[Curietherapy of the Eustachian tube using Ir-192 in chronic otitis of tubal origin].
Failure of chronic otitis surgery, especially tympanoplasty, are mainly related to Eustachian tube dysfunction. A new technique of anti-inflammatory irradiation of the Eustachian tube was designed in 1985 in Créteil to improve the Eustachian tube function. The Eustachian tube is catheterized during the tympanoplasty using a plastic tube, 1.6 mm in diameter; this tube is closed at the external end. The other end of the tube is open and goes through the opposite nasal cavity. The plastic tube is loaded 24 h later with a 4.5 cm long irridium 192 wire to deliver a dose of 3 Gy on the reference isodose, 4 mm in diameter, in approximately 3 h. The tube is then gently withdrawn through the nasal cavity. Seventy-four patients, 16 years old or more, took part in the study. The method was performed successfully in 62 patients. Fifty-six patients were followed up; mean follow-up was more than 20 months. The follow-up assessment included otoscopy, audiometry, impedancemetry and residual Rinne measurement. Otoscopy results were adequate in 86% of patients. Hearing was improved in 44% of patients. Impedancemetry was adequate in 70% of patients and residual Rinne lower than 20 dB in 56%. These results are better if compared with those of a series of 30 tympanoplasties performed without intracavitary irradiation in 1984: the tympanoplasty failure rate then was 73%. In conclusion, this new procedure proved to be safe and simple and led to an improvement of the functional results of complex tympanoplasty.
Mazeron
J J
JJ
Département de cancérologie, hôpital Henri-Mondor, Créteil, France.
Desvaux
P
P
Piedbois
P
P
Peynègre
R
R
Pierquin
B
B
D000293:Adolescent; D000328:Adult; D001918:Brachytherapy; D018424:Cholesteatoma, Middle Ear / Q000150:complications; D002908:Chronic Disease; D005064:Eustachian Tube / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000209:etiology / Q000532:radiotherapy*; D010034:Otitis Media with Effusion / Q000532:radiotherapy; D013997:Time Factors
D007496:Iridium Radioisotopes
Plésiocuriethérapie de la trompe d'Eustache par iridium 192 dans les otites chroniques d'origine tubaire.