title: The effect of ventilation tube insertion or trans-tympanic silicone plug insertion on a patulous Eustachian tube.
abstract: Conclusions This study suggests that long-term ventilation tube insertion is the first-choice surgical treatment for a 'sniff-type' patulous Eustachian tube (PET). When treating a refractory PET, it is important to determine whether the patient had a habitual sniff. Objectives PET patients were divided into two groups: patients with a habitual sniff (sniff-type PET) and those without a habitual sniff (non-sniff-type PET). This study examined the effects of ventilation tube insertion or silicone plug insertion in each group. Methods Surgical procedures such as ventilation tube insertion or trans-tympanic silicone plug insertion were performed for these patients. Tubotympanoaero-dynamic graphy (TTAG) was also performed to determine the mechanisms underlying these treatments. Results There were 11 cases (17 ears) of sniff-type PET and 20 cases (27 ears) of non-sniff-type PET. An improvement in symptoms was found in 72.7% of the patients who underwent silicone plug insertion (66.7% for sniff-type PET and 74.1% for non-sniff-type PET) and in 90.9% of the patients who underwent ventilation tube insertion for sniff-type PET. In TTAG assessments, many sniff-type PET patients showed significant synchronous changes at high levels of pressure (over 40 daPa) in the external auditory meatus and nasopharynx when performing a slight Valsalva manoeuvre (below 200 daPa).
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Shiori
authors.initials: S
authors.lastname: Endo
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Mizuta
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Goro
authors.initials: G
authors.lastname: Takahashi
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakanishi
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamatodani
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Misawa
authors.affiliation: b Department of Otorhinolaryngology , Iwata City Hospital , Iwata , Shizuoka , Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Hosokawa
authors.affiliation: a Department of Otorhinolaryngology/Head and Neck Surgery , Hamamatsu University School of Medicine , Hamamatsu , Shizuoka , Japan ;
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mineta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005064:Eustachian Tube / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000295:instrumentation*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Kobayashi Plug; habitual sniff; tubotympanoaero-dynamic graphy; tympanogram