Dr. Aldriweesh, who also uses balloon dilation for Eustachian tube dysfunction and subglottic and/or tracheal stenosis, said she liked using balloon dilation in this case for providing a means to expand a stenotic area with a high-pressure mechanism, facilitating a graft insertion into the cricoid split.
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April 2023According to the study, compared to the traditional transcervical approach, EPCS/RG has a reduced operative time and aspiration risk, is associated with minimal morbidity, and does not require a neck incision. It has an excellent overall surgical success rate of up to 89%, which was defined as either the avoidance of tracheostomy or successful decannulation. EPCS/RG has been popularized for pediatric patients due to age-related changes in the cricoid cartilage’s stiffness and ossification, thus limiting its use in older patients.
“We found that with balloon dilation technique, endoscopic posterior cricoid grafting could be done with ease in an older age group, even with age-related changes in the cartilage,” Dr. Aldriweesh said. “The pressure of the balloon helped in dilating the posterior cricoid split and in locking the graft in place.” Another benefit, she added, was a faster operative time. She said other novel uses for balloon dilation are in oropharyngeal and hypopharyngeal stenosis management.
BDET with Laser Myringoplasty for Tympanic Membrane Atelectasis
Maggie M. Mouzourakis, MD was the lead resident speaker at the 2023 Triological Society Sections Meetings for a presentation on the role of BDET as an adjunct procedure for laser myringoplasty treatment of tympanic membrane atelectasis. Dr. Mouzourakis is a PGY3 at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire; her mentor, Dr. Saunders, was the lead researcher.
Prior to the invention of balloon dilation, patients who had chronic dilatory Eustachian tube dysfunction, or difficulty equalizing pressure in their middle ears, had few options. —Maggie M. Mouzourakis, MD
“This is of particular interest to anybody in otology, I think,” Dr. Mouzourakis said, “because prior to the invention of balloon dilation, patients who had chronic dilatory Eustachian tube dysfunction, or difficulty equalizing pressure in their middle ears, had few options. We were frequently placing ear tubes, sometimes as often as every two years, because they [ear tubes] can become clogged, fall out, or have other complications.
Additionally, each time a new set of ear tubes is placed, the incision made in the eardrum can make the area weaker over time and cause scarring, with a recurring risk of a permanent tear. Balloon dilation, on the other hand, gets around the problem of repeated trauma and potential scarring to the eardrum while at the same time addressing at the source the inability to equalize pressure in the Eustachian tube.