Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube.
Studies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow-ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET.



A prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long-term follow-up.



Regional Academic Center.



Out of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects' inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy.



All cases were dilated successfully, without significant complications. Mean follow-up was 2.5 years (range, 1.5-4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41).



The results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues and we are investigating possible reasons for failures.
Department of Otorhinolaryngology, Päijät-Häme Central Hospital, Lahti, Finland Department of Otolaryngology, Oslo University Hospital, Rikshospitalet, Oslo, Norway juha.silvola@ous-hf.no.
Juha
J
Silvola
Department of Otolaryngology and Communication Enhancement Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA Department of Otorhinolaryngology, Tampere University Hospital and the University of Tampere, Tampere, Finland.
Ilkka
I
Kivekäs
Department of Otolaryngology and Communication Enhancement Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Dennis S
DS
Poe
D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000473:pathology; D002404:Catheterization / Q000379:methods; D004106:Dilatation / Q000379:methods; D005064:Eustachian Tube / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000628:therapy*; D038781:Otoscopy / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty
Eustachian tube; balloon dilation; secretory otitis media