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Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep

BACKGROUND: Untreated chronic otitis media severely impairs quality of life in affected individuals. Local destruction of the middle ear and subsequent loss of hearing are common sequelae, and currently available treatments provide limited relief. Therefore, the objectives of this study were to eval...

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Autores principales: Pohl, Friederike, Schuon, Robert A., Miller, Felicitas, Kampmann, Andreas, Bültmann, Eva, Hartmann, Christian, Lenarz, Thomas, Paasche, Gerrit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935938/
https://www.ncbi.nlm.nih.gov/pubmed/29728102
http://dx.doi.org/10.1186/s13005-018-0165-5
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author Pohl, Friederike
Schuon, Robert A.
Miller, Felicitas
Kampmann, Andreas
Bültmann, Eva
Hartmann, Christian
Lenarz, Thomas
Paasche, Gerrit
author_facet Pohl, Friederike
Schuon, Robert A.
Miller, Felicitas
Kampmann, Andreas
Bültmann, Eva
Hartmann, Christian
Lenarz, Thomas
Paasche, Gerrit
author_sort Pohl, Friederike
collection PubMed
description BACKGROUND: Untreated chronic otitis media severely impairs quality of life in affected individuals. Local destruction of the middle ear and subsequent loss of hearing are common sequelae, and currently available treatments provide limited relief. Therefore, the objectives of this study were to evaluate the feasibility of the insertion of a coronary stent from the nasopharynx into the Eustachian tube in-vivo in sheep and to make an initial assessment of its positional stability, tolerance by the animal, and possible tissue reactions. METHODS: Bilateral implantation of bare metal cobalt-chrome coronary stents of two sizes was performed endoscopically in three healthy blackface sheep using a nasopharyngeal approach. The postoperative observation period was three months. RESULTS: Stent implantation into the Eustachian tube was feasible with no intra- or post-operative complications. Health status of the sheep was unaffected. All stents preserved their cylindrical shape. All shorter stents remained in position and ventilated the middle ear even when partially filled with secretion or tissue. One of the long stents became dislocated toward the nasopharynx. Both of the others remained fixed at the isthmus but appeared to be blocked by tissue or secretion. Tissue overgrowth on top of the struts of all stents resulted in closure of the tissue-lumen interface. CONCLUSION: Stenting of the Eustachian tube was successfully transferred from cadaver studies to an in-vivo application without complications. The stent was well tolerated, the middle ears were ventilated, and clearance of the auditory tube appeared possible. For fixation, it seems to be sufficient to place it only in the cartilaginous part of the Eustachian tube. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13005-018-0165-5) contains supplementary material, which is available to authorized users.
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spelling pubmed-59359382018-05-11 Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep Pohl, Friederike Schuon, Robert A. Miller, Felicitas Kampmann, Andreas Bültmann, Eva Hartmann, Christian Lenarz, Thomas Paasche, Gerrit Head Face Med Research BACKGROUND: Untreated chronic otitis media severely impairs quality of life in affected individuals. Local destruction of the middle ear and subsequent loss of hearing are common sequelae, and currently available treatments provide limited relief. Therefore, the objectives of this study were to evaluate the feasibility of the insertion of a coronary stent from the nasopharynx into the Eustachian tube in-vivo in sheep and to make an initial assessment of its positional stability, tolerance by the animal, and possible tissue reactions. METHODS: Bilateral implantation of bare metal cobalt-chrome coronary stents of two sizes was performed endoscopically in three healthy blackface sheep using a nasopharyngeal approach. The postoperative observation period was three months. RESULTS: Stent implantation into the Eustachian tube was feasible with no intra- or post-operative complications. Health status of the sheep was unaffected. All stents preserved their cylindrical shape. All shorter stents remained in position and ventilated the middle ear even when partially filled with secretion or tissue. One of the long stents became dislocated toward the nasopharynx. Both of the others remained fixed at the isthmus but appeared to be blocked by tissue or secretion. Tissue overgrowth on top of the struts of all stents resulted in closure of the tissue-lumen interface. CONCLUSION: Stenting of the Eustachian tube was successfully transferred from cadaver studies to an in-vivo application without complications. The stent was well tolerated, the middle ears were ventilated, and clearance of the auditory tube appeared possible. For fixation, it seems to be sufficient to place it only in the cartilaginous part of the Eustachian tube. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13005-018-0165-5) contains supplementary material, which is available to authorized users. BioMed Central 2018-05-04 /pmc/articles/PMC5935938/ /pubmed/29728102 http://dx.doi.org/10.1186/s13005-018-0165-5 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pohl, Friederike
Schuon, Robert A.
Miller, Felicitas
Kampmann, Andreas
Bültmann, Eva
Hartmann, Christian
Lenarz, Thomas
Paasche, Gerrit
Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep
title Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep
title_full Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep
title_fullStr Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep
title_full_unstemmed Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep
title_short Stenting the Eustachian tube to treat chronic otitis media - a feasibility study in sheep
title_sort stenting the eustachian tube to treat chronic otitis media - a feasibility study in sheep
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935938/
https://www.ncbi.nlm.nih.gov/pubmed/29728102
http://dx.doi.org/10.1186/s13005-018-0165-5
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