title: Laser Eustachian Tuboplasty for Eustachian Tube Dysfunction: a case series review.
abstract: The authors reviewed the literature regarding the safety and efficacy of Laser Eustachian Tuboplasty (LETP) in the treatment of Eustachian tube dysfunction (ETD). Medline via Pubmed, OvidSP and Science Direct were consulted, with a supplementary manual review of citations. English language case series constituted a baseline for inclusion. Primary outcome measures were pre- and post-operative tympanometry, otoscopy findings, subjective symptoms and pure tone audiometry, and findings were stratified into short term (≤6 months) and long term (>6 months-5 years). Eight unique case series were identified, detailing LETP procedures in 306 patients (462 Eustachian tubes). LETP demonstrated mixed short-term and positive long-term results across primary outcome measures. There was an overall complication rate of ≈4.4%, and no major adverse events were reported. Poor documentation of pre- and post-operative primary outcome measures and inter-study outcome heterogeneity prevents substantive comment on efficacy. Whilst LETP is safe, its use should remain limited to research in adults. Future trials should be case controlled, and detail pre- and post-operative tympanometry, otoscopy findings, subjective symptoms, and pure tone audiometry. Patients should also be stratified into those suffering from baro-challenge induced ETD, and those suffering from ETD with intractable sequelae, such as Chronic Otitis Media.
authors.affiliation: General Intensive Care Unit, St George's Hospital, London, UK. benjaminmiller@nhs.net.
authors.forename: Benjamin John
authors.initials: BJ
authors.lastname: Miller
authors.affiliation: Department of Otolaryngology, Morriston Hospital, Swansea, UK.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Jaafar
authors.affiliation: Department of Otolaryngology, Morriston Hospital, Swansea, UK.
authors.forename: Hassan A
authors.initials: HA
authors.lastname: Elhassan
mesh_terms: D002908:Chronic Disease; D003939:Diagnostic Techniques, Otological; D005064:Eustachian Tube / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D010033:Otitis Media / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000295:instrumentation / Q000379:methods
keywords: Chronic Otitis Media; ETD; Eustachian Tube Dysfunction; Eustachian tube; LETP; Laser Eustachian Tuboplasty; Lasers