title: Endoscopic autologous cartilage injection for the patulous eustachian tube.
abstract: Patulous eustachian tube (PET) can have a significant negative impact on a patient's quality of life. Several methods of surgical management can be an option to treat PET, and our objective is to evaluate the safety and efficacy of autologous cartilage injection in patients with PET. Thirty-three ears of twenty-five patients with chronic PET refractory to conservative treatment were enrolled to this study. Autologous tragal cartilage was harvested, and chopped into fine pieces to allow its injection using a 1 cc Bruening syringe. Endoscopic cartilage injection was performed submucosally into the anterior (0.5 mL) and posterior aspects (0.5 mL) of the nasopharyngeal ET under local anesthesia in an operating room. Patients were evaluated postoperatively by nasal endoscopy and by interview to document symptoms. Successful treatment was defined as complete relief or significant improvement plus satisfaction with treatment. The only complication that occurred was temporary otitis media with effusion in one ear. Inferior turbinate reduction was performed in three ears with accompanying nasal septal deviation or turbinate hypertrophy to allow better nasopharyngeal ET visualization. After autologous cartilage injection, the successful treatment rate, as determined by subjective autophony symptoms, was 69.7% (23/33). The average follow-up period was 25.2 months. Autologous cartilage injection is a minimally invasive technique that has been used by the authors to successfully treat patulous eustachian tube. The described procedure was found to provide a good overall success rate without long-term complications.
authors.affiliation: Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Se-Joon
authors.initials: SJ
authors.lastname: Oh
authors.affiliation: Department of Otorhinolaryngology and Biomedical Research Institute, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea.
authors.forename: Il-Woo
authors.initials: IW
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Eui-Kyung
authors.initials: EK
authors.lastname: Goh
authors.affiliation: Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea. Electronic address: entkong@gmail.com.
authors.forename: Soo-Keun
authors.initials: SK
authors.lastname: Kong
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D004724:Endoscopy / Q000379:methods*; D005064:Eustachian Tube; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing / Q000502:physiology*; D006801:Humans; D007267:Injections; D008297:Male; D010034:Otitis Media with Effusion / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome