title: Laser Eustachian tuboplasty: efficiency evaluation in the pressure chamber.
abstract: OBJECTIVE
  Laser Eustachian tuboplasty (LETP) with ablation of the epipharyngeal orifice of the Eustachian tube (ET) shows good results in clinical observation. However, to this day, there are no reports evaluating the surgical procedure with valid test methods. The purpose of this study was to test the effect of minimally invasive LETP by means of a pressure chamber ET function test.
  
  
  METHODS
  Prospective surgical trial.
  
  
  METHODS
  Tertiary and university hospital.
  
  
  METHODS
  Thirty patients with a history of ET dysfunction during pressure changes were examined.
  
  
  METHODS
  Minimally invasive LETP was performed with an 812-nm diode laser under local anesthesia as an outpatient procedure.
  
  
  METHODS
  The ET function was tested preoperatively and postoperatively by pressure chamber ET function test. Eustachian tube closing pressure (ETCP) was evaluated as a measure of the tissue pressure of the ET. In cases of a severely impaired ET function, a "blocked" pattern was evident, and no measurement of ETCP was possible.
  
  
  RESULTS
  Before minimally invasive LETP, 17 patients showed a completely blocked pattern. Postoperatively, 13 patients of this group showed an improved ET function with a restored normal opening pattern (p < 0.001). The ETCP was reduced from 6.24 ± 3.46 mbar preoperatively to 4.06 ± 2.36 mbar postoperatively (p < 0.013).
  
  
  CONCLUSIONS
  The results strongly indicate that the effect of minimally invasive LETP can be proven by measuring the ET function in a pressure chamber. Results must be interpreted in combination with clinical methods like Valsalva maneuver and tympanometry. Patients with ET dysfunction during pressure changes seem to benefit from the minimally invasive LETP.
authors.affiliation: Clinic of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany. masen.jumah@uk-koeln.de
authors.forename: Masen Dirk
authors.initials: MD
authors.lastname: Jumah
authors.forename: Miriam
authors.initials: M
authors.lastname: Jumah
authors.forename: David
authors.initials: D
authors.lastname: Pazen
authors.forename: Benedikt
authors.initials: B
authors.lastname: Sedlmaier
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D001273:Atmosphere Exposure Chambers; D005064:Eustachian Tube / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013506:Otologic Surgical Procedures / Q000379:methods*; D011300:Preoperative Care; D011312:Pressure; D011446:Prospective Studies; D016896:Treatment Outcome; D014636:Valsalva Maneuver