Outcome of Balloon Eustachian Tuboplasty in SCUBA Divers

Ungar, Omer J.; Cavel, Oren; Oron, Yahav; Tsur, Nir; Handzel, Ophir

doi:10.1177/0145561320933957

Cited by 8 publications

(20 citation statements)

References 24 publications

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“…This study suggests that patients with baro‐challenged‐induced ETD can achieve good results from the procedure. This finding is consistent with other published series involving the clinical results of BDET in SCUBA divers and military divers and aviators 29,30 …”

Section: Discussionsupporting

confidence: 93%

Balloon dilation eustachian tuboplasty for dilatory dysfunction: Safety and efficacy analysis in an Australian cohort

Cheng

Saxby

Jufas

et al. 2021

ANZ Journal of Surgery

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Background Eustachian tube dysfunction (ETD) is a common clinical condition encountered by otolaryngologists. The severity and duration of symptoms range from the mild and transient to the chronic and severe along with secondary pathologies. Balloon dilation eustachian tuboplasty (BDET) as a treatment, was first described in 2010 and has been studied extensively. This study evaluates the efficacy and safety of BDET in an Australian cohort. Methods Retrospective chart review on all patients who underwent BDET from September 2016 to March 2020 was performed. The Eustachian Tube Dysfunction Patient Questionnaire (ETDQ‐7) was chosen as the primary outcome measure. Secondary outcome measures included subjective global assessment of presenting symptoms, ability to perform Valsalva maneuver and tympanometry. Any complications related to the procedures were reported. Results One hundred and nineteen eustachian tube operations were included in this study. The patient cohort showed statistically significant improvement of mean EDTQ‐7 score from 0.7 to 2.9. Improvement in EDTQ‐7 was achieved in 83.9% of the cases. All patients in the baro‐challenge‐induced subgroup achieved improvement in ETDQ‐7 score. Complete resolution of symptoms with an ETDQ <2.1 was achieved in 37.1% of the cohort. There were no adverse safety events associated with the procedures. Conclusion BDET resulted in improvement of the EDTQ‐7 score in most of patients in this Australian cohort with no reported complications. BDET was most successful in baro‐challenge‐induced subgroup with universal improvement. Lower success rates were seen in patients with secondary pathology from their ETD.

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Section: Discussionsupporting

confidence: 93%

Balloon dilation eustachian tuboplasty for dilatory dysfunction: Safety and efficacy analysis in an Australian cohort

Cheng

Saxby

Jufas

et al. 2021

ANZ Journal of Surgery

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“…Understanding ETDQ‐7 scores and tympanometry for a large cohort of individual patients presenting to an otolaryngology clinic would allow for a more robust assessment of the predictive power of ETDQ‐7. However, based upon the currently available evidence, it is unlikely that future studies would support the use of EDTQ‐7 scores as a substitute for tympanometry or other objective measures in diagnosing ETD 43‐47 …”

Section: Discussionmentioning

confidence: 99%

“…However, based upon the currently available evidence, it is unlikely that future studies would support the use of EDTQ‐7 scores as a substitute for tympanometry or other objective measures in diagnosing ETD. 43 , 44 , 45 , 46 , 47 …”

Section: Discussionmentioning

confidence: 99%

Predictive value of the Eustachian Tube Dysfunction Questionnaire‐7 for identifying obstructive Eustachian tube dysfunction: A systematic review

Andresen

Sharon

Nieman

et al. 2021

Laryngoscope Investig Oto

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Objective To perform a systematic review to determine if a total score of ≥14.5 (mean score ≥ 2.1) on the ETDQ‐7 accurately identifies patients with obstructive Eustachian tube dysfunction (OETD) on impedance tympanometry (peak compliance <0.2 mL or middle ear pressure of −100 daPa) or other objective measures of OETD. Methods A systematic review without a meta‐analysis was performed of studies in four electronic databases (Pubmed, Embase, Web of Science, and Scopus) that used the ETDQ‐7 and at least one objective measure of OETD. Results Six‐hundred and fifty‐two studies were identified in the initial literature search. Abstracts from 337 studies were screened, followed by full‐text review of 61 studies, and qualitative synthesis of 12 studies. Tympanometry was used as an objective measure in ten studies. Eight of the 12 included studies had patient cohort selection bias. Eight studies administered the ETDQ‐7 in cohorts of patients with or without OETD, already confirmed on tympanometry, and found a sensitivity of 91%‐100% and specificity of 67%‐100%. Four studies administered the ETDQ‐7 to patients who had not previously undergone objective testing and found a sensitivity of 49%‐80% and specificity of 24%‐78%. Conclusions The ETDQ‐7 is an important patient‐reported outcome measure. However, based upon existing literature, the ETDQ‐7 appears limited as a diagnostic tool for OETD or as an objective measure of Eustachian tube function.

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“…The authors were contacted, but unfortunately, confirmation was not achieved. Ultimately, 11 publications were included in the systematic review 8,9,24,32–39 . Three publications were case reports and therefore were not included in the meta‐analysis 8,36,39 .…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

et al. 2022

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Objective: To examine the effectiveness of Eustachian tube procedures for the treatment of baro-challenge Eustachian tube dysfunction.Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, databases, including PubMed (National Library of Medicine, National Institutes of Health), Scopus (Elsevier), and CINAHL (EBSCO), were searched for articles examining the effectiveness of Eustachian tube procedures for baro-challenge Eustachian tube dysfunction. Outcome measures included symptom resolution, ability to return to work, equalization problems (EP) scores, Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores, and pressure chamber testing parameters. Pooled meta-analysis was performed for dichotomous measures and ETDQ-7 scores.Results: Eleven articles with 81 patients were included. Seventy-two patients from 10 articles underwent balloon Eustachian tube dilation; nine patients in 1 study underwent laser Eustachian tuboplasty (LET). All 81 patients were preoperatively symptomatic with barometric pressure change, and 26/30 (86.7%) were unable to work due to symptoms. On meta-analysis, after balloon dilation Eustachian tuboplasty (BDET), 82.5% (n = 30 [95% confidence interval: 42%-100%]) had improvement in ability to valsalva, 79.1% (n = 16 [57.9%-94.1%]) in ability to return to work, and 84.3% (n = 69 [69.8%-94.7%]) in any symptom. Of 25 patients with individual ETDQ-7 scores, 79.1% [51.4, 96.9] had improvements after BDET. For four case series with 36 patients, ETDQ-7 scores decreased by 1.2 [0.7, 1.7] (p < 0.00001). Of 20 patients with preoperative ETDQ-7 scores >2.0, there was a mean decrease of 2.1 [1.3, 2.8] (p < 0.00001).Conclusion: From the available evidence, Eustachian tube procedures appear to be effective at improving symptoms of baro-challenge Eustachian tube dysfunction. However, higher quality evidence is needed to support making definite recommendations for the use of balloon Eustachian tube dilation or LET for these patients.

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Outcome of Balloon Eustachian Tuboplasty in SCUBA Divers

Cited by 8 publications

References 24 publications

Balloon dilation eustachian tuboplasty for dilatory dysfunction: Safety and efficacy analysis in an Australian cohort

Balloon dilation eustachian tuboplasty for dilatory dysfunction: Safety and efficacy analysis in an Australian cohort

Predictive value of the Eustachian Tube Dysfunction Questionnaire‐7 for identifying obstructive Eustachian tube dysfunction: A systematic review

A Systematic Review of Eustachian Tube Procedures for Baro‐challenge Eustachian Tube Dysfunction

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