Fluoroscopic balloon diameter measurement at different pressures during Eustachian balloon dilation

Clin Otolaryngol. 2018 Dec;43(6):1573-1577. doi: 10.1111/coa.13218. Epub 2018 Sep 12.

Abstract

Objectives: To measure the diameter of inflated balloons at different pressures during Eustachian tube (ET) balloon dilation under fluoroscopic guidance.

Design: Prospective cohort study.

Setting: Tertiary academic referral centre.

Participants: Eighteen patients who underwent ET balloon dilation with use of a balloon catheter, 20 mm long and 6 mm in diameter, under combined endoscopic and fluoroscopic guidance.

Main outcome measures: Degrees of inflation at three different portions (proximal, middle and distal) of the balloon at controlled pressures (3, 5, 8 and 10 atmospheres [atm]) and at the maximum pressure manually applied.

Results: The mean proximal, middle and distal diameters of the inflated balloons were 5.3 ± 0.4 mm, 5.3 ± 0.4 mm and 4.9 ± 0.5 mm at 10 atm. The distal diameters were significantly smaller than middle and proximal diameters at all the pressures (P < 0.01). When compared to the distal diameter (100%, 4.9 ± 0.5 mm) at 10 atm, the distal diameters were 73% (3.6 ± 0.6 mm) at 3 atm, 88% (4.3 ± 0.5 mm) at 5 atm and 96% (4.7 ± 0.4 mm) at 8 atm. The distal diameter (4.1 ± 0.3 mm) at the maximum pressure manually applied was in between those at 3 and 5 atm.

Conclusions: The distal diameter of the balloon increased significantly as a function of the pressure and most (88%) inflation occurred at a low pressure of 5 atm, which was sufficient to inflate the distal diameter of the balloon more than 3 mm. The manual pressurisation could inflate a balloon by as much as could be expected, at between 3 and 5 atm.

Keywords: Eustachian tube; balloon catheter; dilation; otitis media; pressure.

MeSH terms

  • Adult
  • Aged
  • Catheterization / instrumentation*
  • Chronic Disease
  • Dilatation / instrumentation*
  • Endoscopy / methods*
  • Equipment Design
  • Eustachian Tube / diagnostic imaging*
  • Eustachian Tube / physiopathology
  • Female
  • Fluoroscopy / methods*
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Otitis Media with Effusion / diagnosis*
  • Otitis Media with Effusion / therapy
  • Pressure
  • Prospective Studies
  • Tomography, X-Ray Computed