Comparison of Balloon Dilation and Laser Eustachian Tuboplasty in Patients with Eustachian Tube Dysfunction: A Meta-analysis

2018 ◽  
Vol 158 (4) ◽  
pp. 617-626 ◽  
Author(s):  
Tang-Chuan Wang ◽  
Chia-Der Lin ◽  
Tzu-Ching Shih ◽  
Hsiung-Kwang Chung ◽  
Ching-Yuang Wang ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Balloon Dilatation ◽  
Event Rate ◽  
Valsalva Maneuver ◽  
Meta Analysis ◽  
Balloon Dilation ◽  
Outcome Data ◽  
Eustachian Tube Dysfunction ◽  
Improvement Rate ◽  
Tube Dysfunction

Objective We aimed to perform a meta-analysis examining balloon dilatation and laser tuboplasty for the treatment of eustachian tube dysfunction (ETD). Data Sources PubMed, Cochrane, and Embase search up to April 18, 2016, with the following keywords: eustachian, middle-ear, eustachian tuboplasty, balloon tuboplasty, laser tuboplasty, laser dilatation, and balloon dilatation. Review Methods Randomized controlled trials and prospective, retrospective, and 1-arm studies of patients with ETD treated with balloon dilatation or laser tuboplasty were included. Outcome measures were improvement of eustachian tube score (ETS) and tympanometry and Valsalva maneuver results. Results Two retrospective and 11 prospective studies were included (1063 patients; 942 treated with balloon and 121 with laser tuboplasty). Balloon tuboplasty resulted in a significant improvement of ETS (pooled standardized mean difference [SMD], 0.94; 95% confidence interval [CI], 0.23-1.66; P = .009) and, compared with laser tuboplasty, a greater tympanometry improvement rate (pooled event rate = 73% vs 13%; P = .001). Valsalva maneuver improvement rate was not different between the group results (pooled event rate = 67% vs 50%; P = .472). The maximum number of studies that provided outcome data for any one measure was only 4, and sensitivity analysis indicated ETS results may have been overly influenced by 2 studies. No balloon tuboplasty studies reported ETS data, preventing comparison between the 2 procedures. Conclusion Both procedures can improve symptoms of ETD; however, because of the limited numbers of studies reporting data of the outcomes of interest, it remains unclear if one procedure provides greater benefits.

Eustachian Tube Balloon Dilation: A Systematic Review and Meta-analysis of Treatment Outcomes

2020 ◽  
Vol 163 (5) ◽  
pp. 870-882
Author(s):  
Michael H. Froehlich ◽  
Phong T. Le ◽  
Shaun A. Nguyen ◽  
Theodore R. McRackan ◽  
Habib G. Rizk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Eustachian Tube ◽  
Valsalva Maneuver ◽  
Meta Analysis ◽  
Balloon Dilation ◽  
Eustachian Tube Dysfunction ◽  
Significant Difference ◽  
Tube Dysfunction ◽  
Outcome Metrics

Objective To examine the effectiveness of eustachian tube balloon dilation for the treatment of eustachian tube dysfunction. Data Sources PubMed, Scopus, and Google Scholar. Review Methods A systematic review of eustachian tube balloon dilation for the treatment of eustachian tube dysfunction was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify randomized control trials and prospective and retrospective studies published prior to January 31, 2019. Meta-analysis of proportions evaluated 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ7) scores, tympanometry, otoscopy findings, and the ability to perform a Valsalva maneuver. Results The systematic review identified 35 studies. Twelve studies met inclusion for meta-analysis (448 patients). Mean ETDQ7 scores decreased by 2.13 from baseline to 6 weeks (95% CI, –3.02 to −1.24; P < .001). From baseline to 6 weeks, 53.0% of patients had improvement in tympanograms ( P < .001). At the long-term point (3-12 months), 50.5% of patients had improved tympanograms from baseline ( P < .001). There was no significant difference in the proportion of improved tympanograms at 6 weeks compared to long term ( P = .535). Normal otoscopy exams at baseline increased by 30.0% at 6 weeks ( P < .001) and 55.4% in the long term ( P < .001). There was a 67.8% increase in proportion of patients able to perform a Valsalva maneuver in the long term compared to baseline ( P < .001). Conclusion Eustachian tube balloon dilation appears to be associated with improvement in subjective and objective treatment outcome metrics. The improvement appears stable at 3 to 12 months after dilation. Patients with eustachian tube dysfunction are likely to benefit from balloon dilation, particularly those with medication-refractory disease.

Repeat Eustachian Tube Balloon Dilation Outcomes in Adults With Chronic Eustachian Tube Dysfunction

2021 ◽  
pp. 019459982110379
Author(s):  
David Keschner ◽  
Rohit Garg ◽  
Randall Loch ◽  
Lauren Joelle Luk
Keyword(s):  
Eustachian Tube ◽  
Age Distribution ◽  
Balloon Dilation ◽  
Primary Outcome Measure ◽  
Outcome Data ◽  
Eustachian Tube Dysfunction ◽  
Care Community ◽  
Tube Dysfunction ◽  
Initial Procedure ◽  
Second Procedure

Objective With increased focus on surgical management of the eustachian tube, clarifying management decisions benefits patients and surgeons. In this study, we examine the value of repeating the balloon dilation of the eustachian tube (BDET) procedure in patients who did not improve after the initial BDET. Study Design Level IV retrospective review of 145 BDETs performed on 86 patients between January 1, 2014, and May 1, 2019, identified 10 patients who underwent BDET more than once. Setting Managed care community otolaryngology practice. Methods Demographic and outcome data were collected on both single and repeat BDET cohorts. Results The Eustachian Tube Dysfunction Questionnaire 7 (ETDQ-7) was used as the primary outcome measure when comparing single vs repeat BDET cohorts. Generally, the 2 cohorts were similar in terms of sex and age distribution. Tobacco use and radioallergosorbent test–positive results were greater proportionally in the repeat BDET cohort. Preoperative ETDQ-7 scores were similar in both cohorts. Single BDET patients overall showed significant improvement in ETDQ-7 scores. ETDQ-7 scores for repeat BDET patients who did not improve after the first procedure similarly did not demonstrate improvement after the second procedure. Conclusions Inevitably, some patients will not improve after an initial BDET procedure. The utility of a repeated BDET procedure should be considered in determining how to manage such failures. The results of this limited study suggest that patients who fail to improve meaningfully on ETDQ-7 scores after the initial procedure are unlikely to show substantial improvements after a repeated procedure.

Outcome of Eustachian Tube Balloon Dilation in Children: A Systematic Review

2021 ◽  
pp. 000348942110413
Author(s):  
Jeyasakthy Saniasiaya ◽  
Jeyanthi Kulasegarah ◽  
Prepageran Narayanan
Keyword(s):  
Eustachian Tube ◽  
Systematic Reviews ◽  
Balloon Dilation ◽  
Case Series ◽  
Eustachian Tube Dysfunction ◽  
Common Finding ◽  
Secondary Outcome ◽  
Large Sample Size ◽  
Line Treatment ◽  
Tube Dysfunction

Objective: Eustachian tube dysfunction (ETD) is a chronic entity that has been historically managed with adenoidectomy and ventilation tube insertion. Recently, balloon dilation of the eustachian tube has shown promising results in recalcitrant eustachian tube dysfunction. We reviewed the literature to determine the outcome of eustachian tube balloon dilation in children. Methods: A literature search was conducted for the period from 1990 to 2020 by searching several databases over a 1-month period (January 2021) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews for Interventions. Primary outcome was defined as the success of the intervention determined by the resolution of symptoms, and secondary outcome was determined by revisions surgery and presence of complications. Results: Only 7 articles were identified based on our objectives and selection criteria. All studies included are retrospective cohort case series (Level IV) and 1 cohort of matched controls (Level III). A total of 284 patients were included in this review, with a mean age of 7.8 years. A total of 463 balloon dilation were performed either bilaterally or unilaterally. The most common finding of ETD is middle ear effusion in 5 studies. Balloon dilation of eustachian tube was second-line treatment in 6 studies and first-line treatment in 1 study. Improvement of symptoms was identified in all studies through various assessments performed. Revision surgery was performed in 1 study with no major complications reported. Conclusions: Balloon dilation of the eustachian tube may be considered as an alternative procedure following failed standard treatment in children. The quality of evidence is inadequate to recommend widespread use of the technique until a better-quality study has been completed. Future randomized controlled studies with a large sample size are warranted to determine the efficacy of this procedure amongst children.

Medical Management for Eustachian Tube Dysfunction in Adults: A Systematic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Neil K. Mehta ◽  
Cheng Ma ◽  
Shaun A. Nguyen ◽  
Theodore R. McRackan ◽  
Ted A. Meyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Eustachian Tube ◽  
Medical Management ◽  
Meta Analysis ◽  
Eustachian Tube Dysfunction ◽  
Tube Dysfunction

Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction: One year follow-up study

2016 ◽  
Vol 37 (2) ◽  
pp. 99-102 ◽  
Author(s):  
Hao Xiong ◽  
Maojin Liang ◽  
Zhigang Zhang ◽  
Yaodong Xu ◽  
Yongkang Ou ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Balloon Dilation ◽  
Eustachian Tube Dysfunction ◽  
Follow Up Study ◽  
Tube Dysfunction ◽  
One Year

Balloon Eustachian tuboplasty treatment of longstanding Eustachian tube dysfunction

2017 ◽  
Vol 131 (7) ◽  
pp. 614-619 ◽  
Author(s):  
T Singh ◽  
V Taneja ◽  
K Kulendra ◽  
M Farr ◽  
J Robinson ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Eustachian Tube ◽  
Balloon Dilation ◽  
Primary Outcome Measure ◽  
Eustachian Tube Dysfunction ◽  
Secondary Outcome ◽  
Tube Dysfunction ◽  
Previously Treated ◽  
Objective Outcomes ◽  
Balloon Eustachian Tuboplasty

AbstractBackground:Eustachian tube dysfunction is a poorly defined condition associated with various symptoms and it can predispose to middle-ear disease. Balloon dilation Eustachian tuboplasty has been proposed as a treatment for Eustachian tube dysfunction.Objective:To evaluate the subjective and objective outcomes of balloon dilation Eustachian tuboplasty in patients with recurrent, previously treated chronic Eustachian tube dysfunction.Methods:The study was conducted on 11 patients (13 ears) who had undergone previous unsuccessful medical and surgical treatment. Tympanometry was the primary outcome measure. Secondary outcome measures included pure tone audiogram assessment and seven-item Eustachian Tube Dysfunction Questionnaire score.Results:Balloon dilation Eustachian tuboplasty resulted in significant improvements in 11 patients’ subjective but not objective outcome measures.Conclusion:The objective abnormality and subjective symptoms in Eustachian tube dysfunction may represent two distinct pathological processes, which may nevertheless influence and exacerbate each other.

Balloon Dilation for Obstructive Eustachian Tube Dysfunction in Children

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Joonas Toivonen ◽  
Kosuke Kawai ◽  
Joshua Gurberg ◽  
Dennis Poe
Keyword(s):  
Eustachian Tube ◽  
Balloon Dilation ◽  
Eustachian Tube Dysfunction ◽  
Tube Dysfunction

Analysis of chemosensory function in patients with chronic Eustachian tube dysfunction prior to and after balloon dilatation

2018 ◽  
Vol 45 (5) ◽  
pp. 959-965
Author(s):  
Walliczek-Dworschak Ute ◽  
Schmierer Lisa ◽  
Greene Brandon ◽  
Pellegrino Robert ◽  
Dworschak Philipp ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Balloon Dilatation ◽  
Eustachian Tube Dysfunction ◽  
Tube Dysfunction ◽  
Chemosensory Function

scholarly journals Chronic obstructive Eustachian tube dysfunction: CT assessment with Valsalva maneuver and ETS-7 score

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247708
Author(s):  
Diletta Angeletti ◽  
Annalisa Pace ◽  
Giannicola Iannella ◽  
Valeria Rossetti ◽  
Andrea Colizza ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Middle Ear ◽  
Valsalva Maneuver ◽  
Eustachian Tube Dysfunction ◽  
Diagnostic Tools ◽  
Chronic Obstructive ◽  
Temporal Bone Ct ◽  
Before And After ◽  
Tube Dysfunction ◽  
Strong Suspicion

Chronic obstructive Eustachian tube dysfunction (ETD) is a common disorder of the middle ear. In recent years, two main diagnostic tools have become available: Eustachian tube score (ETS-7) and computed tomography (CT) combined with Valsalva maneuver. The aim of this study is to evaluate the outcomes of ETS-7 and CT in a group of patients affected by middle ear atelectasis with a strong suspicion of ETD. Three males and nine females, affected by middle ear atelectasis with retraction of the TM were enrolled. Each patient underwent to Eustachian tube dysfunction evaluation adopting the ETS-7 score and a temporal bone CT with Valsalva maneuver. The ears analyzed at steady state were divided into 2 groups: ETS<7 group and ETS≥ 7 group. The same division was applied for the ears analyzed after the Valsalva maneuver: ETS<7 group and ETS≥ 7 group. ETs were categorized as “well defined” (WD) and “not defined” (ND). The results of the analysis of the ETS-7 score in all 24 ears showed that 42% presented ETS ≥7, while 58% had ETS <7, indicating a diagnosis of ETD. In the ETS<7 group after Valsalva, ET was visualized in 33% of patients. In the ETS≥7 group it was WD in 29% after the Valsalva manoeuver. In both groups the comparison between the visualization of the ET before and after the Valsalva manoeuver did not present a statistical difference. No correlation emerged between ET evaluation with CT scan during Valsalva maneuver and ETS-7 score. It confirms that there is not a gold standard for the study of ET dysfunction.

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