Cross-hatching Eustachian Tuboplasty Long Term Outcomes

Carlos Yanez Sandra L

doi:10.4172/2375-4427.1000123

Abstract

Objective: To review the long term outcomes of Cross-hatching Eustachian Tuboplasty (ChEt) in patients with Chronic Obstructive Eustachian Tube Dysfunction (COETD), as well as assess the clinical factors associated with surgical success. Study design: Retrospective case series review. Setting: Tertiary healthcare institution. Methods: This is a retrospective review by the senior author of all cases of non-revision ChEt for COETD. Follow-up period was 5 years. The curvature of the posterior cushion was modified using an argon laser to alter the spring of the cartilage alleviating the obstructed valve's aperture. Several clinical factors were reviewed in relation to the successful opening of Eustachian tube valve. Results: One hundred and twenty patients, 72 males/48 females, average age 42.4+2 years old, met study inclusion criteria. COETD patients/obstructive causes were: Posterior cushion hypertrophy, 68(56.6%). Tensor Veli and Levator Veli Palatini muscles hypertrophy, 15(12.5%). Remarkable mucosal hypertrophic disease, 37(30.8%). Total of ET tubes was 198. Bilateral 143(72.2%), 55 unilateral (27.7%) ET Valve was seen more open postoperatively on Simple Endoscopy (SE) and Slow Motion Video Analysis (SMVEA). There were no complications. Mean pure tone average improved by 20 dB postoperatively; P=0.015. Mean immitance changes in tympanometric measurements improved postoperatively at least 0.10 mmhos in 91% of the patients (P=.010). Resolution of symptoms was considered a successful outcome. Failure correlated with the severity of disease. Conclusion: High rates of improvement (96%) were achieved. ChEt is a promising technique for the treatment of COETD.

Highlights

Chronic Obstructive Eustachian Tube Dysfunction (COETD) is a common disorder causing repeated visits to the doctor’s office and substantial medical expenses
Cross-hatching Eustachian Tuboplasty (ChEt) is a promising technique for the treatment of COETD
Obstructive hypertrophy of the Tensor Veli Palatine Muscle (TVPM), Levatorveli Palatine Muscle (LVPM) and Sphenopharyngeous Muscle (SphM) areas was seen in 35 patients (29.16%)

Summary

Introduction

COETD is a common disorder causing repeated visits to the doctor’s office and substantial medical expenses. We [3] described the laser-assisted Cross-hatching Eustachian Tuboplasty (ChEt) and reported the preliminary results in 25 patients including a 15 month follow-up. Laser-assisted ChEt is being considered as a minimally invasive surgical modality for COETD, further studies are required for determining whether it is an alternative to COETD, instead of repeated tympanostomy tube placement in selected patients. We developed a Eustachian tube numerical staging, as well as a results reporting system that better assists in the analysis of Eustachian tube surgery [4]. This classification method is simple to use and contributes to a higher level of both intra- and inter-observer agreement in the assessment of COETD. This study reports on the validated outcomes of ET surgery in our personal clinical patient series

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Results

Discussion

Conclusion