Subjective and Objective Effectiveness of Eustachian Tube Balloon Dilatation for Patients With Eustachian Tube Dysfunction—Evaluation in a Pressure Chamber

Abstract

Introduction: The Eustachian tube plays a crucial role in pressure equalization between the middle ear and ambient pressure for fast and large pressure differences. In patients with chronic Eustachian tube dysfunction, Eustachian tube balloon dilatation is increasingly used as surgical therapy. Subjectively, many patients report an improvement of the symptoms postoperatively. Hence, there is a need to objectively measure this effect. Methods: The objectivity of Eustachian tube balloon dilatation was evaluated using a precise method of measuring Eustachian tube function. In a hypo/hyperbaric pressure chamber, 23 ears in 13 patients were exposed to a standardized profile of compression and decompression before Eustachian tube balloon dilatation and 4 weeks afterwards. Standardized parameters of Eustachian tube function were determined and statistically compared before and 4 weeks after intervention. In addition, an Eustachian Tube Dysfunction Questionnaire-7 (ETDQ7) questionnaire was completed beforehand and 4 weeks postoperatively to determine subjective surgical success. Results: The results from the ETDQ7 questionnaire showed a significant improvement in symptoms after Eustachian tube balloon dilatation (p = 0.0002). Objective measurements results showed a significant reduction of the Eustachian tube opening pressure during pressure decrease 4 weeks after intervention (p = 0.0012). Conclusion: Eustachian tube balloon dilatation significantly reduced Eustachian tube opening pressure, in addition to subjective improvement of symptoms determined by ETDQ7.

Eustachian tube dysfunction (ETD) in chronic rhinosinusitis with comparison to primary ETD: A systematic review and meta‐analysis

“…There were nine prospective studies (three case‐control, six cohort studies) encompassing 1336 patients with CRS and patients with CRS and ETD (CRS+ETD) 1,8–15 . There were seven studies (one RCT, four prospective case series, and two retrospective case series) including 161 patients with primary ETD 3,16–19 2122. Risk of bias assessment can be found in Figure 2.…”

Comparison of Electrocoagulation Tuboplasty and Continued Medical Therapy for Treating Persistent Eustachian Tube Dysfunction With Hypertrophic Mucosa Disease

“…9,16 Recently, balloon dilation of the cartilaginous ET has shown encouraging results. Jansen et al 17 described significant improvement in symptoms in 23 ears at 4 weeks postoperatively. Formánek et al 18 described significant improvements in ETDQ-7 scores in all 14 ears at the 12-month follow-up.…”

“…9,16 Recently, balloon dilation of the cartilaginous ET has shown encouraging results. Jansen et al 17 In this study, we performed electrocoagulation tuboplasty to treat patients with chronic ETD. Although the proportion of patients with normalized ETDQ-7 scores was not significantly different between the groups at 6 months posttreatment, the difference was significant between the groups at 12 months posttreatment.…”

Combined Endoscopic Sinus Surgery and Eustachian Tube Balloon dilatation improves Eustachian Tube Functions in patients had Chronic rhinosinusitis with nasal polyposis and Eustachian tube dysfunction

“…These findings point to the efficacy of dual surgical procedures and to the superadded benefit of BET on the outcome of FESS for management of ETD. Similarly, Meyer et al [32] reported improvements in the ETDQ-7 scores after balloon dilation and Jansen et al [33] documented that ET balloon dilatation significantly reduced ET opening pressure with significant improvement in symptoms as judged subjectively by ETDQ-7. Also, Froehlich et al [34], out of a systematic literature review for the effectiveness of ET balloon dilation for treatment of ETD, reported significantly decreasing ETDQ-7 scores and improving tympanogram with normal otoscopic findings and positive Valsalva maneuver.…”