe the detailed characteristics and define the patulous type of AdOM associated with patulous ETD (PET).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A total of 62 ears of patients diagnosed with AdOM, PET, and traumatic perforation were included from a tertiary referral center (university hospital).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Obstructive\u2013AdOM, patulous\u2013AdOM, PET, and a control group with traumatic perforation patients underwent endoscopic examinations, completed symptom questionnaires, and had passive ET opening pressure evaluated using a modified inflation\u2013deflation test following tympanostomy tube insertion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patulous\u2013AdOM was identified in 43% of the patients and was characterized by significantly lower median opening pressures (222\u2009daPa) than those in patients with obstructive\u2013AdOM (400\u2009daPa) and PET (below 100\u2009daPa). Habitual sniffing was reported in 92.3% of patients with patulous\u2013AdOM, and reduced mastoid pneumatization was observed in both the patulous and obstructive subtypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Accurate differentiation between patulous\u2013AdOM and obstructive\u2013AdOM is essential because BET may exacerbate symptoms in patients with patulous characteristics. A comprehensive evaluation of ET function is critical before initiating treatment, underscoring the need for tailored approaches to manage AdOM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1169","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T08:53:36Z","timestamp":1739782416000},"page":"1633-1639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Eustachian Tube Dysfunction in Adhesive Otitis Media: Obstructive Versus Patulous Types"],"prefix":"10.1002","volume":"172","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9243-9392","authenticated-orcid":false,"given":"Seong Hoon","family":"Bae","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology Gangnam Severance Hospital, Yonsei University College of Medicine Seoul South Korea"},{"name":"Institute for Lee Won Sang Yonsei Ear Science Seoul South 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