The effect of balloon dilatation eustachian tuboplasty combined with grommet insertion on the structure and function of the eustachian tube in patients with refractory otitis media with effusion

Abstract

Background: The treatments for refractory secretory otitis media with effusion usually choose long-term grommet insertion. This study evaluated the effect of balloon eustachian tuboplasty combined with grommet insertion on the function and the opening length of the eustachian tube in patients with refractory otitis media with effusion.Methods: Fifty-seven patients with refractory otitis media with effusion were enrolled. A threedimensional reconstruction of an iohexol-enhanced computed tomography image was applied to evaluate the structural and length changes of the eustachian tube at both resting and Valsalva maneuver states. The grommet was removed 3 months after the operation and postoperative follow-up was carried out from 3 to 12 months. We performed pre-and post-operative observation of the following: appearance of the tympanic membrane, pure-tone audiometry threshold, eustachian tube score, seven-item Eustachian Tube Dysfunction Questionnaire scores (ETDQ-7), quantitative examination of eustachian tube function dynamic observation of tympanogram peak pressure point, and computed tomography examination of the eustachian tube.Results: The pure-tone audiometry at 1, 3, 6, 9, and 12 months postoperatively were all significantly lower compared to the preoperative value (all P<0.05). There was no significant difference between the pure-tone audiometry at 6 and 9 months postoperatively, neither was for the air-bone conduction gap at these time points. The quantitative examination peak pressure deviation was markedly increased at 6 months postoperatively compared with that before the operation (all P<0.05). The peak pressure deviation of tympanometry at 6 and 9 months postoperatively were both higher than the value at 12 months after surgery (P<0.05). The eustachian tube score at 1, 3, 6, 9, and 12 months postoperatively were notably higher than that before the operation (all P<0.05). A significant difference was also observed between the 6-and 12-month postoperative eustachian tube score (P<0.05). There was a significant difference in the ETDQ-7 scores at 6-and 12-month postoperatively (P<0.05). The quantitative examination peak pressure deviation and eustachian tube score were both correlated with development length of the eustachian tube after threedimensional computed tomography reconstruction (P<0.05).Conclusions: Eustachian tube balloon dilatation combined with grommet insertion is an effective treatment for refractory otitis media with effusion.

Efficacy and Safety of Endoscopic Tympanic Membrane Catheterization Plus Ofloxacin Ear Drops in the Treatment of Secretory Otitis Media in Infants and Toddlers

“…e new type of quinolone broad-spectrum antibacterial drugs can reduce the drug tolerance of bacteria, greatly improve the bactericidal activity of drugs, and effectively curb the generation of drug resistance. It acts on bacterial type II-A topoisomerases (DNA rotase and topoisomerase IV) [2][3][4]. Studies have shown that the process of bacterial DNA replication is essential for the growth and survival of bacteria, and this process requires the combined action of DNA rotase and topoisomerase IV [4].…”

“…It acts on bacterial type II-A topoisomerases (DNA rotase and topoisomerase IV) [2][3][4]. Studies have shown that the process of bacterial DNA replication is essential for the growth and survival of bacteria, and this process requires the combined action of DNA rotase and topoisomerase IV [4]. e treatment of new quinolones with broad-spectrum antibacterial drugs forms a "drug-topoisomerase-DNA" triple complex interaction and promotes the molecular processing law of the complex to release broken DNA, thereby deepening the understanding of the bactericidal mechanism of quinolones.…”

“…Due to the underdevelopment of muscles and cartilage of the eustachian tube in infants and toddlers, the muscles of the body are prone to weak contractions, leading to the pressure resulting from the collapse of the cartilage tube and inducing secretory otitis media [ 3 ]. Li et al [ 4 ] highlighted that secretory otitis media in infants and toddlers entails adverse effects on their language competence, intelligence, and development. Based upon ventilation and drainage of effusion, current treatment regimens of secretory otitis media in infants and toddlers mainly include endoscopic tympanic membrane catheterization for the mitigation of the clinical symptoms.…”

Balloon Eustachian Tuboplasty and Grommet Insertion: A Combined Surgical Treatment for Chronic Suppurative Otitis Media with Eustachian Tube Dysfunction

“…BET as a minimally invasive intervention first described in 2010 has been successfully investigated by randomized control trials and clinical studies in the past decade [ 29 , 30 ]. Considering BET surgery did not achieve significant symptom improvement of OM, the combination treatment with BET and Grommet insertion has been evaluated in OM [ 12 , 31 , 32 ] and ETD [ 19 ].…”

“…It has generally been considered that surgery for improving hearing can be considered only when eustachian tube function becomes normal [ 36 ]. COME patients treated with BET and grommet insertion was reported to have an improvement in eustachian tube function and structure [ 12 , 32 ]. In a previous study, the ETDQ-7 score with total score of ≥14.5 (mean score of ≥2.1) showed 100% sensitivity and 100% specificity for categorizing a patient as having ETD [ 37 ].…”