Tympanic membrane atelectasis, when the eardrum becomes weaker over time and can withdraw into the middle ear space, forming cysts called cholesteatoma, can erode the bones in the ear as well as the bones that separate the ear from the brain and surrounding structures. “Using balloon dilation, we can address issues with chronic dilatory Eustachian tube dysfunction or negative pressure over time,” Dr. Mouzourakis said.
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April 2023In patients with dilatory Eustachian tube dysfunction, laser myringoplasty can be done in conjunction with tympanostomy tubes to equalize pressure. “We thought that it might be interesting to see how laser myringoplasty patients fared with balloon dilation as an adjunct procedure to address the cause of tympanic membrane retraction, the dilatory Eustachian tube dysfunction,” Dr. Mouzourakis said, adding that Dr. Saunders usually does the balloon dilation procedure first, followed by laser myringoplasty in the operating room.
Preliminary results showed that balloon dilation may be equivalent to placement of tympanostomy tubes, can help prevent further procedures, and are also equivalent in terms of the researchers’ ideological outcomes. Because there weren’t many patients in the cohort study, this is an area that needs further research, Dr. Mouzourakis said, as it may be very useful in the future for patients with tympanic membrane atelectasis. She added that there has been very little research on the use of Eustachian tube balloon dilation for patients who have middle ear problems, tympanic membrane atelectasis, or adhesive otitis media, and for patients who are undergoing tympanoplasties.
“This is an area that’s still being discovered,” she said, “so I think it was just interesting to be able to explore that and be in the forefront of the field to see if this is something that can be useful so that we can prevent people from needing many, many sets of ear tubes.”
While the small study did not show a definite benefit to using BDET over tympanostomy tubes, Dr. Saunders said it does seem to be at least equivalent and has many potential advantages. “I think the biggest caveat is that not all patients with chronic ear disease have active Eustachian tube dysfunction. On the other hand, some of these patients may have dilatory dysfunction that’s too severe to be effectively treated with BDET.” He recommended being selective in choosing which patients might benefit from BDET alone.
Based on the preliminary research from this study, Dr. Mouzourakis said one of the big takeaways was that BDET is a very reasonable adjunct option for patients who have dilatory Eustachian tube dysfunction and tympanic membrane atelectasis and can potentially be equivalent to tubes.