Functional aspects of the Eustachian tube by means of 3D-modeling

Schuon, Robert; Schwarzensteiner, Josef; Paasche, Gerrit; Lenarz, Thomas; John, Samuel

doi:10.1371/journal.pone.0244909

Cited by 8 publications

(5 citation statements)

References 53 publications

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“…The reconstructed longitudinal view of the IVUS scans, as shown in Figure 4 with the corresponding circular views, was then compared with the 3D model and the corresponding histological sectional images of Schuon et al, 2021 [ 24 ] ( Figure 5 ). Based on this, the surrounding structures could be identified in the IVUS image.…”

Section: Resultsmentioning

confidence: 99%

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Intravascular Ultrasonography (IVUS)—A Tool for Imaging the Eustachian Tube?

et al. 2022

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The Eustachian tube (ET) has a key role in the pathogenesis of otitis media. Until now, there has been a lack of meaningful imaging methods to investigate the ET and its surrounding tissue. The aim of the current study was to investigate the possibilities of imaging the ET using Intravascular Ultrasonography (IVUS). ETs from sheep were scanned ex vivo and in vivo with different IVUS probes. In addition to native ETs, water was also used to improve coupling. Scans were subsequently compared with histological sections and a 3D model of the ET. In addition, ETs with a stenosis induced by a hyaluronic acid depot, after stent insertion, and during lower jaw movement were examined. The IVUS catheter was inserted into the ET lumen without any problems or injuries in all cases. The surrounding structures of the ET were identified in the ultrasound image. In addition, a change in size of the ET lumen due to movement was observed, and the position of the stent and the depot of hyaluronic acid could be examined. With the use of IVUS, a non-invasive possibility to examine the ET over its course with the adjacent structures as well as after different treatments is presented.

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Section: Resultsmentioning

confidence: 99%

“…The obtained scans were then compared with the histologic 3D model of the ovine ET by Schuon et al, 2021 [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Intravascular Ultrasonography (IVUS)—A Tool for Imaging the Eustachian Tube?

et al. 2022

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“…As the accuracy of the distances achieved with this method can be influenced by different parameters such as asymmetry of grinding or different degrees of hardness of the preparations [ 31 ], data sets from CBCT and histology were superimposed. This approach has successfully been used in processing the ET of a black-face sheep to generate a 3D model of the ET [ 32 ]. Here, the samples were sawed, but the general problem remains the same.…”

Section: Discussionmentioning

confidence: 99%

“…The stent is round by production and only resistance from the outside can cause any deviations from a round shape. Some rotation in tubal structures was observed in sheep with a rotation of the tubal cartilage by 38° [ 32 ] without having a stent implanted. The values in the current study on human donors were generally smaller (between 6° and 32°), but these were only collected for the stented parts of the ET.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Stent Prototypes for the Eustachian Tube in Human Donor Bodies

Rosenbusch,

Schuon,

Wilfling

et al. 2023

Bioengineering

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Chronic otitis media is often connected to Eustachian tube dysfunction. As successful treatment cannot be guaranteed with the currently available options, the aim is to develop a stent for the Eustachian tube (ET). Over the course of this development, different prototypes were generated and tested in ex vivo experiments. Four different prototypes of an ET stent and one commercially available coronary stent were implanted in the ET of seven human donor bodies. The position of the stents was verified by cone beam CT. The implanted ETs were harvested, embedded in resin and ground at 200 µm steps. Resulting images of the single steps were used to generate 3D models. The 3D models were then evaluated regarding position of the stent in the ET, its diameters, amount of squeezing, orientation of the axes and other parameters. Virtual reconstruction of the implanted ET was successful in all cases and revealed one incorrect stent placement. The cross-section increased for all metal stents in direction from the isthmus towards the pharyngeal orifice of the ET. Depending on the individual design of the metal stents (open or closed design), the shape varied also between different positions along a single stent. In contrast, the cross-section area and shape remained constant along the polymeric prototype. With the current investigation, insight into the behavior of different prototypes of ET stents was gained, which can help in defining the specifications for the intended ET stent.

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“…This procedure could be performed by one operator alone. The insertion depth of the cannula in this study was set to 12 mm, as this is half the length of the cartilaginous part of the ET of black face sheep [ 14 ], and the tubal cartilage is accompanying this entire length except for the first 1 or 2 mm [ 30 ]. As the ET narrows from the pharyngeal orifice towards the isthmus, generating a depot in the central region of the cartilaginous part should impede or at least disturb the natural function of the ET.…”

Section: Discussionmentioning

confidence: 99%

Development of an In Vivo Model for Eustachian Tube Dysfunction

Oppel

Ezzat

Krüger³

et al. 2022

Bioengineering

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Otitis media is often connected to Eustachian tube dysfunction (ETD). Until now, there was no large animal model available for the examination of new treatment methods such as stents for the Eustachian tube (ET). Thus, the aim of the study was to develop a method to reproducibly induce ETD by injection of fillers and without permanent closure of the ET. Tools for safe injection of hyaluronic acid (HA) in the surrounding of the ET were developed. In ex vivo experiments, HA mixed with Imeron® was injected close to the nasopharyngeal orifice of the ET of blackface sheep. The established depot was visualized using cone beam computer tomography and magnetic resonance imaging, and stents could be placed into the ET. A reliable position of the HA depot was achieved. This method was transferred to in vivo, and middle ear ventilation was investigated by tympanometry. ETD was achieved with amounts of 2.5 mL HA or higher. None of the animals showed any sign of discomfort or complications. The induced ETD lasted for 3 to 13 (maximum observation period) weeks and was also combined with middle ear effusion. A model of ETD based on injection of HA next to the ET was successfully established and is now available to test novel treatment options for ET functionality.

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Functional aspects of the Eustachian tube by means of 3D-modeling

Cited by 8 publications

References 53 publications

Intravascular Ultrasonography (IVUS)—A Tool for Imaging the Eustachian Tube?

Intravascular Ultrasonography (IVUS)—A Tool for Imaging the Eustachian Tube?

Investigation of Stent Prototypes for the Eustachian Tube in Human Donor Bodies

Development of an In Vivo Model for Eustachian Tube Dysfunction

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