Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty

Carlos Yanez,Nallely Mora,Sandra Velázquez

doi:10.4236/ijohns.2015.41002

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 of non-revision ChET for COETD. Follow-up period was 5 years. The inclusion criteria were persistent otitis media with effusion, conductive hearing loss of 5 or more years, and constant COETD related-symptoms. 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 = 0.010). 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 theHow to cite this paper: Yanez, C., Velázquez, S. and Mora, N. (2015) Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty
No bony dehiscence were recognized in the carotid canal and no opacification was seen in the bony portion
Mobility of the medial aspect of the ET seen during slow motion video analysis (SMVEA) improved notoriously the first year in 87% of the cases (105 patients) with good valve dilation

Summary

Introduction

Chronic obstructive Eustachian tube dysfunction (COETD) is a common disorder causing repeated visits to theHow to cite this paper: Yanez, C., Velázquez, S. and Mora, N. (2015) Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty. Hopf et al [1] proposed that intraluminal surgery improves Eustachian tube dysfunction using laser techniques. Metson and Kujawski [4] describe their preliminary results on Laser Eustachian Tuboplasty on 2003. We [5] described the laser-assisted cross-hatching Eustachian Tuboplasty (ChEt) and reported the preliminary results in 25 patients including a 15-month followup. Laser-assisted ChEt is being considered a minimally invasive surgical modality for COETD, further studies are required for determining whether it is alternative to COETD, instead of repeated tympanostomy tube placement in selected patients. We developed a Eustachian tube dysfunction numerical staging, as well as results reporting system that better assists in the analysis of Eustachian tube surgery [6]. We present here the outcomes of ET surgery in our personal clinical patient series

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Discussion

Conclusion