Eustachian tuboplasty and shrinkage of ostial mucosa with new devices

Businco, L; Mario, Antonella Di; Tombolini, Mario; Mattei, Antonella; Lauriello, M

doi:10.1007/s00106-017-0346-8

Cited by 6 publications

(6 citation statements)

References 18 publications

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“…This means that more severe AR or a greater degree of nasal obstruction is more likely to cause ETD. Many patients with severe AR are prone to concomitant inferior turbinate hypertrophy [ 24 ] and torus tubarius swelling, causing both nasal obstruction and ETD [ 25 ]. Previous studies have shown that patients with nasal obstruction due to inferior turbinate enlargement or nasal septum deviation have significantly higher ETDQ-7 scores than healthy controls [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Eustachian tube dysfunction in patients with house dust mite-allergic rhinitis

Liang

Tian

et al. 2020

Clin Transl Allergy

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Background One of the important pathogeneses of eustachian tube dysfunction (ETD) is nasal inflammatory disease. The prevalence of allergic rhinitis (AR) in adults ranges from 10 to 30% worldwide. However, research on the status of eustachian tubes in AR patients is still very limited. Methods This prospective controlled cross-sectional study recruited 59 volunteers and 59 patients with AR from Sun Yat-sen Memorial Hospital. Visual analogue scale (VAS) scores for AR symptoms and seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores were collected for both groups. Nasal endoscopy, tympanography and eustachian tube pressure measurement (tubomanometry, TMM) were used for objective assessment. All AR patients underwent 1 month of treatment with mometasone furoate nasal spray and oral loratadine. Then, the nasal condition and eustachian tube status were again evaluated. Results TMM examination revealed that 22 patients (39 ears, 33.1%) among the AR patients and 5 healthy controls (7 ears, 5.9%) had abnormal eustachian pressure. Twenty-two AR patients (37.3%) and 9 healthy controls had an ETDQ-7 score ≥ 15. With regard to nasal symptoms of AR, the VAS scores of nasal obstruction were correlated with the ETDQ-7 scores, and the correlation coefficient was r = 0.5124 ( p < 0.0001). Nasal endoscopic scores were also positively correlated with ETDQ-7 scores, with a correlation coefficient of 0.7328 ( p < 0.0001). After 1 month of treatment, VAS scores of nasal symptoms, endoscopic scores and ETDQ-7 scores were significantly decreased in AR patients ( p < 0.0001), and TMM examination also suggested that eustachian tube function was significantly improved after treatment ( p < 0.0001). Conclusions AR patients, especially those with severe nasal obstruction, could have ETD. The local conditions of the pharyngeal orifices of the eustachian tubes are closely related to the symptoms of ETD. After treatment with nasal glucocorticoids and oral antihistamines, eustachian tube function can significantly improve as nasal symptoms subside. Trial registration Chinese Clinical Trial Registery (ChiCTR2000029071) Registered 12 January 2020—Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=48328&htm=4

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Section: Discussionmentioning

confidence: 99%

Eustachian tube dysfunction in patients with house dust mite-allergic rhinitis

Liang

Tian

et al. 2020

Clin Transl Allergy

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“…In the case of treatment for, or prophylaxis against, refractory CSF rhinorrhea via the ET, we envision an endonasal or lateral approach through the ET with introduction of a 14-gauge or 16-gauge semirigid microcatheter with flexible guidewire to cannulate and then obliterate the lumen from within; techniques for endonasal catheter delivery may build off of similar approaches to dilate the membranocartilaginous segment, such as described by Di Rienzo Businco et al 23 Such techniques would be useful for both otolaryngologists and neurosurgeons involved in lateral skull-based procedures involving the middle ear, as these practitioners already perform prophylactic middle ear and ET packing as components of these procedures. ET packing in this setting typically involves only obstruction of the tympanic orifice of the ET and destroys structures critical to hearing in the process.…”

Section: Discussionmentioning

confidence: 99%

Surgical Parameters for Minimally Invasive Trans–Eustachian Tube CSF Leak Repair: A Cadaveric Study and Literature Review

et al. 2019

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BACKGROUND:Cerebrospinal fluid rhinorrhea from a lateral skull base defect refractory to spontaneous healing and/or conservative management is most commonly managed via open surgery. Approach for repair is dictated by location of the defect, which may require surgical exploration. The final common pathway is the eustachian tube (ET). Endoscopic ET obliteration via endonasal and lateral approaches is under development. Whereas ET anatomy has been studied, surgical landmarks have not been previously described or quantified. We aimed to define surgical parameters of specific utility to endoscopic ET obliteration. METHODS:A literature review was performed of known ET anatomic parameters. Next, using a combination of endoscopic and open techniques in cadavers, we cannulated the intact ET and dissected its posterior component to define the major curvature position of the ET, defined as the genu, and quantified the relative distances through the ET lumen. The genu was targeted as a major obstacle encountered when cannulating the ET from the nasopharynx. RESULTS: Among 10 ETs, we found an average distance of 23 ± 5 mm from the nasopharynx to the ET genu, distance of 24 ± 3 mm from the genu to the anterior aspect of the tympanic membrane and total ET length of 47 ± 4 mm. CONCLUSIONS:Although membranous and petrous components of the ET are important to its function, the genu may be a more useful surgical landmark. Basic surgical parameters for endoscopic ET obliteration are defined.

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“…Eustachian tube dysfunction in cases of localized amyloidosis may be treated by balloon Eustachian tube dilation; however, it may lead to unsatisfactory results in our cases. Further surgical approaches in literature include Quantum Molecular Resonance mediated shrinkage of the mucosa of the torus tubarius [18], laser tuboplasty [19] and a microdebrider [20]. Contributing factors, such as gastroesophageal reflux with signs of mucosal inflammation, should be addressed.…”

Section: Case Report Discussionmentioning

confidence: 99%