Histopathology of balloon‐dilation eustachian tuboplasty

Kivekäs, Ilkka; Chao, Wei; Faquin, William C.; Hollowell, Monica; Silvola, Juha; Rasooly, Tali; Poe, Dennis S.

doi:10.1002/lary.24894

Cited by 82 publications

(91 citation statements)

References 10 publications

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“…7 A recent study examining the histopathological changes associated with eustachian tube balloon dilation found that the balloon had a crushing effect on inflammatory cells within the eustachian tube mucosa while sparing the basal layer, rapidly replacing the inflamed mucosa with a fibrous scar. 7 One major concern of eustachian tube balloon dilation is the theoretical risk of injury to a dehiscent carotid artery running adjacent to the bony eustachian tube; 18 hence, computed tomography (CT) of the petrous temporal bones was routinely performed as a part of the pre-operative investigations. Abdel-Aziz et al 18 conducted a retrospective analysis of petrous temporal bone CT scans of 285 patients who underwent eustachian tube balloon dilation.…”

Section: Discussionmentioning

confidence: 99%

“…Its proposed mechanisms include mechanical dilation of the cartilaginous eustachian tube and initiation of histopathological changes to the mucosa that can alter the inflammatory process. 7 However, eustachian tube balloon dilation is a new procedure, and the operative technique needs to be verified for its efficacy and complications. This paper systematically reviews the available evidence on eustachian tube balloon dilation for treating chronic eustachian tube dysfunction.…”

Section: Introductionmentioning

confidence: 99%

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Balloon dilation for eustachian tube dysfunction: systematic review

2016

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Background: Eustachian tube dysfunction is a disorder for which there are limited medical and surgical treatments. Recently, eustachian tube balloon dilation has been proposed as a potential solution.Method: A systematic literature review was performed. Abstracts were selected for relevance, and pooled data analysis and qualitative analysis was conducted.Results: Nine prospective studies, describing 713 eustachian tube balloon dilations in 474 patients (aged 18-86 years), were identified. Follow-up duration ranged from 1.5 to 18 months. Ability to perform a Valsalva manoeuvre improved from 20 to 177 out of 245 ears following eustachian tube balloon dilation and, where data were reported in terms of patient numbers, from 15 to 189 out of 210 patients. Tympanograms were classified as type A in 7 out of 141 ears pre-operatively and in 86 out of 141 ears post-operatively.Conclusion: Prospective case series can confirm the safety of eustachian tube balloon dilation. As a potential solution for chronic eustachian tube dysfunction, further investigations are warranted to establish a higher level of evidence of efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Balloon dilation for eustachian tube dysfunction: systematic review

2016

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“…8 Limiting dilatation techniques to the cartilaginous portion has the added safety advantage of an increased distance buffer from the carotid artery. However, a competing school of thought is that both the cartilaginous and bony portions should be targeted in balloon dilatation of the eustachian tube.…”

Section: Introductionmentioning

confidence: 99%

Transtympanic balloon dilatation of the eustachian tube: systematic review

Jufas

Patel

2016

J. Laryngol. Otol.

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Objective: To investigate the evidence for balloon dilatation of the eustachian tube using a transtympanic approach.Methods: A systematic search of several databases was conducted (using the search terms 'dilation' or 'dilatation', and 'balloon' and 'eustachian tube'). Only studies that used a transtympanic approach for the procedure were included. These studies were then assessed for risk of bias.Results: Three studies were included. Each of these studies was a limited case series, with two performed on human subjects and one on human cadavers. Results of safety and efficacy are conflicting. There is a high risk of bias overall.Conclusion: At present, there is a very narrow evidence base for transtympanic balloon dilatation of the eustachian tube. There are a number of advantages and disadvantages of the technique. Previously identified and theoretical safety concerns will need to be addressed thoroughly in future studies prior to wider clinical use.

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“…В данном случае основным оценочным критерием являлось состояние барабан-ной перепонки [21]. В других исследованиях основ-ное внимание уделялось не тимпанометрическим данным, а пробе Вальсальвы, а также субъективной оценке состояния пациентов [22][23][24][25]. C нашей точки зрения, не менее важно определить, насколько бы-стро наступают или не наступают изменения в венти-ляции полости среднего уха.…”

Section: Discussionunclassified