Abstract
The authors reviewed the literature regarding the safety and efficacy of Laser Eustachian Tuboplasty (LETP) in the treatment of Eustachian tube dysfunction (ETD). Medline via Pubmed, OvidSP and Science Direct were consulted, with a supplementary manual review of citations. English language case series constituted a baseline for inclusion. Primary outcome measures were pre- and post-operative tympanometry, otoscopy findings, subjective symptoms and pure tone audiometry, and findings were stratified into short term (≤6 months) and long term (>6 months–5 years). Eight unique case series were identified, detailing LETP procedures in 306 patients (462 Eustachian tubes). LETP demonstrated mixed short-term and positive long-term results across primary outcome measures. There was an overall complication rate of ≈4.4%, and no major adverse events were reported. Poor documentation of pre- and post-operative primary outcome measures and inter-study outcome heterogeneity prevents substantive comment on efficacy. Whilst LETP is safe, its use should remain limited to research in adults. Future trials should be case controlled, and detail pre- and post-operative tympanometry, otoscopy findings, subjective symptoms, and pure tone audiometry. Patients should also be stratified into those suffering from baro-challenge induced ETD, and those suffering from ETD with intractable sequelae, such as Chronic Otitis Media.
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References
Browning GG, Gatehouse S (1992) The prevalence of middle ear disease in the adult British population. Clin Otolaryngol 17:317–321
Bluestone CD (1996) Pathogenesis of otitis media: role of the eustachian tube. Pediatr Infect Dis J 15:281–291
Yücetürk AV, Unlü HH, Okumuş M, Yildiz T, Filiz U (1997) The evaluation of eustachian tube function in patients with chronic otitis media. Clin Otolaryngol Allied Sci 22:449–452
Casselbrant ML, Mandel EM, Kurs-Lasky M, Rockette HE, Bluestone CD (1995) Otitis media in a population of black American and white American infants, 0–2 years of age. Int J Pediatr Otorhinolaryngol 33:1–16
Gluth MB, McDonald DR, Weaver AL et al (2011) Management of eustachian tube dysfunction with nasal steroid spray: a prospective, randomized, placebo-controlled trial. Archives of otolaryngology—head neck. Surgery 137:449–455
Ludman H (1988) Mawson’s diseases of the Ear. Edward Arnold, London
Yung MW (1997) Retraction of the pars tensa—long-term results of surgical treatment. Clin Otolaryngol 22:323–326
Miller BJ, Elhassan HA (2013) Balloon dilatation of the Eustachian tube: an evidence-based review of case series for those considering its use. Clin Otolaryngol 38:525–532
Hwang SY, Kok S, Walton J (2016) Balloon dilation for eustachian tube dysfunction: systematic review. J Laryngol Otol S4:S2–6
Schilder AGM, Bhutta MF, Butler CC, Holy C, Levine LH, Kvaerner KJ, Norman G, Pennings RJ, Poe D, Silvola JT, Sudhoff H, Lund VJ (2015) Eustachian tube dysfunction: a consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol 40:407–411
Caffier PP, Sedlmaier B, Haupt H, Göktas O, Scherer H, Mazurek B (2011) Impact of laser eustachian tuboplasty on middle ear ventilation, hearing, and tinnitus in chronic tube dysfunction. Ear Hear 32:132–139
Jumah MD, Jumah M, Pazen D, Sedlmaier B (2012) Laser eustachian tuboplasty—efficiency evaluation in the pressure chamber. Otol Neurotol 33:406–412
Jumah M, Jumah MD (2013) Restoring middle ear pressure equalization in divers by laser Eustachian tuboplasty. Undersea Hyperb Med 40:299–306
Kujawski OB, Poe DS (2004) Laser eustachian tuboplasty. Otol Nerotol 25:1–8
Poe DS, Metson RB, Kujawski O (2003) Laser eustachian tuboplasty—a preliminary report. Laryngoscope 113:583–591
Poe DS, Grimmer JF, Metson R (2007) Laser eustachian tuboplasty—2-year results. Laryngoscope 117:231–237
Sedlmaier B, Pomorzev A, Haisch A, Halleck P, Scherer H, Göktas O (2009) The improvement of middle ear ventilation by laser ablation of the epipharyngeal eustachian tube: a prospective study. Lasers Med Sci 24:793–800
Yañez C (2010) Cross-hatching—a novel technique for Eustachian tuboplasty. Preliminary report. Otolaryngol Head Neck Surg 142:688–693
Yañez C, Velázquez S, Mora N (2014) Long term outcomes of cross-hatching Eustachian tuboplasty. Int J Otolaryngol Head Neck Surg 4:6–12
McCoul ED, Lucente FE, Anand VK (2011) Evolution of Eustachian tube surgery. Laryngoscope 121:661–666
O’Connor AF, Shea JJ (1981) Autophony and the patulous eustachian tube. Laryngoscope 91:1427–1435
Poe DS, Abou-Halawa A, Abdel-Razek O (2001) Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 22:590–595
Hopf J, Linnarz M, Gundlach P et al (1991) Microendoscopy of the eustachian tube and the middle ear indications and clinical application [in German]. Laryngorhinootologie 70:391–394
Mathew GA, Kuruvilla G, Job A (2007) Dynamic slow motion video endoscopy in eustachian tube assessment. Am J Otolarygol 28:91–97
Metson R, Pletcher SD, Poe DS (2007) Microdebrider eustachian tuboplasty: a preliminary report. Otolaryngol Head Neck Surg 136:422–427
Randrup TS, Ovesen T (2015) Balloon eustachian tuboplasty: a systematic review. Otolaryngol Head Neck Surg 152:383–392
Sudo M, Sando I (1996) Developmental changes in folding of the human eustachian tube. Acta Otolaryngolica 116:307–311
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Benjamin Miller, Mustafa Jaafar and Hassan A. Elhassan declare that they have no conflicts of interest.
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Miller, B.J., Jaafar, M. & Elhassan, H.A. Laser Eustachian Tuboplasty for Eustachian Tube Dysfunction: a case series review. Eur Arch Otorhinolaryngol 274, 2381–2387 (2017). https://doi.org/10.1007/s00405-017-4476-0
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DOI: https://doi.org/10.1007/s00405-017-4476-0