Efficacy of Balloon Tuboplasty for Baro-Challenge-Induced Eustachian Tube Dysfunction: A Systematic Review and a Retrospective Cohort Study of 39 Patients

Abstract

ObjectiveBaro-challenge-induced Eustachian tube dysfunction (ETD) manifests due to inadequate Eustachian tube (ET) function during rapid ambient pressure changes, although ET function may be normal in normobaric situations. This systematic review and retrospective cohort study aimed to evaluate the effectiveness of balloon Eustachian tuboplasty (BET) for the treatment of baro-challenge-induced ETD.Data SourcesPubMed, the Cochrane Library, Scopus, and Helsinki University Hospital cohort.MethodsA systematic literature search was conducted in November 2020 and resulted in 174 articles. Eight articles fulfilled the inclusion criteria. Data was available altogether from 74 adult baro-challenge-induced ETD patients. In addition, we retrospectively evaluated 39 BET operations at Helsinki University Hospital from 2011 to 2020. Data from these 39 patients were collected from medical charts, and a questionnaire was sent to the patients. Meta-analysis was used to evaluate subjective symptom improvement, changes in ETD Questionnaire-7 (ETDQ-7) scores, and Valsalva maneuver performance.ResultsIn the systematic review, the outcome parameters varied between studies. Improvement was reported in subjective symptoms, Valsalva maneuver, ETDQ-7, tubomanometry, and pressure chamber test. Response rate for the Helsinki University Hospital cohort study was 72% (28/39). Mean follow-up time from the BET to the questionnaire was 4 years 8 months (SD 26months). Of those patients 93% (26/28) found the operation beneficial. Meta-analysis including up to 113 patients showed improvement in Valsalva maneuver, ETDQ-7, and improvement in subjective symptoms. Overall improvement in symptoms was noted in 81% of the patients.ConclusionBET seems to be effective in the majority of patients with baro-challenge-induced ETD.

Balloon Eustachian tuboplasty for obstructive Eustachian tube dysfunction: retrospective multicentre cohort study of 248 patients

“…With regards to this statement, there are not many publications analysing the results in the different groups of OETD. Few of them evaluated the results of BET in patients with CSOM [26][27][28][29][30], and some other in baro-challenge [31][32][33], including a systematic review [34]. Finally, to the best of our knowledge, there are not literature reports about BET in adhaesive otitis media as stand-alone treatment nor associated with other procedures such as cartilage tympanoplasty [35].…”