Clin Exp Otorhinolaryngol.  2022 Nov;15(4):319-325. 10.21053/ceo.2022.00129.

Long-term Changes of Hearing Thresholds and Eustachian Tube Function After Balloon Dilation of the Eustachian Tube in Patients With Chronic Otitis Media

• Choi Y
• Kang WS
• Ha SC
• Lee SH
• Ahn JH
• Chung JW
• Park HJ

• KMID: 2536530
• DOI: http://doi.org/10.21053/ceo.2022.00129

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.

Keyword

Otitis Media; Eustachian Tube; Balloon Dilation; Eustachian Tube Dysfunction; Mastoidectomy

Figure

• 

  Fig. 1. Technique of endoscopy- and fluoroscopy-guided E-tube balloon dilation. (A) Balloon was positioned in Eustachian tube orifice via endoscopy guide. (B) Guide wide was positioned in Eustachian tube via fluoroscopy guide. (C) Balloon positioned in Eustachian tube was inflated via fluoroscopy guide.

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  Fig. 2. Air-bone gap before and 1 year after balloon dilation of the Eustachian tube (BDET) in the successful Valsalva group (A) and the unsuccessful Valsalva group (B). VT, ventilation tube.

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  Fig. 3. Changes in the air-bone gap (ABG) before and 1 year after balloon dilation of the Eustachian tube. The ABG improved by 8.9±12.4 dB in the successful Valsalva maneuver group, whereas the ABG was aggravated by 3.8±11.8 dB in the unsuccessful Valsalva maneuver group. *Statistically significant.

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