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Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube

OBJECTIVE: To assess the role and effect of concomitant adjunctive procedures when combined with balloon dilation of the Eustachian tube (BDET), including a new technique for treating obstructive disease within the bony Eustachian tube (ET). STUDY DESIGN: Retrospective case series. SETTING: Tertiary...

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Autores principales: Ashry, Yehia, Kawai, Kosuke, Poe, Dennis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743173/
https://www.ncbi.nlm.nih.gov/pubmed/29299505
http://dx.doi.org/10.1002/lio2.110
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author Ashry, Yehia
Kawai, Kosuke
Poe, Dennis
author_facet Ashry, Yehia
Kawai, Kosuke
Poe, Dennis
author_sort Ashry, Yehia
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description OBJECTIVE: To assess the role and effect of concomitant adjunctive procedures when combined with balloon dilation of the Eustachian tube (BDET), including a new technique for treating obstructive disease within the bony Eustachian tube (ET). STUDY DESIGN: Retrospective case series. SETTING: Tertiary medical center. SUBJECTS: Adults with persistent (≥2 years): 1) OME or non‐fixed TM retraction AND type B or C tympanogram OR 2) Consistent symptoms of barochallenge with flights or diving, all despite medical treatment for ≥6 weeks. METHODS: Balloon dilation of the cartilaginous ET (BDET) was performed under general anesthesia using concomitant myringotomy with or without tube placement if indicated. Adjunctive turbinectomy, adenoidectomy, and/or tympanoplasty were used in selected cases. For suspected disease in the bony ET, an illuminated guidewire was used for probing and clearing the lumen. Outcome measures were tympanogram, otomicroscopy, ET mucosal inflammation score, Valsalva maneuver, and PTA audiometry. RESULTS: 67 ETs (48 patients) underwent BDET: 1) 30/67 balloon w/wo myringotomy, w/wo tube, 2) 20/67 plus adjunctive procedure or 3) 17/67 plus guidewire. Follow‐up was ranging from 0.4 to 3.4 years (mean 1.3 year, SD = 0.7). Significant improvement occurred in 79%. There was no significant difference in the failure rate comparing balloon dilation with adjunctive procedures 5/20 (25%) or without adjunctive procedures; 4/30 p = 0.45 (13%). Failure rate for BDET plus guide wire was 5/17 (29%) and resistance within the bony ET occurred in 8/17 (47%). CONCLUSION: Balloon dilation of the cartilaginous ET demonstrated significant improvement despite expansion of indications that necessitated the addition of adjunctive procedures. LEVEL OF EVIDENCE: 4
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spelling pubmed-57431732018-01-03 Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube Ashry, Yehia Kawai, Kosuke Poe, Dennis Laryngoscope Investig Otolaryngol Otology, Neurotology, and Neuroscience OBJECTIVE: To assess the role and effect of concomitant adjunctive procedures when combined with balloon dilation of the Eustachian tube (BDET), including a new technique for treating obstructive disease within the bony Eustachian tube (ET). STUDY DESIGN: Retrospective case series. SETTING: Tertiary medical center. SUBJECTS: Adults with persistent (≥2 years): 1) OME or non‐fixed TM retraction AND type B or C tympanogram OR 2) Consistent symptoms of barochallenge with flights or diving, all despite medical treatment for ≥6 weeks. METHODS: Balloon dilation of the cartilaginous ET (BDET) was performed under general anesthesia using concomitant myringotomy with or without tube placement if indicated. Adjunctive turbinectomy, adenoidectomy, and/or tympanoplasty were used in selected cases. For suspected disease in the bony ET, an illuminated guidewire was used for probing and clearing the lumen. Outcome measures were tympanogram, otomicroscopy, ET mucosal inflammation score, Valsalva maneuver, and PTA audiometry. RESULTS: 67 ETs (48 patients) underwent BDET: 1) 30/67 balloon w/wo myringotomy, w/wo tube, 2) 20/67 plus adjunctive procedure or 3) 17/67 plus guidewire. Follow‐up was ranging from 0.4 to 3.4 years (mean 1.3 year, SD = 0.7). Significant improvement occurred in 79%. There was no significant difference in the failure rate comparing balloon dilation with adjunctive procedures 5/20 (25%) or without adjunctive procedures; 4/30 p = 0.45 (13%). Failure rate for BDET plus guide wire was 5/17 (29%) and resistance within the bony ET occurred in 8/17 (47%). CONCLUSION: Balloon dilation of the cartilaginous ET demonstrated significant improvement despite expansion of indications that necessitated the addition of adjunctive procedures. LEVEL OF EVIDENCE: 4 John Wiley and Sons Inc. 2017-11-30 /pmc/articles/PMC5743173/ /pubmed/29299505 http://dx.doi.org/10.1002/lio2.110 Text en © 2017 The Authors Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Otology, Neurotology, and Neuroscience
Ashry, Yehia
Kawai, Kosuke
Poe, Dennis
Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube
title Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube
title_full Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube
title_fullStr Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube
title_full_unstemmed Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube
title_short Utility of Adjunctive Procedures With Balloon Dilation of the Eustachian Tube
title_sort utility of adjunctive procedures with balloon dilation of the eustachian tube
topic Otology, Neurotology, and Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5743173/
https://www.ncbi.nlm.nih.gov/pubmed/29299505
http://dx.doi.org/10.1002/lio2.110
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