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. 2023 Sep;132(9):1032-1039.
doi: 10.1177/00034894221129912. Epub 2022 Oct 12.

Clinical Predictors of Symptom Improvement Following Eustachian Tube Balloon Dilation

Hong-Ho Yang  1 , Jose Alonso  1 , Akira Ishiyama  1 , Quinton S Gopen  1 , Jeffrey D Suh  1 , Marilene B Wang  1 , Christine Wells  2 , Vivian Wung  1 , Jivianne T Lee  1
Affiliations

Clinical Predictors of Symptom Improvement Following Eustachian Tube Balloon Dilation

Hong-Ho Yang et al. Ann Otol Rhinol Laryngol. 2023 Sep.

Abstract

Objective: This study aims to identify clinical predictors of treatment response to Eustachian Tube Balloon Dilation (ETBD) as measured by changes in Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores.

Methods: One hundred thirteen patients who underwent ETBD at an institution from 2017 to 2021 completed ETDQ-7 pre- and post-operatively. We conducted multivariable regression analyses with ETDQ-7 normalization (<2.1 post-op), minimum clinically important difference (MCID) (>0.5 pre-op - post-op), and quantitative improvement in ETDQ-7 score as outcome variables. Pre-operative ETDQ-7 score, tympanogram type, chronic otitis media, chronic rhinosinusitis (CRS), inferior turbinate hypertrophy, deviated septum, allergic rhinitis, and rhinorrhea were included as covariates. Models controlled for age, sex, ethnicity, prior ear or sinus surgery, and follow-up duration.

Results: The mean age was 49 years old. 51% were females, and all patients had pre-operative ETDQ-7 above 2.1. After a mean follow-up period of 13 months, 77% achieved MCID and 37% had normalized. Higher pre-operative ETDQ-7 score was associated with greater ETDQ-7 score improvement (B = 0.60, 95% CI = [0.37, 0.83]) and greater odds of achieving MCID (aOR = 1.65; 95% CI = [1.06, 2.59]). A history of CRS improved chances of achieving MCID (aOR = 4.53; 95% CI = [1.11, 18.55]) and a history of chronic otitis media predicted increased odds of ETDQ-7 normalization (aOR = 2.88; 95% CI = [1.09, 7.58]).

Conclusions: Our findings suggest that ETBD was highly effective among patients with pre-operative ETDQ-7 above 2.1. Furthermore, higher pre-operative ETDQ-7 score, CRS, and chronic otitis media predicted more favorable symptomatic benefit from ETBD. These factors may be important to consider when counseling potential candidates for this procedure.

Keywords: ETDQ-7; Eustachian tube; Eustachian tube balloon dilation; chronic rhinosinusitis; otitis media.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Relationship between pre-operative ETDQ-7 score and quantitative improvement in ETDQ-7 score from pre- to post-ETBD.
See this image and copyright information in PMC

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