Balloon tuboplasty in patients with Eustachian tube dysfunction: a prospective study in 39 patients (55 ears)

Bowles, Philippe; Agrawal, Satish C; Salam, Mohamed A. Abd El

doi:10.1111/coa.12812

Cited by 22 publications

(16 citation statements)

References 10 publications

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“…Two centres in the UK have published generally favourable short-term results in small groups of patients. 12,13 However, despite the potential for long-term Eustachian tube dysfunction management, many remain sceptical about balloon Eustachian tuboplasty.…”

Section: Introductionmentioning

confidence: 99%

Balloon Eustachian tuboplasty for Eustachian tube dysfunction: report of long-term outcomes in a UK population

et al. 2020

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BackgroundBalloon Eustachian tuboplasty is a surgical management option for Eustachian tube dysfunction; it has shown promising results in studies worldwide, but has had limited uptake in the UK. This study reports long-term outcomes for patients offered balloon Eustachian tuboplasty for chronic dilatory and baro-challenge-induced Eustachian tube dysfunction, and describes practical experience gained from its implementation.MethodsBalloon Eustachian tuboplasty was conducted in 25 patients (36 ears) with Eustachian tube dysfunction over three years. Information on presenting symptoms and signs, audiometric findings, tympanometry, and Eustachian Tube Dysfunction Questionnaire-7 scores were recorded pre- and post-operatively with a minimum follow up of one year.ResultsSixteen (64 per cent) of the 25 patients demonstrated symptom resolution after balloon Eustachian tuboplasty according to the Eustachian Tube Dysfunction Questionnaire-7. Fourteen (64 per cent) of the 22 patients with a type B or C tympanogram pre-operatively, had a type A trace post-operatively. Fifteen (75 per cent) of 20 patients with pre-operative conductive hearing loss showed improvement post-operatively, and 11 (50 per cent) of 22 patients with pre-operative middle-ear effusion or tympanic membrane retraction showed resolution.ConclusionBalloon Eustachian tuboplasty can improve subjective and objective measures of Eustachian tube dysfunction, and provide longer-term resolution.

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Section: Introductionmentioning

confidence: 99%

Balloon Eustachian tuboplasty for Eustachian tube dysfunction: report of long-term outcomes in a UK population

et al. 2020

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“…We hypothesized that image-guided navigation balloon catheter insertion may be a complementary method to the standard technique, because the balloon catheter tip can be identified during the procedure. It is critical to confirm the position of the catheter tip during BET, as a potential risk of the BET procedure is that a false passage may be created by the balloon catheter, especially when introducing the catheter tip [8,[17][18][19]. Although cadaveric studies have documented intentional dilation of the bone on postprocedural CT scans, this does not rule out the possibility of a micro-fracture along a bony canal [4,8].…”

Section: Discussionmentioning

confidence: 99%

Navigation-Assisted Balloon Eustachian Tuboplasty for Eustachian Tube Dilatory Dysfunction

Choi

Lee

et al. 2020

Clin Exp Otorhinolaryngol

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Objectives. Balloon Eustachian tuboplasty (BET) is a novel treatment method for Eustachian tube dilatory dysfunction (ETD). However, surgeons cannot identify the insertion depth of the catheter during BET, resulting in potential risks such as internal carotid artery (ICA) injury. Therefore, we developed an image-guided navigation balloon catheter to identify the insertion depth of the catheter and to establish awareness of the proximity of the ICA. This study aimed to evaluate the technical feasibility of this image-guided navigation balloon catheter system in patients with ETD.Methods. Twenty-nine patients (38 ears; nine bilateral; 21 right ears, and 17 left ears) diagnosed with ETD were assessed. All patients who showed no improvement despite medical therapy with topical steroids, anti-reflux medication, and the Valsalva maneuver for a minimum of 6 weeks received image-guided navigation-assisted BET. The 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score and Valsalva maneuver were used to evaluate patients’ symptoms preoperatively and at the postoperative follow-up.Results. Image-guided navigation-assisted BET was safely performed in all patients. The mean total ETDQ-7 score was 25.4±7.1 preoperatively, 17.5±6.2 at 1 month, and 15.2±7.0 at 6 months (<i>P</i><0.001). In total, a Valsalva maneuver was possible for 28 of 38 ears (73.7%) at the time of the patient’s final visit at 6 months post-procedure.Conclusion. Image-guided navigation balloon catheters are a potentially valuable tool in patients with ETD. Their use is also technically feasible and safe when performing BET to treat ETD.

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“…While Eustachian tube balloon dilatation has mainly been reported as a treatment for obstructive Eustachian tube dysfunction, 20 it has also been suggested as a potential treatment for adhesive otitis media with effusion, and as an adjunct to tympanomastoid surgery. 21 The indications reported for performing the procedure in UK practice were variable. Treatment of Eustachian tube dysfunction symptoms was the most common indication, followed by otitis media with effusion or obstructive Eustachian tube dysfunction, retraction pockets, and baro-challenge-induced Eustachian tube dysfunction symptoms (i.e.…”

Section: Discussionmentioning

confidence: 99%

Eustachian tube balloon dilatation: a cross-sectional, survey-based study of 137 UK consultants

Koumpa

Bowles

et al. 2019

J. Laryngol. Otol.

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ObjectiveTo explore the opinions of the UK consultant body on endoscopic Eustachian tube balloon dilatation in the context of Eustachian tube dysfunction.MethodA 10-question online survey was distributed to ENT consultants currently practising in the UK (July–September 2018).ResultsA total of 137 ENT consultants responded. Twenty-three per cent reported experience of Eustachian tube balloon dilatation, with a further 10 per cent planning to start performing the procedure. Of those performing the procedure, 16 per cent had more than two years’ experience. Thirty-two per cent were performing zero to five procedures a year. Eustachian tube balloon dilatation was primarily conducted to treat Eustachian tube dysfunction symptoms, as well as retraction pockets, baro-challenge-induced Eustachian tube dysfunction and otitis media with effusion. The most common reason for not undertaking Eustachian tube balloon dilatation was insufficient evidence of efficacy (65 per cent). Seventy-two per cent of consultants thought that creating a national database for audit and monitoring purposes would benefit the specialty.ConclusionThe majority of UK ENT consultants do not practise Eustachian tube balloon dilatation, citing a lack of high-level evidence to support its use. A national database for auditing and research could facilitate the creation of guidelines.

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Balloon tuboplasty in patients with Eustachian tube dysfunction: a prospective study in 39 patients (55 ears)

Cited by 22 publications

References 10 publications

Balloon Eustachian tuboplasty for Eustachian tube dysfunction: report of long-term outcomes in a UK population

Balloon Eustachian tuboplasty for Eustachian tube dysfunction: report of long-term outcomes in a UK population

Navigation-Assisted Balloon Eustachian Tuboplasty for Eustachian Tube Dilatory Dysfunction

Eustachian tube balloon dilatation: a cross-sectional, survey-based study of 137 UK consultants

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