Balloon Dilation Eustachian Tuboplasty for Dilatory Dysfunction With and Without Effusion: A Comprehensive Outcome Analysis

Otolaryngol Head Neck Surg. 2023 Nov;169(5):1179-1186. doi: 10.1002/ohn.383. Epub 2023 Jun 2.

Abstract

Objective: This study aimed (1) to demonstrate the efficacy of balloon dilation Eustachian tuboplasty (BDET) for dilatory Eustachian tube dysfunction (ETD) and (2) to determine whether adjunctive ventilation tube insertion (VTI) is superior to myringotomy in relieving symptoms for patients with ETD and concurrent middle ear effusion (MEE) treated with BDET.

Study design: A retrospective cohort study.

Setting: Tertiary care academic center.

Methods: Patients with dilatory ETD undergoing BDET with a ≥6-month follow-up period were enrolled and evaluated mainly using Eustachian tube function (ETF) tests and Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7). Participants with concurrent MEE were further classified into 2 subgroups, BDET with VTI and BDET with myringotomy. An intergroup comparison and comprehensive outcome evaluation were performed.

Results: In total, 35 patients with 50 symptomatic ears were enrolled. According to ETF test results, the normalized ETF rate was 94% on the last visit. The mean ETDQ-7 scores decreased significantly from 3.7 ± 1.4 to 2.0 ± 0.9 after interventions, with the most improvement in symptoms occurring for "ear fullness" and "muffled hearing." For the final visit, strong correlations among ETF tests, tympanometry, and Valsalva results were noted. The aforementioned assessment results did not significantly differ between (1) the patients with MEE and patients without MEE and (2) "BDET with VTI" subgroup and "BDET with myringotomy" subgroup.

Conclusion: BDET was effective for dilatory ETD, even in cases with concurrent MEE. For patients with ETD and MEE, further research is required to evaluate the benefits of adjunctive myringotomy with or without VTI.

Keywords: Eustachian tube dysfunction; Eustachian tube function tests; balloon dilation Eustachian tuboplasty; middle ear effusion; ventilation tube insertion.

MeSH terms

  • Acoustic Impedance Tests
  • Dilatation / methods
  • Ear Diseases* / diagnosis
  • Endoscopy
  • Eustachian Tube* / surgery
  • Humans
  • Otitis Media with Effusion* / surgery
  • Retrospective Studies