Balloon dilation eustachian tuboplasty for dilatory dysfunction: Safety and efficacy analysis in an Australian cohort

Abstract

Background Eustachian tube dysfunction (ETD) is a common clinical condition encountered by otolaryngologists. The severity and duration of symptoms range from the mild and transient to the chronic and severe along with secondary pathologies. Balloon dilation eustachian tuboplasty (BDET) as a treatment, was first described in 2010 and has been studied extensively. This study evaluates the efficacy and safety of BDET in an Australian cohort. Methods Retrospective chart review on all patients who underwent BDET from September 2016 to March 2020 was performed. The Eustachian Tube Dysfunction Patient Questionnaire (ETDQ‐7) was chosen as the primary outcome measure. Secondary outcome measures included subjective global assessment of presenting symptoms, ability to perform Valsalva maneuver and tympanometry. Any complications related to the procedures were reported. Results One hundred and nineteen eustachian tube operations were included in this study. The patient cohort showed statistically significant improvement of mean EDTQ‐7 score from 0.7 to 2.9. Improvement in EDTQ‐7 was achieved in 83.9% of the cases. All patients in the baro‐challenge‐induced subgroup achieved improvement in ETDQ‐7 score. Complete resolution of symptoms with an ETDQ <2.1 was achieved in 37.1% of the cohort. There were no adverse safety events associated with the procedures. Conclusion BDET resulted in improvement of the EDTQ‐7 score in most of patients in this Australian cohort with no reported complications. BDET was most successful in baro‐challenge‐induced subgroup with universal improvement. Lower success rates were seen in patients with secondary pathology from their ETD.

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

“…Grommet insertions are traditional treatment for ETD and/ or recurrent/chronic otitis media because of the persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy, to re-establish ambientmiddle ear pressure, resolving inflammation, clearing effusions, and improve hearing, thus being the most commonly performed ambulatory procedure [26][27][28]. BET as a minimally invasive intervention first described in 2010 has been successfully investigated by randomized control trials and clinical studies in the past decade [29,30]. Considering BET surgery did not achieve significant symptom improvement of OM, the combination treatment with BET and Grommet insertion has been evaluated in OM [12,31,32] and ETD [19].…”

A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

“…The authors were contacted, but unfortunately, confirmation was not achieved. Ultimately, 11 publications were included in the systematic review 8,9,24,32–39 . Three publications were case reports and therefore were not included in the meta‐analysis 8,36,39 .…”

“…Ultimately, 11 publications were included in the systematic review. 8,9,24,[32][33][34][35][36][37][38][39] Three publications were case reports and therefore were not included in the meta-analysis. 8,36,39 A PRISMA diagram outlining the literature search is shown in Figure 1.…”

“…18 Three articles included patients with both BCETD and DETD. 24,32,35 Corresponding authors of these publications were contacted for release of data pertaining only to patients with BCETD when the relevant data had been combined with that of patients with dilatory dysfunction (see acknowledgements). 24,32 From the 11 publications, a total of 81 patients with 105 ears treated with ET procedures were included.…”

“…24,32,35 Corresponding authors of these publications were contacted for release of data pertaining only to patients with BCETD when the relevant data had been combined with that of patients with dilatory dysfunction (see acknowledgements). 24,32 From the 11 publications, a total of 81 patients with 105 ears treated with ET procedures were included. Ten of the 11 studies reporting on BDET included 72 patients.…”