Concurrent Balloon Dilation Eustachian Tuboplast and TT Placement Effective in Children with ETD

by Linda Kossoff •

CLINICAL QUESTION

What are the long-term outcomes of children with Eustachian Tube Dysfunction (ETD) who underwent concurrent balloon dilation Eustachian tuboplasty (BDET) and tympanostomy tube (TT) placement?

BOTTOM LINE

Concurrent BDET and TT placement may be an effective treatment option for pediatric patients with persistent Eustachian tube dysfunction.

BACKGROUND: Tympanostomy tube placement is the standard of care for chronic ETD. Unlike TT placement, however, BDET targets ETD directly at the mucosal level within the cartilaginous Eustachian tube. Like TT, BDET has been proven safe for children. Concurrent BDET and TT placement may be efficacious in certain pediatric patients.

STUDY DESIGN: Retrospective review

SETTING: Department of Otolaryngology-Head and Neck Surgery, Ascension St. John Hospital, Detroit

SYNOPSIS: Researchers reviewed the charts of 19 pediatric patients (58% male, mean age 11.4 years) who underwent concurrent BDET and TT placement between March 2018 and February 2020. These patients were extracted from a cohort of 43 subjects in a broader 2021 study. For the 19 patients, the mean duration of postoperative surveillance was 32.15 months, consisting of an average of three post-operative visits. Data points included the need for re-operation, rates of middle ear pathology, audiological outcomes, and the number of previous TT placements. Results showed that pediatric patients who underwent concurrent BDET and TT placement had long-term success in 34/36 ears (94.4%). All post-operative tympanograms and audiograms (100%) were normal when performed within 12 months after the procedure. A total of 34/36 ears (94.4%) had a history of tube placement in the past, with an average of three sets of tympanostomy tubes prior to undergoing concurrent BDET and TT. Only one of the 36 ears had a documented episode of acute otitis media following the concurrent procedures. Study limitations included its retrospective nature and potential benefits from adjunctive procedures undergone by the patients.

CITATION: Ahluwalia J, et al. Outcomes of concurrent balloon Eustachian tuboplasty and tympanostomy tube placement in children. Laryngoscope. 2024;134(11):4799-4802. doi: 10.1002/lary.31572.