Endonasal dilatation of the Eustachian tube (EET) in children: feasibility and the role of tubomanometry (Estève) in outcomes measurement

Abstract

Studies on endonasal dilatation of the Eustachian tube (EET) utilizing a balloon catheter have shown encouraging results over the last years. This retrospective analysis presents our outcomes with EET in children with chronic obstructive dysfunction of the Eustachian tube, as well as the role of tubomanometry (TMM, Estève) as a diagnostic tool in the pre- and postoperative assessment of the Eustachian tube (ET) dysfunction. The data of 33 children, having undergone EET between September 2010 and March 2014, were retrospectively evaluated. They were assessed using tubomanometry before and after the EET. The R-data as the rate of Eustachian tube function in tubomanometry (TMM) were pre- and postoperatively matched with the clinical outcomes. Moreover, the patients' complaints before and after the procedure were analyzed. We did not see any EET-related complications in children. Most patients noticed a relief of their complaints. In the same time, tubomanometry was not able to show improved tube function or favorable postoperative changes in the R-data. Ear-related symptoms (e.g. otorrhea, otalgia, hearing loss) have been improved. EET is a feasible method in adults as well as in children to treat chronic tube dysfunction. However, tubomanometry does not seem to be the adequate tool to evaluate the tube function and thus the success rate of EET in children with chronic dysfunction of the Eustachian tube.

Balloon dilation for eustachian tube dysfunction: systematic review

“…15 Currently, there are 2 retrospective case series that describe eustachian tube balloon dilations in 33 children aged 5-14 years (mean, 9 years), 19 and in 66 children aged 4-14 years (mean, 8 years), 20 with no reported complications and an improvement in middle-ear symptoms.…”

Presentation and eustachian tube function test results in children evaluated at a specialty clinic

“…The recently introduced Eustachian Tube Score‐7 combines subjective parameters with objective measures, including tubomanometry results . Although these efforts are promising, the tubomanometer device is not available in most centers, and diagnostic accuracy has not been established, especially in the pediatric population …”

“…35 Although these efforts are promising, the tubomanometer device is not available in most centers, and diagnostic accuracy has not been established, especially in the pediatric population. 16,21 This report on the first 30 pediatric patients referred to a specialty clinic for ETD provides detailed information regarding their history, examination findings, and ETF test results. Results show a broad range of ETD manifestations, even though all were referred for ETF testing.…”

“…Increased interest in the management of ET dysfunction (ETD) has reached a new level with the recent approval by the Food and Drug Administration of a new device for balloon dilation of the ET (BDET) in adults . Pediatric use of this intervention has been advocated at professional meetings, and children have already been receiving BDET treatment (off‐label in the United States) around the world for years . This study discusses the clinical presentations, findings, and results of ETF tests in children evaluated for ETD at a specialty clinic and discusses the implications for BDET in this population.…”

Evidence and evidence gaps in the treatment of Eustachian tube dysfunction and otitis media

“…The subjective satisfaction was around 80% [107]. Even in children, balloon dilation is more and more often applied [54], [122]. …”