Cartilaginous Eustachian tube length and carotid canal dehiscence in children: a radiological study.

Abstract

The use of Balloon Eustachian tuboplasty (BET) for Eustachian tube dysfunction is increasing in adults but to a lesser extent in children. Despite growing experience, concerns remain that BET could theoretically cause carotid artery rupture, which may be more likely if there is carotid canal dehiscence adjacent to the bony Eustachian tube. This radiological study aims to assess the prevalence of carotid canal dehiscence and length of cartilaginous Eustachian tube in children. 75 consecutive computed tomography scans of the petrous temporal bones performed in children were identified (150 carotid canals/Eustachian tubes). Two independent raters measured the length of the cartilaginous Eustachian tube and thickness of carotid canal wall. 8% of carotid canals had radiological dehiscence. Prevalence of carotid canal dehiscence on either side per child was 12%. Mean cartilaginous Eustachian tube length was 24.5mm (SD 3.1mm) and the minimum measured was 14.1mm. The minimum length measured in a child over 3years old (n = 65) was 18.1mm. The mean thickness of bone of the carotid canal was 0.7mm (SD 0.27mm). There was a positive relationship between age and Eustachian tube length (Pearson's correlation coefficient = 0.622, p < 0.001). Carotid canal dehiscence in children has a low prevalence. Variation in the length of the cartilaginous Eustachian tube is low but is correlated with age. More research is required to define the indications, safety, efficacy and technical aspects of BET in children.