Eustachian Tube Balloon Dilation: Emerging Practice Patterns for a Novel Procedure

Micucci, Steven; Keschner, David B.; Liang, Jonathan

doi:10.1177/0003489418798858

Cited by 6 publications

(7 citation statements)

References 35 publications

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“…Surgical treatment of ETD via transnasal eustachian tube balloon dilation is becoming more widely employed as evidence continues to support its effectiveness 18 , 19 . The added value of eustachian tube dilation when performed concurrently with sinus surgery has not been well studied.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment of ETD via transnasal eustachian tube balloon dilation is becoming more widely employed as evidence continues to support its effectiveness. 18,19 The added value of eustachian tube dilation when performed concurrently with sinus surgery has not been well studied. Our findings suggest that the majority of patients undergoing ESS alone demonstrate significant long-term improvement in ETD symptoms.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Endoscopic Sinus Surgery on Eustachian Tube Dysfunction Symptoms

Chang

Hosseini

Song

et al. 2020

Otolaryngol.--head neck surg.

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Objective We assessed how eustachian tube dysfunction (ETD) changed with endoscopic sinus surgery (ESS) and identified factors associated with improvement. Study Design Retrospective chart review. Setting Academic center. Subjects and Methods Patients undergoing ESS for chronic rhinosinusitis with and without nasal polyposis (CRSwNP, CRSsNP) or recurrent acute rhinosinusitis (RARS) completed the Eustachian Tube Dysfunction Questionnaire 7 (ETDQ-7) preoperatively and postoperatively at 2 weeks, 6 weeks, 3 months, and 6 months. Included in analyses were demographics, comorbidities, Sinonasal Outcome Test 22 (SNOT-22), radiographic score, endoscopy score, procedure, and medication use. Regression analysis identified factors associated with improvement, defined as ΔETDQ-7 >3.5. Results In total, 302 patients were studied. ETD prevalence was 68% in CRSsNP, 48% in CRSwNP, and 88% in RARS. Patients with ETD had a mean baseline ETDQ-7 of 25.8 ± 8.0 and improved postoperatively at 2 weeks (19.9 ± 8.1, P < .001), 6 weeks (17.8 ± 9.3, P < .001), 3 months (16.8 ± 8.5, P < .001), and 6 months (16.4 ± 7.9, P < .001). At 6 months, ETD improved in 89% of patients with CRSsNP, 68% with CRSwNP, and 78% with RARS. On multivariate analysis, ETD improvement was associated with higher preoperative ETDQ-7 score (adjusted odds ratio [aOR], 1.12; 95% confidence interval [CI], 1.04-1.22; P = .030), higher preoperative SNOT-22 score (aOR, 1.02; 95% CI, 1.02-1.08; P = .001), higher preoperative SNOT-22 ear subscore (aOR, 1.27; 95% CI, 1.02-1.65; P = .034), posterior ethmoidectomy (aOR, 1.59; 95% CI, 1.22-4.92; P = .025), and postoperative corticosteroid spray use (aOR, 1.57; 95% CI, 1.17-1.66; P = .008). Conclusion ETD symptoms often improve following ESS. Factors associated with improvement include higher preoperative disease burden, posterior ethmoidectomy, and postoperative corticosteroid spray. Level of Evidence: 4

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Effect of Endoscopic Sinus Surgery on Eustachian Tube Dysfunction Symptoms

Chang

Hosseini

Song

et al. 2020

Otolaryngol.--head neck surg.

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“…Similarly, a US-based study by Micucci et al . 7 highlighted the need for higher level studies to ascertain the role of Eustachian tube balloon dilatation in the treatment of Eustachian tube dysfunction. Yet uptake of the procedure in the USA has been greater than in the UK, with 49.7 per cent ( n = 143) of US consultants surveyed by Micucci et al .…”

Section: Discussionmentioning

confidence: 99%

“…reported to be practising Eustachian tube balloon dilatation, compared to 23 per cent ( n = 31) of UK consultants in our current study. 7 The approval of the procedure by the Food and Drug Administration for the treatment of persistent Eustachian tube dysfunction may explain the discrepancy in uptake and experience levels between US and UK ENT surgeons, with only 23 per cent ( n = 33) of US consultants practising Eustachian tube balloon dilatation having performed less than five procedures, compared to 67 per cent ( n = 24) in the UK. 7…”

Section: Discussionmentioning

confidence: 99%

“…The main limitation of this study is the low response rate of 31.3 per cent, although this does compare favourably with the response rate reported in a similar web-based questionnaire study, of 9.1 per cent. 7 A further limitation is that the survey is limited to the ENT-UK membership and does not include the practice of those UK ENT consultants who are not members. The retrospective nature of this survey-based study subjects it to recall bias.…”

Section: Discussionmentioning

confidence: 99%

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Eustachian tube balloon dilatation: a cross-sectional, survey-based study of 137 UK consultants

Koumpa

Bowles

et al. 2019

J. Laryngol. Otol.

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ObjectiveTo explore the opinions of the UK consultant body on endoscopic Eustachian tube balloon dilatation in the context of Eustachian tube dysfunction.MethodA 10-question online survey was distributed to ENT consultants currently practising in the UK (July–September 2018).ResultsA total of 137 ENT consultants responded. Twenty-three per cent reported experience of Eustachian tube balloon dilatation, with a further 10 per cent planning to start performing the procedure. Of those performing the procedure, 16 per cent had more than two years’ experience. Thirty-two per cent were performing zero to five procedures a year. Eustachian tube balloon dilatation was primarily conducted to treat Eustachian tube dysfunction symptoms, as well as retraction pockets, baro-challenge-induced Eustachian tube dysfunction and otitis media with effusion. The most common reason for not undertaking Eustachian tube balloon dilatation was insufficient evidence of efficacy (65 per cent). Seventy-two per cent of consultants thought that creating a national database for audit and monitoring purposes would benefit the specialty.ConclusionThe majority of UK ENT consultants do not practise Eustachian tube balloon dilatation, citing a lack of high-level evidence to support its use. A national database for auditing and research could facilitate the creation of guidelines.

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