Balloon Dilation Of Eustachian Tube Research Articles

Balloon Dilation of the Cartilaginous Eustachian Tube

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Long-term effects of Eustachian tube balloon dilatation on patient symptoms and satisfaction

Long-term effects of Eustachian tube balloon dilatation on patient symptoms and satisfaction

Balloon dilation of the Eustachian tube: a tympanometric outcomes analysis.

BackgroundEustachian tube dysfunction (ETD) is a common medical issue, occurring in at least 1 % of the adult population. Patients suffering from ET dysfunction typically present with complaints of hearing loss or sensation of pressure or plugged ear, which can lead to impaired quality of life. Over time ETD can result in conductive hearing loss or choleastatoma formation. Effective theraputic options for ET dysfunction are few. Eustachian tube balloon dilation is a novel surgical technique being used to treat ETD.The aim of our study is to objectively measure the success of Eustachian tube balloon dilation by comparing pre and post-operative middle ear pressures using tympanometric testing.MethodsRA retrospective chart review was preformed on all patients who underwent balloon dilation of the Eustachian tube by authors NC or MB from 2010 to 2014. Pre and post-operative tympanograms were analyzed and categorized based on type (Type A, Type B, Type C). Success was defined by an improvement in tympanogram type: Type B or C to Type A, or Type B to type C. Pre and post-operative tympanograms were further analyzed using middle ear pressure values. Follow-up ranged from 3 to 15 months.ResultsTwenty-five ears (18 patients) were included in the study. Overall 36 % of ears had improvement in tympanogram type, and 32 % had normalization of tympanogram post-operatively. The Jerger tympanogram type improved significantly following the procedure (p = 0.04). Patients also had statistically significant improvement in measured middle ear pressure post-operatively (P = 0.003).ConclusionThe natural history of Eustachian tube dysfunction is poorly understood, and evidence for current treatments are limited. Eustachian tube balloon dilation is a safe procedure, and produces significant improvement in tympanogram values up to 15 months post-operatively. Further refinement of patient selection and standardization of technique is required to optimize the effect of this therapy. Longterm follow-up data will clarify the persistence of the effect.

Balloon dilation of the Eustachian tube: early outcome analysis.

To assess Eustachian tube balloon dilation in the treatment of Eustachian tube dysfunction by objective analysis, especially tubomanometry. Retrospective cohort study. Tertiary referral hospital. Patients undergoing Eustachian tube balloon dilation for treatment of Eustachian tube dysfunction. Eustachian tube balloon dilation. Subjective improvement, otomicroscopic findings, tympanogram, air-bone gap in pure-tone audiogram, R-value in tubomanometry at three pressure measurements (30, 40, and 50 mbar) and the Eustachian Tube Score (ETS). Eustachian tube balloon dilation was performed in 21 patients. The Eustachian Tube Score including the R-values, tympanogram, and air-bone gap all showed a statistically positive outcome (p < 0.005) after Eustachian tube balloon dilation. Subjective improvement was seen in 76%. Normal R-values were achieved in 57%. Retraction processes of the tympanic membrane improved in 18% of patients. Only one minor bleeding complication occurred. Eustachian tube balloon dilation constitutes a safe and very promising treatment option for patients with Eustachian tube dysfunction based on early-outcome analysis. ETS and specifically tubomanometry appear promising as assessment tools but await validation for use in the diagnostic workup and outcome analysis after ETBD. The pathophysiologic mechanism of Eustachian tube balloon dilation remains unclear. Long-term analysis and stratification of patients are needed to better evaluate the definite value of Eustachian tube balloon dilation.

Does balloon Eustachian tuboplasty increase the success rate in repair of subtotal tympanic membrane perforations with resistant tubal dysfunction?

ObjectivesTo evaluate the effect of balloon Eustachian tuboplasty on the results of surgical reconstruction of subtotal tympanic membrane perforations in cases of resistant Eustachian tube dysfunction. DesignProspective randomized study. SettingTertiary care university hospital. PatientsSeventy-two patients with dry subtotal tympanic membrane perforations and resistant Eustachian tube dysfunction, aging 19–51years, were distributed randomly in two groups A and B. InterventionsBoth groups underwent underlay myringoplasty using temporalis fascia graft. In group A, myringoplasty was preceded by balloon dilatation of the cartilaginous Eustachian tube. Main outcome measuresGraft take rate, hearing results and middle ear pressure. ResultsGraft take rate at 12months postoperative showed a significant difference between the two groups where it was 89.2% in group A (33 of 37 cases) and 80% in group B (28 of 35 cases). Pure tone audiometry results at 12months postoperative showed a significant improvement of air conduction curves at all frequencies in both groups. The middle ear pressure was significantly better in group A at 6months (mean pressure: −29daPa in group A, −60daPa in group B) and at 12months postoperative (mean pressure: −55daPa in group A, −79daPa in group B). ConclusionBalloon Eustachian tuboplasty is a safe, easy and effective procedure that yields better results in reconstruction of subtotal tympanic membrane perforations in cases of resistant Eustachian tube dysfunction.

Balloon Catheter Dilatation of Eustachian Tube

Eustachian tube dysfunction is a common problem and transnasal endoscopic balloon dilation of the Eustachian tube (ET) is a new surgical technique. The goal of this study is to review the evolution of this novel technique and study the preliminary outcomes. Balloon catheter dilation of the 100 Eustachian tubes in 70 adults was performed at a tertiary medical center from January 2009 to January 2011. A 5-mm sinus balloon catheter was endoscopically placed transnasally into the proximal ET to dilate the cartilaginous ET. Cases were reviewed with respect to indications, outcomes, and complications. Of the 100 ETs, ear fullness and pressure were improved in 71% of patients studied for 26.3 weeks (± 3.6). Of 8 patients followed for a minimum of 34 months, 87% reported persistent improvement. One complication is reported. Endoscopic transnasal ET balloon dilation is a novel approach to treating ET dysfunction. Benefits can be durable up to 3 years. This technique holds much promise and merits further investigation.

Eustachian tube balloon dilation surgery

Eustachian tube dysfunction (ETD) is a common condition without an effective, accepted treatment. Balloon dilation Eustachian tuboplasty (BDET) has been recently proposed for the management of ETD. Previous studies of Eustachian tube function and treatment have not included a validated assessment of patient symptoms. We report for the first time the outcomes of BDET using a validated disease-specific symptom score, the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Consecutive patients undergoing BDET were prospectively enrolled from an otolaryngology practice at a tertiary care medical center. Inclusion criteria were adults with a diagnosis of ETD based on symptoms and abnormal tympanogram. Patients with craniofacial abnormalities or active infection were excluded from study. Primary outcome measures included the ETDQ-7 score, tympanometry, and otoscopic appearance. Secondary measures included the 22-item Sinonasal Outcome Test (SNOT-22) score. Twenty-two consecutive patients underwent 35 BDET procedures. Significant postoperative improvement was seen in tympanometry and otoscopic appearance (p < 0.001). ETDQ-7 scores at 3 weeks, 6 weeks, 12 weeks, and 6 months postoperatively were significantly improved over baseline (p < 0.001). ETDQ-7 scores showed fair correlation with SNOT-22 scores (r > 0.65). ETDQ-7 change scores demonstrated good responsiveness and sensitivity to clinical change following BDET. BDET is an effective surgical intervention for the treatment of ETD in adults. Postoperative improvements were observed using objective and subjective measures. The ETDQ-7 is a valid, disease-specific instrument for the assessment of treatment outcomes and may be applied for clinical use in patients with ETD. Further study is necessary to determine long-term effectiveness.

Balloon Dilation of the Cartilaginous Eustachian Tube

(1) To translate techniques developed in a previous cadaver study of balloon dilation of the cartilaginous eustachian tube (ET) into clinical treatment for refractory dilatory dysfunction and (2) to study the safety/efficacy of the technique in a pilot clinical trial. Prospective with subjects as their own historical controls since June 2009. Regional academic center. Eleven consecutive adult patients with longstanding otitis media with effusion (OME) who were unable to autoinsufflate their ET by Valsalva, swallow, or yawn and who had previous tympanostomies (average, 4.7). At the time of intervention, 5 of 11 had a tube; 2 of 11 had a tympanic membrane (TM) perforation. Four of 11 had intact TMs, 2 with OME and tympanogram type B and 2 with TM retraction and tympanogram types B and C. Balloon dilation of the cartilaginous ET was performed with sinus dilation instruments via transnasal endoscopic approach under general anesthesia in a day surgery setting. Inflation was to a maximum of 12 atm for 1 minute. ability to Valsalva, rating of ET mucosal inflammation, tympanogram, and otomicroscopy findings. All cases successfully dilated. Eleven of 11 could self-insufflate by Valsalva (P < .001); tympanograms were A (4/11), C (1/11), or open (6/11). All atelectases resolved. Procedures were well tolerated, without pain or complications related to dilation. Dilation of the cartilaginous ET appeared to be beneficial and without significant adverse effects in the treatment of ET dilatory dysfunction. Larger controlled trials with long-term results are now justified and needed.

Balloon Dilation of the Cartilaginous Eustachian Tube

Free accessAbstractFirst published online August 2010Balloon Dilation of the Cartilaginous Eustachian TubeDennis Poe, MD, presenter and Juha Silvola, MD, PhDVolume 143, Issue 2_supplhttps://doi.org/10.1016/j.otohns.2010.06.133