Tympanoplasty With or Without Balloon Eustachian Tuboplasty for Chronic Suppurative Otitis Media With Obstructive Eustachian Tube Dysfunction

Abstract

Objective: To further elucidate the role of balloon Eustachian tuboplasty (BET) in tympanoplasty, we conducted a study to compare the outcomes of tympanoplasty with and without BET for the treatment of chronic suppurative otitis media (CSOM) with obstructive Eustachian tube dysfunction (OETD). Study Design: Case control study. Setting: Tertiary referral center. Patients: A total of 70 ears diagnosed with CSOM (tubotympanic type) and OETD were included in this study. Thirty-five patients were prospectively enrolled for BET and tympanomastoidectomy between February 2018 and June 2019. Thirty-five control subjects were matched by sex and age and retrospectively enrolled for tympanomastoidectomy between July 2016 and January 2018. Interventions: BET, tympanomastoidectomy. Main Outcome Measures: The graft take rate, hearing levels, and Eustachian tube function test results. Results: The graft take success rate was higher in the BET group (80.0%; 28/35) than in the control group (68.6%; 24/35). However, the difference was not statistically significant. The average air-bone gap (ABG) improvement was 10.93 ± 7.70 dB in the BET group and 7.11 ± 8.08 dB in the control group, with a statistically significant between-group difference (p = 0.033). Conclusions: Our findings suggest that BET can objectively and subjectively improve the Eustachian tube function, with a slight but significant improvement in ABG despite the lack of a clinically significant improvement overall. However, it does not affect the graft take rate. In summary, BET could be used as an adjunctive procedure in the treatment of CSOM with OETD.

Balloon Eustachian Tuboplasty and Grommet Insertion: A Combined Surgical Treatment for Chronic Suppurative Otitis Media with Eustachian Tube Dysfunction

“…As demonstrated by Chen S et al, at 12 months after the operation, the ABG an important indicator of hearing status [ 33 ] in children having otitis media with effusion treated with BET combined with myringotomy and Grommet insertion was smaller than those treated with myringotomy alone [ 34 ]. Moreover, the average ABG improvement was found in patients with CSOM and OETD treating with the combination of tympanoplasty and BET when compared with the control subjects enrolled for tympanoplasty [ 15 ], suggesting both Grommet insertion and BET could improve the hearing ability. In our study, the ABG was decreased obviously in the BET + Grommet group at 6 and 12 months after the surgery, and the postoperative ABG in the BET + Grommet group was better than that in the BET group.…”

“…All CSOM-ETD subjects fulfilled the following inclusion criteria: (1) The patients were diagnosed as CSOM, a perforated tympanic membrane with persistent drainage from the middle ear lasting >6∼12 weeks [ 20 ]; (2) Patients were identified as severe ETD according to the Eustachian Tube Dysfunction Questionnaire (ETDQ‐7, a seven‐question survey, Table 1 ) with the total score of ≥14.5 (mean score ≥2.1) and the symptoms lasting more than 3 months [ 15 , 21 ]. Exclusion criteria: (1) Patients had previously undergone treatment; (2) Patients were due for revision procedure; (3) Patients had a congenital ear anomaly, a history of ear surgery within the past 6 months, a history of head and neck cancer, acute otitis media, refractory chronic rhinosinusitis, recent use of ototoxic medications, or pregnancy.…”

“…A previous study showed that simultaneous BET and hearing reconstruction surgery can effectively improve the hearing degree in CSOM-ETD patients with better Eustachian tube function [ 14 ]. Moreover, BET could be used as an adjunctive procedure in the treatment of CSOM with obstructive Eustachian tube dysfunction (OETD) [ 15 ]. The Grommets insertion (also known as ventilation or tympanostomy tubes) as one of the most common surgical procedures for OM [ 16 , 17 ] cannot directly resolve ETD being associated with several complications, such as infection, persistent perforation, and tympanosclerosis [ 18 ].…”

Management Options for Patients With Nasopharyngeal Carcinoma Undergoing Cochlear Implantation

“…Balloon dilation Eustachian tuboplasty has been used as an adjunctive procedure in the treatment of COM with ETD. 20 In our opinion, for patients with NPC having an inflamed ET, BET may provide some benefits in terms of clearing the mucociliary secretions of the middle ear to prevent such sequelae. The 2-stage operation or pre-CI surgery is necessary to achieve a safe and dry ear before CI.…”

Expanding Indications: Balloon Dilation of the Eustachian Tube for Patients Undergoing Surgery for Chronic Otitis Media

“…The rate of successful outcomes in this study was similar to those reported by previous studies of OETD [ 1 ]. A case-control study reported that patients who concurrently underwent BDET with tympanoplasty showed greater improvement in the air-bone gap than patients who underwent tympanoplasty without BDET (10.93±7.70 dB vs. 7.11±8.08 dB, P =0.033) [ 8 ]. Another prospective study reported favorable treatment outcomes of ETBD combined with cartilage tympanoplasty in patients with adhesive otitis media [ 9 ].…”