Long-term Changes of Hearing Thresholds and Eustachian Tube Function After Balloon Dilation of the Eustachian Tube in Patients With Chronic Otitis Media
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives. This study aimed to evaluate long-term changes after balloon dilation of the Eustachian tube (BDET) in chronic otitis media (COM) patients with Eustachian tube (ET) dysfunction that persisted after tympanomastoidectomy (TM). Methods. We retrospectively reviewed the medical records of consecutive patients who were diagnosed with COM and ET dysfunction and underwent TM at our tertiary hospital from 2016 to 2017. The tympanic membrane status, the presence of a ventilation tube, ability to perform the Valsalva maneuver, and audiologic changes after dilation of the ET were analyzed. Results. This study included 20 patients (with 21 ears) who underwent TM but could not perform the Valsalva maneuver, showed a persistent air-bone gap, and eventually underwent BDET (male:female, 8:13; right:left, 11:10). Four ears showed perforation of the tympanic membrane after TM. Among the remaining 17 ears, 15 ears underwent ventilation tube insertion before BDET, while two ears underwent ventilation tube insertion and BDET simultaneously. Although none of the patients were capable of the Valsalva maneuver before BDET, 13 (62%) were able to perform the Valsalva maneuver successfully after BDET. When evaluating the tympanic membrane status at the latest follow-up, ventilation tubes were still present in eight ears. In the other 13 ears, intact tympanic membranes were present in nine out of 11 ears n the successful Valsalva group, whereas none of them were intact in the unsuccessful Valsalva group (P=0.014). The successful Valsalva group after BDET showed an improved air-bone gap of 8.9±12.4 dB, while the unsuccessful Valsalva group showed an aggravated air-bone gap of 3.8±11.8 dB at 1 year after BDET; this difference was statistically significant (P=0.031). Conclusion. The Valsalva maneuver could be performed successfully after BDET by 62% of patients with COM and ET dysfunction. BDET is helpful for successful hearing improvement and improved tympanic aeration in COM patients with ET dysfunction.
Abstract
Objectives. This study aimed to evaluate long-term changes after balloon dilation of the Eustachian tube (BDET) in chronic otitis media (COM) patients with Eustachian tube (ET) dysfunction that persisted after tympanomastoidectomy (TM). Methods. We retrospectively reviewed the medical records of consecutive patients who were diagnosed with COM and ET dysfunction and underwent TM at our tertiary hospital from 2016 to 2017. The tympanic membrane status, the presence of a ventilation tube, ability to perform the Valsalva maneuver, and audiologic changes after dilation of the ET were analyzed. Results. This study included 20 patients (with 21 ears) who underwent TM but could not perform the Valsalva maneuver, showed a persistent air-bone gap, and eventually underwent BDET (male:female, 8:13; right:left, 11:10). Four ears showed perforation of the tympanic membrane after TM. Among the remaining 17 ears, 15 ears underwent ventilation tube insertion before BDET, while two ears underwent ventilation tube insertion and BDET simultaneously. Although none of the patients were capable of the Valsalva maneuver before BDET, 13 (62%) were able to perform the Valsalva maneuver successfully after BDET. When evaluating the tympanic membrane status at the latest follow-up, ventilation tubes were still present in eight ears. In the other 13 ears, intact tympanic membranes were present in nine out of 11 ears n the successful Valsalva group, whereas none of them were intact in the unsuccessful Valsalva group (P=0.014). The successful Valsalva group after BDET showed an improved air-bone gap of 8.9±12.4 dB, while the unsuccessful Valsalva group showed an aggravated air-bone gap of 3.8±11.8 dB at 1 year after BDET; this difference was statistically significant (P=0.031). Conclusion. The Valsalva maneuver could be performed successfully after BDET by 62% of patients with COM and ET dysfunction. BDET is helpful for successful hearing improvement and improved tympanic aeration in COM patients with ET dysfunction.
참고문헌 (34)
- Fliss DM, "Chronic suppurative otitis media without cholesteatoma in children in southern Israel : incidence and risk factors", Pediatr Infect Dis J, 10(12), pp.895~899 (1991)
- Kim CS, "Prevalence and risk factors of chronic otitis media in Korea : results of a nation-wide survey", Acta Otolaryngol, 113(3), pp.369~375 (1993)
- Stell PM., "Scott-Brown’s otolaryngology. Vol. 3: management of chronic suppurative otitis media", pp.215~237 (1987), Butterworth International
- Flint PW, "Otolaryngology: head and neck surgery. Vol. 2: chronic otitis media, mastoiditis and petrositis", pp.2139~2155 (1993), Saunders Elsevier
- Schilder AG, "Eustachian tube dysfunction : consensus statement on definition, types, clinical presentation and diagnosis", Clin Otolaryngol, 40(5), pp.407~411 (2015)
- Seibert JW, "Eustachian tube function and the middle ear", Otolaryngol Clin North Am, 39(6), pp.1221~1235 (2006)
- Adil E, "What is the full range of medical and surgical treatments available for patients with Eustachian tube dysfunction?", Curr Opin Otolaryngol Head Neck Surg, 22(1), pp.8~15 (2014)
- Llewellyn A, "Interventions for adult Eustachian tube dysfunction : a systematic review", Health Technol Assess, 18(46), pp.1~180 (2014)
- Ockermann T, "Balloon dilatation eustachian tuboplasty : a clinical study", Laryngoscope, 120(7), pp.1411~1416 (2010)
- Poe DS, "Laser eustachian tuboplasty : a preliminary report", Laryngoscope, 113(4), pp.583~591 (2003)
- Metson R, "Microdebrider eustachian tuboplasty : a preliminary report", Otolaryngol Head Neck Surg, 136(3), pp.422~427 (2007)
- Smith ME, "Tests of Eustachian tube function : a review", Clin Otolaryngol, 40(4), pp.300~311 (2015)
- Poe DS, "Balloon dilation of the cartilaginous Eustachian tube", Otolaryngol Head Neck Surg, 144(4), pp.563~569 (2011)
- Huisman JM, "Treatment of Eustachian tube dysfunction with balloon dilation : a systematic review", Laryngoscope, 128(1), pp.237~247 (2018)
- Kim Y, "Technical feasibility and histological analysis of balloon-expandable metallic stent placement in a porcine Eustachian tube", Appl Sci, 11(4), pp.1359~ (2021)
- Park JH, "Transnasal placement of a balloon-expandable metallic stent : human cadaver study of the Eustachian tube", J Vasc Interv Radiol, 29(8), pp.1187~1193 (2018)
- Kim KY, "Fluoroscopic subtraction eustachian tubography : initial feasibility test in a cadaver model", Eur Radiol, 28(9), pp.3685~3691 (2018)
- Poe DS, "Balloon dilation of the cartilaginous portion of the Eustachian tube : initial safety and feasibility analysis in a cadaver model", Am J Otolaryngol, 32(2), pp.115~123 (2011)
- Ockermann T, "Balloon dilation eustachian tuboplasty : a feasibility study", Otol Neurotol, 31(7), pp.1100~1103 (2010)
- McCoul ED, "Balloon dilation of the eustachian tube in a cadaver model : technical considerations, learning curve, and potential barriers", Laryngoscope, 122(4), pp.718~723 (2012)
- Catalano PJ, "Balloon catheter dilatation of Eustachian tube : a preliminary study", Otol Neurotol, 33(9), pp.1549~1552 (2012)
- McCoul ED, "Eustachian tube balloon dilation surgery", Int Forum Allergy Rhinol, 2(3), pp.191~198 (2012)
- Silvola J, "Balloon dilation of the cartilaginous portion of the Eustachian tube", Otolaryngol Head Neck Surg, 151(1), pp.125~130 (2014)
- Wanscher JH, "Promising results after balloon dilatation of the Eustachian tube for obstructive dysfunction", Dan Med J, 61(4), pp.A4818~ (2014)
- Bowles PF, "Balloon tuboplasty in patients with Eustachian tube dysfunction : a prospective study in 39 patients(55 ears)", Clin Otolaryngol, 42(5), pp.1057~1060 (2017)
- Poe D, "Balloon dilation of the eustachian tube for dilatory dysfunction : a randomized controlled trial", Laryngoscope, 128(5), pp.1200~1206 (2018)
- Demir B, "Efficacy of balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children", J Laryngol Otol, 134(11), pp.1018~1021 (2020)
- Toivonen J, "Balloon dilation for obstructive Eustachian tube dysfunction in children", Otol Neurotol, 42(4), pp.566~572 (2021)
- Kim KY, "Fluoroscopy-guided balloon dilation in patients with Eustachian tube dysfunction", Eur Radiol, 28(3), pp.910~919 (2018)
- Song HY, "Fluoroscopic balloon dilation using a flexible guide wire to treat obstructive Eustachian tube dysfunction", J Vasc Interv Radiol, 30(10), pp.1562~1566 (2019)
- Kang BC, "Fluoroscopic balloon diameter measurement at different pressures during Eustachian balloon dilation", Clin Otolaryngol, 43(6), pp.1573~1577 (2018)
- Xiong H, "Efficacy of balloon dilation in the treatment of symptomatic Eustachian tube dysfunction : one year follow-up study", Am J Otolaryngol, 37(2), pp.99~102 (2016)
- Li YQ, "Effect of balloon dilation eustachian tuboplasty combined with tympanic tube insertion in the treatment of chronic recurrent secretory otitis media", Eur Arch Otorhinolaryngol, 276(10), pp.2715~2720 (2019)
- Smith ME, "Tests of Eustachian tube function : the effect of testing technique on tube opening in healthy ears", Otol Neurotol, 38(5), pp.714~720 (2017)