Effectiveness of Kobayashi plug for 252 ears with chronic patulous Eustachian tube

Kikuchi, Toshiaki; Ikeda, Ryoukichi; Oshima, Hidetoshi; Takata, Iori; Kawase, Tetsuaki; Oshima, Takeshi; Katori, Yukio; Kobayashi, Toshimitsu

doi:10.1080/00016489.2016.1231420

Cited by 36 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17 Others have reported similar success using a transtympanic approach to the bony ET via an anterior tympanotomy or myringotomy to either occlude its lumen with an angiocatheter 13,16 or to place a shim. 12,15 In general, the surgeries were well tolerated, with no carotid artery injuries and a low rate of perioperative complications, mostly related to palate retraction during longer procedures such as PETR.…”

Section: Discussionmentioning

confidence: 96%

“…7 Surgical management of PETD can include addressing the middle ear by placing a tympanostomy tube, mass loading of the tympanic membrane, 10,11 or placing a transtympanic plug. [12][13][14][15][16] Other approaches address the nasopharyngeal end of the ET and include inserting an angiocatheter surrounded by bone wax for occlusion of the ET lumen, 8,9,17 augmentation with calcium hydroxyapatite cement, 18,19 surgically reconstructing the ET valve, 8,[20][21][22][23][24] or permanently obliterating the ET lumen. 20 Two recent systematic reviews showed a wide range of outcomes with heterogeneous study design, limiting the ability to compare groups.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Twelve‐month outcomes of Eustachian tube procedures for management of patulous Eustachian tube dysfunction

et al. 2018

View full text Add to dashboard Cite

Objective To determine the 12‐month effectiveness of transnasal–transoral endoscopic surgical procedures for eliminating symptoms of patulous Eustachian tube dysfunction (PETD). Study Design Retrospective chart review Methods Patients with medically refractory PETD underwent one of the following procedures: 1) shim (catheter) insertion, 2) calcium hydroxyapatite injection, 3) patulous Eustachian tube (ET) reconstruction, or 4) obliteration of the ET lumen. Time to recurrence of any PETD symptoms was recorded, and success was determined as complete symptom resolution at 12 months. The frailty model, an extension of the Cox proportional hazards model, was used for the survival analysis. Results A total of 241 procedures were performed in 80 patients. Median duration of symptom relief after surgery was 5.0 months (interquartile range [IQR]: 1.1–15.5 months) and varied by procedure type, ranging from 3.0 months (IQR: 0.7–7.0 months) for calcium hydroxyapatite injection to 20.6 months (3.4–35.9 months) for obliteration. Compared to shim insertion, the risk of 12‐month failure was significantly higher for calcium hydroxyapatite injection (hazard ratio [HR] = 2.18; 95% confidence interval [CI] 1.29, 3.67; P = 0.004) and patulous ET reconstruction (HR = 1.62; 95% CI 1.04, 2.52; P = 0.035). Patients undergoing shim insertion (52.2%) and obliteration (81.8%) were likely to require pressure equalization tubes or to have had otitis media with effusion. Conclusion Although all procedures potentially resulted in symptom resolution, placement of a shim or obliteration of the ET lumen was more likely to achieve 12‐month resolution of PETD symptoms and more likely to result in otitis media with effusion than hydroxyapatite injection or patulous ET reconstruction. Level of Evidence Level 4 Laryngoscope, 129:222–228, 2019

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Twelve‐month outcomes of Eustachian tube procedures for management of patulous Eustachian tube dysfunction

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Effectiveness of the surgery was evaluated based on clinical records on the final visit to the clinic (more than 3 months after operation, 3–18 months), as previously reported: 1) complete relief, 2) significant improvement (with occasional symptoms controlled by additional conservative treatment), 3) slight improvement (some improvement but definite residual symptoms requiring additional treatment), 4) unchanged, and 5) worse. Success was defined as a sum of complete relief and significant improvement.…”

Section: Resultsmentioning

confidence: 99%

“…11,12 Plugging of the ET was reported using a catheter, 13 angiocut catheter filled with bone wax, 14,15 cartilage, 16 and silicone plug. 3,4,17 The silicone plug (Kobayashi Plug ) has advantages over other materials due to its safety and exchangeability when necessary.…”

Section: Discussionmentioning

confidence: 99%

Endoscope‐assisted silicone plug insertion for patulous Eustachian tube patients

2017

Self Cite

View full text Add to dashboard Cite

“…However, most articles, except Poe's prospective study, were retrospective single‐center studies. We previously reported that the silicone plug (Kobayashi plug) induced long‐term effectiveness for over 80% of chronic and severe PET patients . The aim of this study was to test the efficacy and safety of the Kobayashi plug for patients with severe PET in a prospective multicenter trial.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a silicone plug for patulous eustachian tube: A prospective, multicenter case series

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objectives/Hypothesis: To report the efficacy and safety of transtympanic plugging of the eustachian tube (ET) using a silicone plug (Kobayashi plug) for chronic patulous ET (PET).Study Design: Prospective and multicenter trial conducted in which 30 PET patients were resistant to at least 6 months of conservative treatment.Methods: The efficacy and safety of 28 and 27 patients, respectively, were analyzed. All patients fulfilled inclusion and exclusion criteria. The primary end point used the patulous eustachian tube handicap inventory-10 (PHI-10), and the secondary end point used ET function tests such as sonotubometry, tubo-tympano-aerodynamic-graphy, and respiratory movement of the tympanic membrane and auscultation of voice sounds transmitted from the nose through the ET to the external auditory canal at 3months after surgery.Results: PHI-10 scores were 34.4 AE 4.2, 6.4 AE 9, and 5.7 AE 8.6 at screening, and 3 and 6 months after surgery. Twentythree cases (82.1%, 95% confidence interval: 63.1%-93.9%) were judged as successes. There were five cases (17.2%) of middle ear effusion, four cases (13.8%) of tympanic membrane perforation, and one case of tinnitus due to surgery to remove the plug. No severe or life-threatening complications were found.Conclusions: This study revealed the efficacy and safety of silicone plug insertion for severe PET patients.

show abstract

Effectiveness of Kobayashi plug for 252 ears with chronic patulous Eustachian tube

Cited by 36 publications

References 19 publications

Twelve‐month outcomes of Eustachian tube procedures for management of patulous Eustachian tube dysfunction

Twelve‐month outcomes of Eustachian tube procedures for management of patulous Eustachian tube dysfunction

Endoscope‐assisted silicone plug insertion for patulous Eustachian tube patients

Efficacy of a silicone plug for patulous eustachian tube: A prospective, multicenter case series

Contact Info

Product

Resources

About