Eustachian tube balloon dilation surgery

Abstract

Background: Eustachian tube dysfunction (ETD) is a common condition without an effective, accepted treatment. Balloon dilation Eustachian tuboplasty (BDET) has been recently proposed for the management of ETD. Previous studies of Eustachian tube function and treatment have not included a validated assessment of patient symptoms. We report for the first time the outcomes of BDET using a validated disease-specific symptom score, the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7).

Methods: Consecutive patients undergoing BDET were prospectively enrolled from an otolaryngology practice at a tertiary care medical center. Inclusion criteria were adults with a diagnosis of ETD based on symptoms and abnormal tympanogram. Patients with craniofacial abnormalities or active infection were excluded from study. Primary outcome measures included the ETDQ-7 score, tympanometry, and otoscopic appearance. Secondary measures included the 22-item Sinonasal Outcome Test (SNOT-22) score.

Results: Twenty-two consecutive patients underwent 35 BDET procedures. Significant postoperative improvement was seen in tympanometry and otoscopic appearance (p < 0.001). ETDQ-7 scores at 3 weeks, 6 weeks, 12 weeks, and 6 months postoperatively were significantly improved over baseline (p < 0.001). ETDQ-7 scores showed fair correlation with SNOT-22 scores (r > 0.65). ETDQ-7 change scores demonstrated good responsiveness and sensitivity to clinical change following BDET.

Conclusion: BDET is an effective surgical intervention for the treatment of ETD in adults. Postoperative improvements were observed using objective and subjective measures. The ETDQ-7 is a valid, disease-specific instrument for the assessment of treatment outcomes and may be applied for clinical use in patients with ETD. Further study is necessary to determine long-term effectiveness.