Balloon eustachian tuboplasty for patients with chronic eustachian tube dysfunction: a novel method for Iranian samples

  • Mahnaz Mohamadi ORCID Mail Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Department of Otolaryngology, Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Masoud Motasaddi Zarandy ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Department of Otolaryngology, Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mojtaba Mohammadi Ardehali ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran AND Department of Otolaryngology, Head and Neck Surgery, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mina Motasaddi Zarandy ORCID Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
Keywords:
Balloon eustachian tuboplasty, eustachian tube dysfunction, Iranian

Abstract

Background and Aim: Balloon eustachian tuboplasty (BET) is a recently developed and approved method for management of chronic eustachian tube dysfunction (ETD). In the present study we aimed to evaluate the safety and efficacy of this method in Iranian samples.
Methods: In this prospective case-series study, we included 15 adult patients with chronic ETD who were resistant to previous medical managements and/or ventilation tube use. All patients underwent baseline audiometry (pure tone audiometry and tympanometry), Valsalva maneuver, EDT questionnaire-7 (ETDQ-7), and physical examination. Three to six months after the BET procedure, all patients underwent four evaluation methods again.
Results: We found a significant improvement in the mean ETDQ-7 scores comparing pre- and post-test scores (p < 0.0001). There was also a statistically significant decrease in the average air-bone gap from 40.55 at baseline to 27.22 after treatment (p < 0.001). In the Valsalva test, 17 out of 18 study ears (92.3%) had a positive result after the surgery. Under tympanographic evaluation, 9 ears (50%) reported a conversion from type B to type A after treatment, 2 ears (11%) had a conversion from type B to C, and 7 ears (39%) showed no any change and stayed in type B after BET.
Conclusion: As a novel method in Iran, BET can be an alternative safe treatment option for chronic ETD.

References

1. Bluestone CD, Doyle WJ. Anatomy and physiology of eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol. 1988;81(5 Pt 2):997-1003. doi: 10.1016/0091-6749(88)90168-6
2. Schilder AGM, Bhutta MF, Butler CC, Holy C, Levine LH, Kvaerner KJ, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol. 2015;40(5):407-11. doi: 10.1111/coa.12475
3. Teschner M. [Evidence and evidence gaps in the treatment of eustachian tube dysfunction and otitis media]. Laryngorhinootologie. 2016;95 Suppl 1:S136-54. German. doi: 10.1055/s-0041-108952
4. Singh T, Taneja V, Kulendra K, Farr M, Robinson J, Rejali D. Balloon Eustachian tuboplasty treatment of longstanding eustachian tube dysfunction. J Laryngol Otol. 2017;131(7):614-9. doi: 10.1017/S0022215117000974
5. Randrup TS, Ovesen T. Balloon eustachian tuboplasty: a systematic review. Otolaryngol Head Neck Surg. 2015;152(3):383-92. doi: 10.1177/0194599814567105
6. Hwang SY, Kok S, Walton J. Balloon dilation for eustachian tube dysfunction: systematic review. J Laryngol Otol. 2016;130 Suppl 4:S2-6. doi: 10.1017/S0022215116008252
7. Poe DS, Grimmer JF, Metson R. Laser eustachian tuboplasty: two-year results. Laryngoscope. 2007;117(2):231-7. doi: 10.1097/01.mlg.0000246227.65877.1f
8. Ockermann T, Reineke U, Upile T, Ebmeyer J, Sudhoff HH. Balloon dilatation eustachian tuboplasty: a clinical study. Laryngoscope. 2010;120(7):1411-6. doi: 10.1002/lary.20950
9. Smith ME, Tysome JR. Middle ear pressure changes during balloon eustachian tuboplasty. Otola¬ryngol Head Neck Surg. 2017;156(1):161-5. doi: 10.1177/0194599816672842
10. Huisman JML, Verdam FJ, Stegeman I, de Ru JA. Treatment of Eustachian tube dysfunction with balloon dilation: A systematic review. Laryngoscope. 2018;128(1):237-47. doi: 10.1002/lary.26800
11. McMurran AEL, Hogg GE, Gordon S, Spielmann PM, Jones SE. Balloon Eustachian tuboplasty for Eustachian tube dysfunction: report of long-term outcomes in a UK population. J Laryngol Otol. 2020;134(1):34-40. doi: 10.1017/S0022215119002548
12. Anand V, Poe D, Dean M, Roberts W, Stolovitzky P, Hoffmann K, et al. Balloon dilation of the eustachian tube: 12-month follow-up of the randomized controlled trial treatment group. Otolaryngol Head Neck Surg. 2019;160(4):687-94. doi: 10.1177/0194599818821938
13. Silvola J, Kivekäs I, Poe D. Balloon dilation of the cartilaginous portion of the eustachian tube. Oto¬laryngol Head Neck Surg. 2014;151(1):125-30. doi: 10.1177/0194599814529538
14. Schröder S, Lehmann M, Ebmeyer J, Upile T, Sudhoff H. Balloon Eustachian tuboplasty: a retrospective cohort study. Clin Otolaryngol. 2015;40(6):629-38. doi: 10.1111/coa.12429
15. Luukkainen V, Vnencak M, Aarnisalo AA, Jero J, Sinkkonen ST. Patient satisfaction in the long-term effects of Eustachian tube balloon dilation is encouraging. Acta Otolaryngol. 2018;138(2):122-7. doi: 10.1080/00016489.2017.1384568
16. Poe D, Anand V, Dean M, Roberts WH, Stolovitzky JP, Hoffmann K, et al. Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial. Laryngoscope. 2018;128(5):1200-6. doi: 10.1002/lary.26827
17. Meyer TA, O'Malley EM, Schlosser RJ, Soler ZM, Cai J, Hoy MJ, et al. A randomized controlled trial of balloon dilation as a treatment for persistent eustachian tube dysfunction with 1-year follow-up. Otol Neurotol. 2018;39(7):894-902. doi: 10.1097/MAO.0000000000001853
18. Sudhoff HH, Mueller S. Treatment of pharyngotympanic tube dysfunction. Auris Nasus Larynx. 2018;45(2):207-14. doi: 10.1016/j.anl.2017.07.001
19. McCoul ED, Anand VK, Christos PJ. Validating the clinical assessment of eustachian tube dysfunction: The eustachian tube dysfunction questionnaire (ETDQ-7). Laryngoscope. 2012;122(5):1137-41. doi: 10.1002/lary.23223
20. Leichtle A, Hollfelder D, Wollenberg B, Bruchhage K. Balloon Eustachian Tuboplasty in children. Eur Arch Otorhinolaryngol. 2017;274(6):2411-9. doi: 10.1007/s00405-017-4517-8
21. Tisch M, Maier H, Sudhoff H. Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children. Acta Otorhinolaryngol Ital. 2017;37(6):509-12. doi: 10.14639/0392-100X-1690
Published
2020-10-20
How to Cite
1.
Mohamadi M, Motasaddi Zarandy M, Mohammadi Ardehali M, Motasaddi Zarandy M. Balloon eustachian tuboplasty for patients with chronic eustachian tube dysfunction: a novel method for Iranian samples. Aud Vestib Res. 29(4):204-208.
Section
Research Article(s)