Effect of head and neck radiotherapy on the Eustachian tube functions

Abstract Background Nowadays, radiotherapy is widely used in management of many types of tumors including head and neck tumors; in this study, we concerned with its reverse effects on the Eustachian tube functions and if this effect is temporary or permanent. Results The whole (30) patients have tympanogram at both ears before starting radiotherapy; all patients (100%) were normal. In the immediate post radiotherapy tympanogram at the contralateral side, 6.7% of patients had effusion, and 20% had Eustachian tube dysfunction, while at the ipsilateral side, 20% of patients had effusion, and 33.3% had ET dysfunction. In the follow-up tympanogram 12 weeks post radiotherapy, we found that 6.7% of patients had effusion, and (10%) had Eustachian tube dysfunction at the contralateral side, while 6.7% of patients had effusion, and only 20% had Eustachian tube dysfunction at the ipsilateral side. Conclusion From this study, we concluded that patients with head and neck tumors treated by radiotherapy (apart from the nasopharynx) have a high incidence of affection of Eustachian tube function namely middle ear effusion and Eustachian tube dysfunction. The possibility for development of middle ear effusion and Eustachian tube dysfunction increases with increased tumor stage. Eustachian tube functions immediately post radiotherapy and after 12 weeks of the end of radiotherapy was affected by different effects according to the tumor site. The Eustachian tube functions significantly improved within 12 weeks after the last dose of radiotherapy, and we recommend audiological follow-up for patients with head and neck tumors treated with radiotherapy.

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The Role of Eustachian Tube Dysfunction in Immune-Mediated Middle Ear Effusion and Inflammation

Auris Nasus Larynx ◽

10.1016/s0385-8146(85)80149-8 ◽

1985 ◽

Vol 12 ◽

pp. S203-S205 ◽

Cited By ~ 1

Author(s):

Allen F. Ryan ◽

Jeffrey P. Harris ◽

Antonino Catanzaro ◽

Stephen I. Wasserman

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Eustachian Tube Dysfunction ◽

Middle Ear Effusion ◽

Immune Mediated ◽

Tube Dysfunction ◽

Ear Effusion

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The Role of Soluble Interleukin-4 Receptor and Interleukin-5 Antibody in Preventing Late-Phase Allergy-Induced Eustachian Tube Dysfunction

Otolaryngology ◽

10.1067/mhn.2002.126901 ◽

2002 ◽

Vol 127 (3) ◽

pp. 169-176 ◽

Cited By ~ 14

Author(s):

Hoke W. Pollock ◽

Charles S. Ebert ◽

Marc G. Dubin ◽

David R. White ◽

Jiri Prazma ◽

...

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Late Phase ◽

Allergic Response ◽

Eustachian Tube Dysfunction ◽

Middle Ear Effusion ◽

Tube Dysfunction ◽

The Relationship ◽

Ear Effusion

OBJECTIVES: We investigated the role of soluble interleukin (IL)-4 receptors (sIL-4R) and IL-5 antibodies (IL-5Ab) in preventing allergic eustachian tube dysfunction (ETD) and middle ear effusion (MEE). STUDY DESIGN: Brown-Norway rats were sensitized to ovalbumin (OVA) and challenged transtympanically. Two groups of rats received either IL-4R or IL-5Ab transtympanically 1 hour before challenge. Three additional groups were used as controls. Following the second transtympanic challenge, the ventilatory and clearance functions of the eustachian tube (ET) were assessed at 0, 2, and 8 hours. Histology was prepared using cut paraffin sections stained with hematoxylin and eosin. RESULTS: sIL-4R-pretreated rats showed no significant changes in ventilatory or clearance functions of the ET or inflammatory changes in ET mucosa, whereas IL-5Ab pretreatment showed significant late ventilatory and clearance dysfunction as well as inflammatory mucosal changes. CONCLUSION: These data demonstrate that the late-phase allergic inflammatory response that leads to subsequent formation of ETD and MEE is prevented by pretreatment with sIL-4R and, more modestly, with IL-5Ab. Otitis media with effusion (OME) remains a significant problem in the pediatric population today. Despite advances in screening and treatment, the incidence has steadily risen over the past 20 years. It is now estimated that more than 80% of all children with have at least 1 episode of OME by age 3 and 40% will have 3 or more episodes. 1 Furthermore, earaches/ear infections represent the single greatest reason for a visit to the pediatrician after well-child visits. 2 Numerous studies have investigated the sequelae for children exposed to multiple episodes of OME, with conclusions ranging from no significant permanent deficits to impairments in receptive language skills, 1 balance and coordination, 3 and school readiness measures. 4 There remain several important controversies with regards to the pathogenesis and treatment of OME. One of these is the relationship between OME and allergy. A link between OME and allergy has existed for some time, 5 and one of the older empiric observations on the relationship between children with recurrent OME and allergy has resurfaced in recent years to explain the large number of patients with no other causative factor for fluid in the middle ear space. Bernstein 6 has demonstrated in a study of 100 patients with recurrent OME that almost a third can be attributed directly to allergy. Indeed, some consider this number a very conservative estimate. It is the intent of this study to examine the role of newer therapies such as antagonists to interleukin (IL)-4 and IL-5 for preventing the late-phase allergic reaction and their effect of preventing eustachian tube dysfunction and formation of middle ear effusion. IL−4 and −5 are 2 of a host of mediators that comprise the late-phase allergic response. Produced by a variety of cell types, their principal functions are to control subsequent cascades that are a response to antigenic challenge. Tissue inflammation, edema formation, mucus production, and eosinophilia are controlled by these cytokines. Our hypothesis is that administration of antagonists of both IL−4 and IL−5, in the form of sIL-4R and IL−5Ab, respectively, will result in a decreased allergic response to challenged tissue.

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A manually operated device for the treatment of residual middle ear effusion and Eustachian tube dysfunction

Audiological Medicine ◽

10.1080/16513860701794235 ◽

2008 ◽

Vol 6 (2) ◽

pp. 166-168 ◽

Cited By ~ 2

Author(s):

Dario Alpini ◽

Valentina Mattei

Keyword(s):

Eustachian Tube ◽

Middle Ear ◽

Eustachian Tube Dysfunction ◽

Middle Ear Effusion ◽

Tube Dysfunction ◽

Ear Effusion

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

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2015.10.010 ◽

2016 ◽

Vol 37 (2) ◽

pp. 99-102 ◽

Cited By ~ 15

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

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Effect of Balloon Eustachian Tuboplasty in Adults That Only Have Symptoms of Chronic Eustachian Tube Dysfunction, With a 1-Year Follow-Up: Prospective Clinical Trial

Ear Nose & Throat Journal ◽

10.1177/0145561320980199 ◽

2020 ◽

pp. 014556132098019

Author(s):

Martin Formánek ◽

Debora Formánková ◽

Lukáš Školoudík ◽

Karol Zeleník ◽

Viktor Chrobok ◽

...

Keyword(s):

Clinical Trial ◽

Eustachian Tube ◽

Pure Tone Audiometry ◽

Adult Patients ◽

Eustachian Tube Dysfunction ◽

Prospective Clinical Trial ◽

Patient Reported ◽

Tube Dysfunction ◽

Balloon Eustachian Tuboplasty

Objectives: Balloon eustachian tuboplasty (BET) is a promising therapeutic option for eustachian tube (ET) dysfunction. However, data are lacking on the effect of BET in adults with symptoms of chronic ET dysfunction but without a contributing pathology. This study investigated the effect of BET in adult patients with only symptoms of chronic ET dysfunction. Methods: This prospective clinical trial included adult patients with aerated physiological middle ears and symptoms of ET dysfunction for more than 6 months. Compliance with follow-up was 93.3%. We evaluated the effects of BET with tympanometry, assessment of the Valsalva or Toynbee maneuver with tympanometry verification, a Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and pure-tone audiometry. Data were recorded 1 day before surgery and 2, 6, and 12 months after BET. Therapy was considered successful when the patient exhibited a newly acquired ability to perform the Valsalva or Toynbee maneuver or when the ETDQ-7 score improved by 20% or more. Results: We included 14 ears in the analysis. After 2, 6, and 12 months, therapy was successful, according to the ETDQ-7, in 11/14 (78.6%; 95% CI: 48.8-94.3), 13/14 (92.9%; 95% CI: 64.2-99.6), and 12/14 (85.7%; 95% CI: 56.2-97.5) ears, respectively. These results were statistically significant. The ETDQ-7 scores also significantly decreased at 2, 6, and 12 months after the BET, when any change was observed. All patients experienced improvement. Only 1 patient reported temporary deterioration after 2 months. Treatment was more frequently successful in patients without nasal polyps or pollinosis. Conclusions: Adults with only symptoms of chronic ET dysfunction benefitted more and had longer lasting results from BET, compared to patients with pathologies caused by ET dysfunction. Balloon eustachian tuboplasty could be recommended for these patients.

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A Randomized Controlled Trial of Balloon Dilation as a Treatment for Persistent Eustachian Tube Dysfunction With 1-Year Follow-Up

Otology & Neurotology ◽

10.1097/mao.0000000000001853 ◽

2018 ◽

Vol 39 (7) ◽

pp. 894-902 ◽

Cited By ~ 20

Author(s):

Ted A. Meyer ◽

Ellen M. O’Malley ◽

Rodney J. Schlosser ◽

Zachary M. Soler ◽

Jason Cai ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Eustachian Tube ◽

Controlled Trial ◽

Balloon Dilation ◽

Eustachian Tube Dysfunction ◽

Randomized Controlled ◽

Tube Dysfunction

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Balloon Dilation of the Eustachian Tube: 12-Month Follow-up of the Randomized Controlled Trial Treatment Group

Otolaryngology ◽

10.1177/0194599818821938 ◽

2019 ◽

Vol 160 (4) ◽

pp. 687-694 ◽

Cited By ~ 16

Author(s):

Vijay Anand ◽

Dennis Poe ◽

Marc Dean ◽

William Roberts ◽

Pablo Stolovitzky ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Treatment Group ◽

Eustachian Tube ◽

Controlled Trial ◽

Balloon Dilation ◽

The United States ◽

Eustachian Tube Dysfunction ◽

Randomized Controlled ◽

Tube Dysfunction

Objective Obstructive eustachian tube dysfunction (OETD) affects up to 5% of adults; however, available treatment strategies have limitations. It was previously reported that balloon dilation of the eustachian tube (BDET) with the eustachian tube balloon catheter + medical management (MM) results in a significantly higher proportion of subjects with normalized tympanograms versus MM alone at 6- and 24-week follow-up. The current analysis extends these initial findings by investigating the durability of BDET + MM treatment outcomes through 52 weeks. Study Design Prospective cohort follow-up study from the treatment group in a previously reported multicenter randomized controlled trial. Setting Twenty-one investigational sites across the United States. Subjects and Methods Here we report on secondary and exploratory endpoints for patients with OETD who previously failed MM and were randomized to the BDET + MM cohort. Analyses of tympanogram outcomes are reported by ear, unless specified otherwise, as a more accurate measure of durability of the procedure over time. Results Among subjects randomized to BDET + MM, the overall number with normalized tympanograms and ETDQ-7 scores (Eustachian Tube Dysfunction Questionnaire–7) remained comparable to those reported at 6- versus 52-week follow-up: tympanograms, 73 of 143 (51.0%) versus 71 of 128 (55.5%); ETDQ-7, 79 of 142 (55.6%) versus 71 of 124 (57.3%). The overall number of ears with normalized tympanograms also remained comparable, with 117 of 204 (57%) versus 119 of 187 (63.6%). Conclusions The present study suggests that the beneficial effects of BDET + MM on tympanogram normalization and symptoms of subjects with refractory OETD demonstrate significant durability that is clinically relevant through 52 weeks.

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