Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial

Poe, Dennis S.; Anand, Vijay K.; Dean, Marc; Roberts, William H.; Stolovitzky, J. Pablo; Hoffmann, Karen K.; Nachlas, Nathan E.; Light, Joshua P.; Widick, Mark H.; Sugrue, John P.; Elliott, C. Layton; Rosenberg, Seth I.; Guillory, Paul; Brown, Neil Andrew; Syms, Charles A.; Hilton, Christopher; McElveen, John T.; Singh, Ameet; Weiss, Raymond L.; Arriaga, Moisés A.; Leopold, John

doi:10.1002/lary.26827

Cited by 119 publications

(185 citation statements)

References 26 publications

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“…New treatments for nonpatulous ETD, including balloon dilation, have generated renewed interest in the pathophysiology, treatment options, and prognosis for these patients. [5][6][7] Recent advances in diagnostic evaluation include a more rigorous evaluation and nuanced understanding of the eustachian tube orifice anatomy and dynamic function via nasal endoscopy, as well as more research-related diagnostic tests such as sonotubometry, tubomanometry, pressure chamber test, and inflation-deflation test. [8][9][10][11][12][13][14][15] The ETDQ-7 is a recently developed tool that more thoroughly and reproducibly evaluates ETD symptoms.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

et al. 2019

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Objectives/Hypothesis Ear fullness and pressure is a common complaint seen in otolaryngology clinics and frequently is attributed to eustachian tube dysfunction (ETD). In addition to traditional tympanometry and physical examination, the seven‐item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) has recently been used to aid in the diagnosis of ETD and to assess its severity. Temporomandibular joint disorder (TMJD) is a common condition that causes similar symptoms to ETD and has been recognized as a potential confounding condition in patients presenting with ETD symptoms. We sought to determine the cross‐sectional prevalence of ETD symptoms in patients with TMJD using the ETDQ‐7. Study Design Prospective cross‐sectional analysis. Methods An analysis was performed of ETDQ‐7 scores in patients diagnosed with TMJD. Results A total of 21 patients with confirmed TMJD completed the ETDQ‐7 at routine consult or follow‐up for their TMJD. The mean ± standard deviation ETDQ‐7 score for the cohort was 24.5 ± 12.5. Two‐thirds of patients had an ETDQ‐7 score of >14.5, which has been used in the literature to denote clinically significant ETD. No single question was scored significantly higher than the others. Conclusions Symptoms of ETD are highly prevalent among patients with TMJD determined by patient‐reported outcome measures. It is not clear if these symptoms reflect true derangement of eustachian tube function in these patients or whether there is only clinical similarity between ETD and TMJD. However, future research efforts may resolve this dilemma. Level of Evidence 4 Laryngoscope, 130:E233–E236, 2020

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Section: Discussionmentioning

confidence: 99%

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

et al. 2019

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“…The most notable improvement, aside from the patient's ability to return to symptom‐free diving operations, is the change in ETDQ‐7 scores from 5.6 (moderately severe symptoms) to 2.0, which is considered normal …”

Section: Discussionmentioning

confidence: 99%

Navy diver with recurrent facial nerve baroparesis treated with eustachian tube balloon dilation

Utz

Wise

2019

The Laryngoscope

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Facial nerve baroparesis is a rare complication of middle ear barotrauma reported almost exclusively in overpressure events related to diving and flying. Until the development of Eustachian tube balloon dilation, no diving compatible options existed to effectively and safely prevent recurrence. We present a case of a U.S. Navy diver with a history of repeated ipsilateral facial nerve paresis that occurred during diving. The patient underwent Eustachian tube balloon dilation of the affected side. Following surgery, the patient completed a recompression chamber simulated dive that allowed the patient to return to diving. The patient has been symptom-free for 12 months following dilation.

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“…Increased interest in the management of ET dysfunction (ETD) has reached a new level with the recent approval by the Food and Drug Administration of a new device for balloon dilation of the ET (BDET) in adults . Pediatric use of this intervention has been advocated at professional meetings, and children have already been receiving BDET treatment (off‐label in the United States) around the world for years .…”

Section: Introductionmentioning

confidence: 99%

“…13,14 Increased interest in the management of ET dysfunction (ETD) has reached a new level with the recent approval by the Food and Drug Administration of a new device for balloon dilation of the ET (BDET) in adults. 15 Pediatric use of this intervention has been advocated at professional meetings, and children have already been receiving BDET treatment (off-label in the United States) around the world for years. 16,17 This study discusses the clinical presentations, findings, and results of ETF tests in children evaluated for ETD at a specialty clinic and discusses the implications for BDET in this population.…”

Section: Introductionmentioning

confidence: 99%

Presentation and eustachian tube function test results in children evaluated at a specialty clinic

et al. 2018

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Objectives/Hypothesis Interest in eustachian tube (ET) dysfunction (ETD) has increased with the recent Food and Drug Administration approval of a new device for balloon dilation of the ET (BDET) in adults. However, children have been receiving BDET treatment with ET‐specific or sinus balloons around the world and off‐label in the United States for years. It is important, therefore, to understand the manifestations of and methods to verify ETD in children. Study Design Retrospective cross‐sectional study. Methods This is a retrospective study of clinical presentations and results of ET function (ETF) tests in children referred to the ETD clinic. An otorhinolaryngology exam, nasopharyngeal videoendoscopy of the ET orifices during swallow and maneuvers, and ETF tests, including inflation deflation, forced response test, and pressure chamber tests, were performed as applicable. Results Data for 30 children aged 6.2 to 17.3 years (mean = 12.9 ± 2.8 years) were analyzed. Of 60 ears, 19 (31.7%) had an intact tympanic membrane (TM), 16 (26.7%) had a patent and two had a blocked ventilation tube, and 23 (38.3%) had a TM perforation. Endoscopy of the nasopharynx revealed a large amount of secretions in 19/45 (42.2%); ET orifices and mucosal inflammation in 22/45 (48.8%); a large amount of adenoid tissue in the fossa of Rosenmuller was noted in 21/45 (46.7%). ETF tests revealed abnormal active function in 43/54 ears (79.6%) and abnormal passive function in 40/54 ears (74.1%). Conclusions ETD in children is often associated with residual or regrowth of adenoids and inflammation. Caution should be taken assigning a uniform phenotype and treatment prior to thorough evaluation and testing. Level of Evidence 4 Laryngoscope, 129:1218–1228, 2019

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Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial

Abstract: 1b. Laryngoscope, 128:1200-1206, 2018.

Cited by 119 publications

References 26 publications

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

The prevalence of eustachian tube dysfunction symptoms in temporomandibular joint disorder patients

Navy diver with recurrent facial nerve baroparesis treated with eustachian tube balloon dilation

Presentation and eustachian tube function test results in children evaluated at a specialty clinic

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