Efficacy of balloon Eustachian tuboplasty combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction

Abstract

To evaluate the efficacy of balloon Eustachian tuboplasty (BET) combined with grommet insertion in the treatment of chronic dilation Eustachian tube dysfunction (CDETD). A retrospective study was performed in 19 patients with CDETD who underwent BET at the Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine, from October, 2014 to September, 2016. The ages of these patients ranged from 10 to 67 years. All the patients underwent the preoperative assessment of oto-endoscope, tympanometry, pure tone audiometry, fiber nasopharyngeal endoscopy, Eustachian tube pressure measurement (TMM), CT and MRI. These patients had failed to respond to medicine, multiple tympanic membrane puncture and at least 2 times grommet insertion before our study. BET was performed in 5 patients (5 ears), and BET+grommet insertionwas performed in other 14 patients (23 ears). The changes of Eustachian tube function in these patients was assessed using the Eustachian tube score (ETS) and Eustachian tube dysfunction questionnaire-7 (ETDQ-7) preoperatively and 1, 3, 6, 9 and 12 months after surgery, respectively. In addition, subjective symptoms including the difficulty level of valsalva, aural fullness and earache were assessed by visual rating scale (VAS score) preoperatively and at 1, 6, and 12 months after surgery. The mean scores before surgery were compared with that at 1, 3, 6, 9 and 12 months. Postoperative adverse reactions and complications were recorded, such as earache, nosebleeding and so on. Valsalva score and VAS score for aural fullness before surgery were 8.286±0.189 and 8.571±0.221, respectively. Valsalva score and VAS score for aural fullness were 3.714±0.317, 2.393±0.434, respectively, at one month after surgery, which were decreased significantly, as compared with the scores before surgery (P<0.05). VAS score at 6 months and 12 months after surgery were statistically significant compared with those before surgery (P<0.05). ETS score after surgery was significantly higher than that before surgery (P<0.05). ETDQ-7 score after surgery was significantly lower than that before surgery (P<0.05). The subjective satisfaction in these patients was 84.2%. BET is simple and safe, with fewer complications, and effective for the treatment of CDETD combined with grommet insertion.