title: Endoscopic hydroxyapatite augmentation for patulous Eustachian tube.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of endoscopic calcium hydroxyapatite injection in patients with patulous Eustachian tube.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Fourteen patients diagnosed with patulous Eustachian tube (PET) underwent endoscopic hydroxyapatite injection under general anesthesia. All patients had at least two of three major PET symptoms including voice autophony, breathing autophony, or aural fullness/pressure. Patients were evaluated postoperatively with nasal endoscopy and a symptom questionnaire.
  
  
  RESULTS
  Endoscopic Eustachian tube injection was performed in a total of 23 sides in 14 patients with an average volume of 2.1 cc injected per side. Mean follow-up was 17.5 months. The most common symptoms reported preoperatively were voice autophony (96%), breathing autophony (91%), and ear fullness (83%). A complete or significant response to treatment was noted in 13/22 sides with voice autophony (59%), 12/21 sides with breathing autophony (57%), and 12/19 sides with ear fullness (63%). All complete or significant symptom improvements remained durable through the entirety of the follow-up period. Four sides that had temporary or no improvement with treatment underwent repeat injection but did not achieve additional improvement. No intraoperative or postoperative complications were observed.
  
  
  CONCLUSIONS
  Endoscopic hydroxyapatite injection of the Eustachian tube is a minimally invasive procedure that provided significant or complete relief of autophony and ear fullness in 57% to 63% of sides treated. The procedure is well tolerated and can be performed safely under endoscopic visualization. Hydroxyapatite injection may be a satisfactory alternative to more invasive treatments for PET.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Reza
authors.initials: R
authors.lastname: Vaezeafshar
authors.forename: Justin H
authors.initials: JH
authors.lastname: Turner
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.forename: Peter H
authors.initials: PH
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000008:administration & dosage*; D017886:Durapatite / Q000008:administration & dosage*; D004427:Ear Diseases / Q000628:therapy*; D004724:Endoscopy; D005064:Eustachian Tube; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite
keywords: Eustachian tube; Patulous Eustachian tube; augmentation; hydroxyapatite; injection