Management of Eustachian Tube Dysfunction: A Review

Bal, Rajeshwaree; Deshmukh, Prasad

doi:10.7759/cureus.31432

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Their lower incidence of side effects and shorter treatment duration also contribute to their higher response rates [ 32 ]. Mechanical treatments, while effective, may be less efficient due to their invasive nature and the requirement for longer treatment duration, possibly impacting patient compliance [ 3 ]. The lower effectiveness of alternative treatments might be due to the variability in modalities and the less direct impact on the Eustachian tube [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…ETD is characterized by symptoms such as ear fullness, pain, hearing loss, tinnitus, and recurrent ear infections. The condition can drastically impact the quality of life, leading to discomfort and communication difficulties [ 3 ]. While ETD can affect individuals of any age, its prevalence and manifestation vary widely among different demographic groups [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis

Alshehri,

Musleh

2024

Diagnostics

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Eustachian tube dysfunction (ETD) affects a significant portion of the population, manifesting symptoms that impact the quality of life. Despite the prevalence of ETD, there remains a notable gap in comprehensive studies exploring the condition’s dynamics within specific demographic contexts, particularly within Saudi Arabia. This study aimed to assess the prevalence and severity of ETD across different demographic groups, to evaluate the efficacy of various treatment modalities, and to identify key predictors of treatment response in a Saudi Arabian cohort. A cross-sectional study was conducted from June 2022 to May 2023 in tertiary care hospitals in the Aseer region, Saudi Arabia. Participants included adults diagnosed with ETD, assessed through clinical symptoms, otoscopic examinations, audiometric evaluations, tympanometry, and the ETDQ-7 questionnaire. The study incorporated advanced diagnostics such as nasopharyngoscopy and pressure equalization tube function tests and involved 154 participants, revealing significant variations in ETD severity, with the 46–60 age group exhibiting the highest mean ETDQ-7 score of 4.85, and urban residents displaying lower severity scores compared to rural counterparts. Pharmacological interventions were most effective, achieving the highest symptom relief and audiological improvement rates of 87.78%. Multivariate regression highlighted age, geographic location, and treatment modality as key predictors of treatment efficacy, with notable interaction effects between climate conditions and treatment types influencing outcomes. The findings underscore the heterogeneity in ETD presentation and the differential efficacy of treatment modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis

Alshehri,

Musleh

2024

Diagnostics

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“…Those requiring correction of the ear disease specially for the chronic/ refractory cases by means of ear surgery should have nasal and/or PNS pathology corrected first, if an ear surgery has to be successful. 8,9 Sino-nasal disease foci might affect the middle ear functions via two mechanisms. Firstly, if the pathological changes occur in the nasal and paranasal sinus mucosa, the normal secretion routes may undergo significant changes and the ciliary beat may get severely affected.…”

Section: Introductionmentioning

confidence: 99%

Impact of functional endoscopic sinus surgery on otologic symptoms associated with chronic rhinosinusitis

Deora¹,

Patel²,

Verma³

et al. 2023

Int J Otorhinolaryngol Head Neck Surg

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Background: The study was aimed at observing the impact of FESS on otologic symptoms associated with Chronic rhinosinusitis. Otitis media and other otologic symptoms develop frequently during the evolution of CRS. The evolution of middle ear disease in the setting of chronic rhino-snusitis possibly reflects the role of a dynamic conduit, eustachian tube, normal functioning of which, is crucial to keep the middle ear functions within physiologic limits. Methods: The study was conducted in the Department of Otorhinolaryngology, Jhalawar Medical College and SRG hospital, Jhalawar (Rajasthan) between August 2021 and November 2022. 53 patients of CRS with associated otologic symptoms were included in the study. Patients were subjected to functional endoscopic sinus surgery and septoplasty where relevant. Results: The majority of the study patients presented with ear discharge (72%), earache (41%) and ear fullness (41%). The most common sinusitis related symptoms were Nasal blockage (77%), frontal headache (53%) and nasal discharge (49%) with relatively lower proportion of post nasal drip (23%), facial pain (21%) and halitosis (15%). All participants were subjected to FESS which was combined with septoplasty and sub-mucous diathermy of the inferior turbinate where it was relevant. Patients were followed at 1st, 3rd and 6th week post-operatively. Conclusions: Majority of the patients (89%) shown a statistically significant subjective improvement in the otologic symptoms following the initial optimum medical therapy for the CRS. Endoscopic sinus surgery was found to improve symptoms on a statistically significant scale.

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First in vivo test of a biodegradable polymeric stent for the Eustachian tube in sheep

Winkelmann,

Lebahn,

Ezzat

et al. 2024

Front. Audiol. Otol.

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IntroductionEustachian tube dysfunction can cause inadequate ventilation of the middle ear and is therefore one of the main reasons for the development of chronic middle ear infections. This can significantly impact the quality of life. There is a variety of treatment options, but in most cases long-term success is limited. For this reason, stenting the Eustachian tube (ET) may be a safe and effective alternative. Biodegradable stents have been developed that support the impaired ET function until natural ventilation of the middle ear via the ET is restored, and dissolve after their function has been fulfilled.ObjectiveThe purpose of the current study was to investigate feasibility of implantation and degradation kinetics of biodegradable polymer stents in the ET.Study designThe study was set up as an orientation study.MethodsBiodegradable stents (diameter: 3.5 mm; length: 15 mm) were made from Poly-L-lactic acid (PLLA) in a dip-coating process and subsequent laser cutting and were crimped on a balloon catheter. Stent implantation into the ET was performed unilaterally in nine healthy female blackface sheep under endoscopic control with a dedicated insertion tool and an inflation pressure of 10 bar for 2 min. Ventilation of the middle ear was controlled by tympanometry weekly throughout the observation period of 3, 6, or 12 months (three animals each). After the final examination, cone beam computed tomography scans and histological examinations of the ETs were performed.ResultsAll stents could be inserted as planned. Pharyngeal orifices of all sheep were closed at half-time and final follow-up inspections. After 3 months, all stents were functional, but already showed first fragment formation. Six months after insertion, the stents had largely collapsed but still held open a residual lumen and after 12 months, the ETs were completely collapsed close to their natural shape. Fragments of various sizes were found distributed in the tissue beneath an epithelialized ET.ConclusionThe polymeric ET stent can be reliably positioned without generating a patulous ET. It seems to support ET function for about 3 months before functionality is lost.

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Management of Eustachian Tube Dysfunction: A Review

Cited by 3 publications

References 29 publications

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis

Comparative Efficacy of Different Therapeutic Interventions in Eustachian Tube Dysfunctions: A Cross-Sectional Analysis

Impact of functional endoscopic sinus surgery on otologic symptoms associated with chronic rhinosinusitis

First in vivo test of a biodegradable polymeric stent for the Eustachian tube in sheep

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