Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty
ABSTRACT
Objective: To review the long term outcomes of cross-hatching Eustachian Tuboplasty (ChEt) in patients with chronic obstructive Eustachian tube dysfunction (COETD), as well as assess the clinical factors associated with surgical success. Study Design: Retrospective case series review. Setting: Tertiary healthcare institution. Methods: This is a retrospective review of non-revision ChET for COETD. Follow-up period was 5 years. The inclusion criteria were persistent otitis media with effusion, conductive hearing loss of 5 or more years, and constant COETD related-symptoms. The curvature of the posterior cushion was modified using an argon laser to alter the spring of the cartilage alleviating the obstructed valve’s aperture. Several clinical factors were reviewed in relation to the successful opening of Eustachian tube valve. Results: One hundred and twenty patients, 72 males/48 females, average age 42.4 + 2 years old, met study inclusion criteria. COETD patients/ obstructive causes were: Posterior cushion hypertrophy, 68 (56.6%); Tensor Veli and Levator Veli Palatini muscles hypertrophy, 15 (12.5%); Remarkable mucosal hypertrophic disease, 37 (30.8%). Total of ET tubes was 198. Bilateral 143 (72.2%), 55 unilateral (27.7%) ET valve was seen more open postoperatively on simple endoscopy (SE) and slow motion video analysis (SMVEA). There were no complications. Mean pure tone average improved by 20 dB postoperatively; P = 0.015. Mean immitance changes in tympanometric measurements improved postoperatively at least 0.10 mmhos in 91% of the patients (P = 0.010). Resolution of symptoms was considered a successful outcome. Failure correlated with the severity of disease. Conclusion: High rates of improvement (96%) were achieved. ChEt is a promising technique for the treatment of COETD
Objective: To review the long term outcomes of cross-hatching Eustachian Tuboplasty (ChEt) in patients with chronic obstructive Eustachian tube dysfunction (COETD), as well as assess the clinical factors associated with surgical success. Study Design: Retrospective case series review. Setting: Tertiary healthcare institution. Methods: This is a retrospective review of non-revision ChET for COETD. Follow-up period was 5 years. The inclusion criteria were persistent otitis media with effusion, conductive hearing loss of 5 or more years, and constant COETD related-symptoms. The curvature of the posterior cushion was modified using an argon laser to alter the spring of the cartilage alleviating the obstructed valve’s aperture. Several clinical factors were reviewed in relation to the successful opening of Eustachian tube valve. Results: One hundred and twenty patients, 72 males/48 females, average age 42.4 + 2 years old, met study inclusion criteria. COETD patients/ obstructive causes were: Posterior cushion hypertrophy, 68 (56.6%); Tensor Veli and Levator Veli Palatini muscles hypertrophy, 15 (12.5%); Remarkable mucosal hypertrophic disease, 37 (30.8%). Total of ET tubes was 198. Bilateral 143 (72.2%), 55 unilateral (27.7%) ET valve was seen more open postoperatively on simple endoscopy (SE) and slow motion video analysis (SMVEA). There were no complications. Mean pure tone average improved by 20 dB postoperatively; P = 0.015. Mean immitance changes in tympanometric measurements improved postoperatively at least 0.10 mmhos in 91% of the patients (P = 0.010). Resolution of symptoms was considered a successful outcome. Failure correlated with the severity of disease. Conclusion: High rates of improvement (96%) were achieved. ChEt is a promising technique for the treatment of COETD
Cite this paper
Yanez, C. , Velázquez, S. and Mora, N. (2015) Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty. International Journal of Otolaryngology and Head & Neck Surgery, 4, 6-12. doi: 10.4236/ijohns.2015.41002.
Yanez, C. , Velázquez, S. and Mora, N. (2015) Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty. International Journal of Otolaryngology and Head & Neck Surgery, 4, 6-12. doi: 10.4236/ijohns.2015.41002.
References
[1] Hopf, J., Linnarz, M., Gundlach, P., et al. (1991) Die Mikroendoskopie der eustachischen rohre und des mittelhres: Indikationen und klinischer einsatzpunkt. Laryngorhinootologie, 70, 391-394. http://dx.doi.org/10.1055/s-2007-998060 [2] Kujawski, O. (2000) Laser Eustachian Tuboplasty (LEPT): 4th European Congress of EUFOS. Otolaryngology—Head and Neck Surgery, 2, 835-842. [3] Kujawski, O.B. and Poe, D.S. (2004) Laser Eustachian Tuboplasty. Otology Neurotology, 25, 1-8.
http://dx.doi.org/10.1097/00129492-200401000-00001 [4] Poe, D.S., Metson, R.B. and Kujawski, O. (2003) Laser Eustachian Tuboplasty: A Preliminary Report. Laryngoscope, 113, 583-591. http://dx.doi.org/10.1097/00005537-200304000-00001 [5] Yanez, C. (2010) Cross-Hatching Technique for Eustachian Tuboplasty: Preliminary Report. Otolaryngology—Head and Neck Surgery, 142, 688-693.
http://dx.doi.org/10.1016/j.otohns.2009.12.046? [6] Yanez, C. and Mora, N. (2008) Classification System for Results in Eustachian Tube Surgery. Otolaryngology—Head and Neck Surgery, 139, P74. http://dx.doi.org/10.1016/j.otohns.2008.05.238 [7] McCoul, E.D., Lucente, F.E. and Anand, V.K. (2011) Evolution of Eustachian Tube Surgery. The Laryngoscope, 121, 661-666. [8] Schroder, S., Lehmann, M., Sauzet, O., Ebmeyer, J. and Sudhoff, H. (2014) A Novel Diagnostic Tool for Chronic Obstructive Eustachian Tube Dysfunction—The Eustachian Tube Score. The Laryngoscope.
http://dx.doi.org/10.1002/lary.24922 [9] Miller, B.J. and Elhassan, H.A. (2013) Balloon Dilatation of the Eustachian Tube: An Evidence Based Review of Case Series for Those Considering Its Use. Clinical Otolaryngology, 38, 525-532. http://dx.doi.org/10.1111/coa.12195 [10] Poe, D.S., Silvola, J. and Pyykko, I. (2011) Balloon Dilation of the Cartilaginous Eustachian Tube. Otolaryngology— Head and Neck Surgery, 144, 563-569.
http://dx.doi.org/10.1177/0194599811399866
[1] Hopf, J., Linnarz, M., Gundlach, P., et al. (1991) Die Mikroendoskopie der eustachischen rohre und des mittelhres: Indikationen und klinischer einsatzpunkt. Laryngorhinootologie, 70, 391-394. http://dx.doi.org/10.1055/s-2007-998060 [2] Kujawski, O. (2000) Laser Eustachian Tuboplasty (LEPT): 4th European Congress of EUFOS. Otolaryngology—Head and Neck Surgery, 2, 835-842. [3] Kujawski, O.B. and Poe, D.S. (2004) Laser Eustachian Tuboplasty. Otology Neurotology, 25, 1-8.
http://dx.doi.org/10.1097/00129492-200401000-00001 [4] Poe, D.S., Metson, R.B. and Kujawski, O. (2003) Laser Eustachian Tuboplasty: A Preliminary Report. Laryngoscope, 113, 583-591. http://dx.doi.org/10.1097/00005537-200304000-00001 [5] Yanez, C. (2010) Cross-Hatching Technique for Eustachian Tuboplasty: Preliminary Report. Otolaryngology—Head and Neck Surgery, 142, 688-693.
http://dx.doi.org/10.1016/j.otohns.2009.12.046? [6] Yanez, C. and Mora, N. (2008) Classification System for Results in Eustachian Tube Surgery. Otolaryngology—Head and Neck Surgery, 139, P74. http://dx.doi.org/10.1016/j.otohns.2008.05.238 [7] McCoul, E.D., Lucente, F.E. and Anand, V.K. (2011) Evolution of Eustachian Tube Surgery. The Laryngoscope, 121, 661-666. [8] Schroder, S., Lehmann, M., Sauzet, O., Ebmeyer, J. and Sudhoff, H. (2014) A Novel Diagnostic Tool for Chronic Obstructive Eustachian Tube Dysfunction—The Eustachian Tube Score. The Laryngoscope.
http://dx.doi.org/10.1002/lary.24922 [9] Miller, B.J. and Elhassan, H.A. (2013) Balloon Dilatation of the Eustachian Tube: An Evidence Based Review of Case Series for Those Considering Its Use. Clinical Otolaryngology, 38, 525-532. http://dx.doi.org/10.1111/coa.12195 [10] Poe, D.S., Silvola, J. and Pyykko, I. (2011) Balloon Dilation of the Cartilaginous Eustachian Tube. Otolaryngology— Head and Neck Surgery, 144, 563-569.
http://dx.doi.org/10.1177/0194599811399866