Abstract:Endonasal ballon dilatation of the Eustachian tube (BET) is a promising treatment for Eustachian tube dysfunction with encouraging results over the last years in adults. In addition, in children, single studies demonstrated promising results, but revealed the necessity for broader and additional studies. Our retrospective analysis presents outcomes with BET in children with chronic obstructive dysfunction of the Eustachian tube, showing resistance to the conventional therapy after adenotomy with paracentesis o… Show more
“…Zudem fehlen Langzeitstudien, die den Nutzen der Tubendilatation über einen Zeitraum von mehr als einem Jahr aufzeigen. Jüngste Forschungsergebnisse weisen wiederum darauf hin, dass die Tubendilatation auch bei Kindern mit chronischer Belüftungsstörung, bei denen die Adenotomie mit Paukendrainagen in der Vorgeschichte keinen durchgreifenden Erfolg gebracht hat, eine vielversprechende Behandlungsoption darstellt [21]. Auch wenn die OMM oft jahrelang ohne subjektive Beschwerden besteht, kann sie in seltenen Fällen zu schwerwiegenden Komplikationen wie Fazialisparese, Mastoiditis oder gar Hirnabszess führen und sollte daher nach Möglichkeit stets behandelt werden.…”
A number of diseases of the middle ear are summed up under the term otitis media: acute otitis media, recurrent acute otitis media, otitis media with effusion, chronic suppurative otitis media and chronic otitis media epitympanalis (= cholesteatoma). Acute otitis media belongs to the most common pediatric diseases and is often caused by bacterial infection. Since the advent of pneumococcal vaccines the quantity of AOM caused by pneumococci has declined; vaccination against NTHi and Moraxella catarrhalis are being developed. Main pillar of conservative treatment of AOM is symptomatic therapy of otalgia and fever as well as restoring the Eustachian tubal function. When indicated, amoxicillin represents antibiotic medication of choice. Acute mastoiditis, facial nerve paresis, labyrinthitis, Gradenigo syndrome, sinus vein thrombosis, meningitis and brain abscess belong to the complications of AOM among others. Both innate and adaptive immune system are involved in recovery of OM with innate immunity playing a critical role. Dysfunction of the Eustachian tube often underlies OM. Manometric measurement of Eustachian tube function may be useful for indication of balloon Eustachian tuboplasty. Several theories explain pathogenesis of cholesteatoma and multiple pro-inflammatory processes promote its progress in the course of the disease.
“…Zudem fehlen Langzeitstudien, die den Nutzen der Tubendilatation über einen Zeitraum von mehr als einem Jahr aufzeigen. Jüngste Forschungsergebnisse weisen wiederum darauf hin, dass die Tubendilatation auch bei Kindern mit chronischer Belüftungsstörung, bei denen die Adenotomie mit Paukendrainagen in der Vorgeschichte keinen durchgreifenden Erfolg gebracht hat, eine vielversprechende Behandlungsoption darstellt [21]. Auch wenn die OMM oft jahrelang ohne subjektive Beschwerden besteht, kann sie in seltenen Fällen zu schwerwiegenden Komplikationen wie Fazialisparese, Mastoiditis oder gar Hirnabszess führen und sollte daher nach Möglichkeit stets behandelt werden.…”
A number of diseases of the middle ear are summed up under the term otitis media: acute otitis media, recurrent acute otitis media, otitis media with effusion, chronic suppurative otitis media and chronic otitis media epitympanalis (= cholesteatoma). Acute otitis media belongs to the most common pediatric diseases and is often caused by bacterial infection. Since the advent of pneumococcal vaccines the quantity of AOM caused by pneumococci has declined; vaccination against NTHi and Moraxella catarrhalis are being developed. Main pillar of conservative treatment of AOM is symptomatic therapy of otalgia and fever as well as restoring the Eustachian tubal function. When indicated, amoxicillin represents antibiotic medication of choice. Acute mastoiditis, facial nerve paresis, labyrinthitis, Gradenigo syndrome, sinus vein thrombosis, meningitis and brain abscess belong to the complications of AOM among others. Both innate and adaptive immune system are involved in recovery of OM with innate immunity playing a critical role. Dysfunction of the Eustachian tube often underlies OM. Manometric measurement of Eustachian tube function may be useful for indication of balloon Eustachian tuboplasty. Several theories explain pathogenesis of cholesteatoma and multiple pro-inflammatory processes promote its progress in the course of the disease.
“…13 Although the Eustachian tube is shorter in children than in adults, the ratio of the cartilaginous portion length to the osseous portion is 8:1 in an infant at the age of 3 months, and this ratio is 4:1 in an adult. 3,14 Thus, there is a low risk of balloon placement in the osseous part instead of the cartilaginous part due to the length of the balloon catheter.…”
Section: Discussionmentioning
confidence: 99%
“…recommended the use of balloon Eustachian tuboplasty as a second line treatment where paracentesis, ventilation tube insertion and adenoidectomy have not succeeded. 12,14 Otitis media with effusion, a middle-ear problem accompanied by fluid and mucus accumulation, commonly leads to hearing lossEustachian tube dysfunction is an important cause of otitis media with effusion in childrenBalloon Eustachian tube dilatation may be an effective and safe primary treatment method of otitis media with effusion in children…”
Section: Discussionmentioning
confidence: 99%
“…The most important disadvantage of the ventilation tube is that recurrent otitis media with effusion can be found in approximately 20–50 per cent of the treated children who then require reinsertion of the ventilation tube. 14,15…”
Section: Discussionmentioning
confidence: 99%
“…4 used the Eustachian Tube Dysfunction Questionnaire, Leichtle et al . 14 used the Lübecker questionnaire. This shows us that there is no standard and objective measurement method to measure the effectiveness of balloon Eustachian tuboplasty in children.…”
Objective
This study aimed to compare the outcomes of ventilation tube insertion and balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children.
Method
This was a retrospective evaluation of 62 children, 30 cases that underwent balloon Eustachian tuboplasty (group 1) and 32 cases that underwent ventilation tube insertion (group 2), from July 2016 to April 2018.
Results
The pre-operative air–bone gap of patients who underwent balloon Eustachian tuboplasty was 15–35 dB (mean: 27.6 ± 8.2 dB). The mean pre-operative air–bone gap decreased to 9.6 dB after a mean of 14.4 months (p < 0.05). The air–bone gap decreased from 25.6 dB to 17.6 dB in the ventilation tube group. There was a significant improvement in the air–bone gap values in both groups; however, this decrease was significantly higher in the balloon Eustachian tuboplasty group (p = 0.043).
Conclusion
Balloon Eustachian tuboplasty may be an effective and safe method for use as a first-line treatment of otitis media with effusion in children.
• Fluoroscopy-guided balloon dilation without general anaesthesia was well-tolerated in all patients. • Location of the balloon catheter can be monitored during the procedure. • Inflation state of the balloon catheter can be monitored during the procedure. • Using guide-wire during the procedure would prevent false passage creation. • All patients had clinical improvement within 3 months after balloon dilation.
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