Balloon dilation of Eustachian tube combined with tympanostomy tube insertion and middle ear pressure equalization therapy for recurrent secretory otitis media

Yin, Gendi; Tan, Jingqian

doi:10.1016/j.joto.2019.05.003

Cited by 10 publications

(13 citation statements)

References 13 publications

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“…In our study, patients treated with BET and grommet insertion had a satisfying outcome in terms of their subjective symptoms and objective evaluations, and also achieved good results in eustachian tube function and structure, which is consistent with the findings of Yin et al (22). The quantitative examination peak pressure deviation of eustachian tube function significantly increased postoperatively (P<0.05), as did the ETS.…”

Section: Discussionsupporting

confidence: 90%

The effect of balloon dilatation eustachian tuboplasty combined with grommet insertion on the structure and function of the eustachian tube in patients with refractory otitis media with effusion

Mao

Hu³

et al. 2021

Ann Palliat Med

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Background: The treatments for refractory secretory otitis media with effusion usually choose long-term grommet insertion. This study evaluated the effect of balloon eustachian tuboplasty combined with grommet insertion on the function and the opening length of the eustachian tube in patients with refractory otitis media with effusion.Methods: Fifty-seven patients with refractory otitis media with effusion were enrolled. A threedimensional reconstruction of an iohexol-enhanced computed tomography image was applied to evaluate the structural and length changes of the eustachian tube at both resting and Valsalva maneuver states. The grommet was removed 3 months after the operation and postoperative follow-up was carried out from 3 to 12 months. We performed pre-and post-operative observation of the following: appearance of the tympanic membrane, pure-tone audiometry threshold, eustachian tube score, seven-item Eustachian Tube Dysfunction Questionnaire scores (ETDQ-7), quantitative examination of eustachian tube function dynamic observation of tympanogram peak pressure point, and computed tomography examination of the eustachian tube.Results: The pure-tone audiometry at 1, 3, 6, 9, and 12 months postoperatively were all significantly lower compared to the preoperative value (all P<0.05). There was no significant difference between the pure-tone audiometry at 6 and 9 months postoperatively, neither was for the air-bone conduction gap at these time points. The quantitative examination peak pressure deviation was markedly increased at 6 months postoperatively compared with that before the operation (all P<0.05). The peak pressure deviation of tympanometry at 6 and 9 months postoperatively were both higher than the value at 12 months after surgery (P<0.05). The eustachian tube score at 1, 3, 6, 9, and 12 months postoperatively were notably higher than that before the operation (all P<0.05). A significant difference was also observed between the 6-and 12-month postoperative eustachian tube score (P<0.05). There was a significant difference in the ETDQ-7 scores at 6-and 12-month postoperatively (P<0.05). The quantitative examination peak pressure deviation and eustachian tube score were both correlated with development length of the eustachian tube after threedimensional computed tomography reconstruction (P<0.05).Conclusions: Eustachian tube balloon dilatation combined with grommet insertion is an effective treatment for refractory otitis media with effusion.

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Section: Discussionsupporting

confidence: 90%

The effect of balloon dilatation eustachian tuboplasty combined with grommet insertion on the structure and function of the eustachian tube in patients with refractory otitis media with effusion

Mao

Hu³

et al. 2021

Ann Palliat Med

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“…Understanding ETDQ‐7 scores and tympanometry for a large cohort of individual patients presenting to an otolaryngology clinic would allow for a more robust assessment of the predictive power of ETDQ‐7. However, based upon the currently available evidence, it is unlikely that future studies would support the use of EDTQ‐7 scores as a substitute for tympanometry or other objective measures in diagnosing ETD 43‐47 …”

Section: Discussionmentioning

confidence: 99%

“…However, based upon the currently available evidence, it is unlikely that future studies would support the use of EDTQ‐7 scores as a substitute for tympanometry or other objective measures in diagnosing ETD. 43 , 44 , 45 , 46 , 47 …”

Section: Discussionmentioning

confidence: 99%

Predictive value of the Eustachian Tube Dysfunction Questionnaire‐7 for identifying obstructive Eustachian tube dysfunction: A systematic review

Andresen

Sharon

Nieman

et al. 2021

Laryngoscope Investig Oto

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Objective To perform a systematic review to determine if a total score of ≥14.5 (mean score ≥ 2.1) on the ETDQ‐7 accurately identifies patients with obstructive Eustachian tube dysfunction (OETD) on impedance tympanometry (peak compliance <0.2 mL or middle ear pressure of −100 daPa) or other objective measures of OETD. Methods A systematic review without a meta‐analysis was performed of studies in four electronic databases (Pubmed, Embase, Web of Science, and Scopus) that used the ETDQ‐7 and at least one objective measure of OETD. Results Six‐hundred and fifty‐two studies were identified in the initial literature search. Abstracts from 337 studies were screened, followed by full‐text review of 61 studies, and qualitative synthesis of 12 studies. Tympanometry was used as an objective measure in ten studies. Eight of the 12 included studies had patient cohort selection bias. Eight studies administered the ETDQ‐7 in cohorts of patients with or without OETD, already confirmed on tympanometry, and found a sensitivity of 91%‐100% and specificity of 67%‐100%. Four studies administered the ETDQ‐7 to patients who had not previously undergone objective testing and found a sensitivity of 49%‐80% and specificity of 24%‐78%. Conclusions The ETDQ‐7 is an important patient‐reported outcome measure. However, based upon existing literature, the ETDQ‐7 appears limited as a diagnostic tool for OETD or as an objective measure of Eustachian tube function.

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“…Selection bias may have influenced this difference as patients with more severe pathology were directed toward the OR. In addition, when FESS with ethmoidectomy or tympanic membrane repair were performed, patients were asked to refrain from Valsalva or nose-blowing for 2 weeks, which might affect the early aeration of the ET 20. Prior studies have reported limitations in performing BDET due to pain.…”

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confidence: 99%

Comparison of outcomes for balloon dilation of the Eustachian tube under local vs general anesthesia

Toivonen

Dean

Kawai

et al. 2022

Laryngoscope Investig Oto

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Objective To compare the effectiveness of balloon dilation of the Eustachian tube (BDET) under local versus general anesthesia in the treatment of obstructive Eustachian tube dysfunction (OETD). Study Design Retrospective review. Methods Consecutive patients ages ≥18 with persistent OETD having failed adequate medical therapy underwent BDET between 2013 and 2018 under local or general anesthesia. Inclusion criteria were persistent type B or C tympanograms with symptoms or type A with symptoms upon barochallenge. Objective outcome measures were tympanometry, otoscopy and the need for additional subsequent intervention (revision dilation and tympanostomy tube). Primary outcome (failure) was defined as no change or worse in tympanogram. Results The 191 patients (332 ETs), ages 18–88 years (mean 58.0) underwent BDET. The 112 patients (59%) were female. The 107 procedures (32%) were performed under local anesthesia. Mean duration of follow‐up was 3.1 years (SD 1.9). Tympanograms improved to type A in 88% for BDET under local and 74% for general anesthesia at 12 months. Probability of being failure‐free at 5 years was 70% (95% confidence interval [CI]: 52%–82%) in the local anesthesia group versus 65% (95% CI: 55%–73%) in the general anesthesia group. Risk of failure did not significantly differ between the groups (HR = 0.60; 95% CI: 0.27–1.31; p = .20). Conclusion BDET under local anesthesia is effective in treating OETD and results in sustained improvements over 2 years. The procedure was successfully performed in all but one case utilizing a precise anesthesia protocol, and results are comparable with the procedure performed under general anesthesia. Level of evidence 4

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Balloon dilation of Eustachian tube combined with tympanostomy tube insertion and middle ear pressure equalization therapy for recurrent secretory otitis media

Cited by 10 publications

References 13 publications

The effect of balloon dilatation eustachian tuboplasty combined with grommet insertion on the structure and function of the eustachian tube in patients with refractory otitis media with effusion

The effect of balloon dilatation eustachian tuboplasty combined with grommet insertion on the structure and function of the eustachian tube in patients with refractory otitis media with effusion

Predictive value of the Eustachian Tube Dysfunction Questionnaire‐7 for identifying obstructive Eustachian tube dysfunction: A systematic review

Comparison of outcomes for balloon dilation of the Eustachian tube under local vs general anesthesia

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