Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-19T18:00:20.398Z Has data issue: false hasContentIssue false

Eustachian tube balloon dilatation: a cross-sectional, survey-based study of 137 UK consultants

Published online by Cambridge University Press:  23 December 2019

F S Koumpa*
Affiliation:
Otolaryngology Department, Northwick Park Hospital, London, UK
I Moraitis
Affiliation:
Vascular Surgery Department, Milton Keynes University Hospital, UK
P Bowles
Affiliation:
Otolaryngology Department, Brighton and Sussex University Hospital Trust, UK
N Saunders
Affiliation:
Otolaryngology Department, Brighton and Sussex University Hospital Trust, UK
*
Author for correspondence: Mr Stefania Koumpa, Otolaryngology Department, Northwick Park Hospital, London, UK E-mail: [email protected]

Abstract

Objective

To explore the opinions of the UK consultant body on endoscopic Eustachian tube balloon dilatation in the context of Eustachian tube dysfunction.

Method

A 10-question online survey was distributed to ENT consultants currently practising in the UK (July–September 2018).

Results

A total of 137 ENT consultants responded. Twenty-three per cent reported experience of Eustachian tube balloon dilatation, with a further 10 per cent planning to start performing the procedure. Of those performing the procedure, 16 per cent had more than two years’ experience. Thirty-two per cent were performing zero to five procedures a year. Eustachian tube balloon dilatation was primarily conducted to treat Eustachian tube dysfunction symptoms, as well as retraction pockets, baro-challenge-induced Eustachian tube dysfunction and otitis media with effusion. The most common reason for not undertaking Eustachian tube balloon dilatation was insufficient evidence of efficacy (65 per cent). Seventy-two per cent of consultants thought that creating a national database for audit and monitoring purposes would benefit the specialty.

Conclusion

The majority of UK ENT consultants do not practise Eustachian tube balloon dilatation, citing a lack of high-level evidence to support its use. A national database for auditing and research could facilitate the creation of guidelines.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr S Koumpa takes responsibility for the integrity of the content of the paper

Presented at the Association of Otolaryngologists in Training meeting, 9–10 May 2019, London, UK.

References

Schilder, AGM, Bhutta, MF, Butler, CC, Holy, C, Levine, LH, Kvaerner, KJ et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol 2015;40:407–1110.1111/coa.12475CrossRefGoogle ScholarPubMed
van Heerbeek, N, Ingels, KJAO, Rijkers, GT, Zielhuis, GA. Therapeutic improvement of Eustachian tube function: a review. Clin Otolaryngol Allied Sci 2002;27:50–610.1046/j.0307-7772.2001.00524.xCrossRefGoogle ScholarPubMed
Poe, DS, Abou-Halawa, A, Abdel-Razek, O. Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 2001;22:590–510.1097/00129492-200109000-00005CrossRefGoogle ScholarPubMed
Tisch, M, Maier, H, Sudhoff, H. Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children. Acta Otorhinolaryngol Ital 2017;37:509–12Google ScholarPubMed
Tisch, M, Störrle, P, Danz, B, Maier, H. Eustachian tube dilation using the Bielefeld balloon catheter: clinical experience with 320 interventions [in German]. HNO 2013;61:488–9110.1007/s00106-013-2712-5CrossRefGoogle Scholar
NICE. Balloon dilatation of the Eustachian tube. In: https://www.nice.org.uk/guidance/IPG409 [17 November 2019]Google Scholar
Micucci, S, Keschner, DB, Liang, J. Eustachian tube balloon dilation: emerging practice patterns for a novel procedure. Ann Otol Rhinol Laryngol 2018;127:848–5510.1177/0003489418798858CrossRefGoogle ScholarPubMed
Abdel-Aziz, T, Schröder, S, Lehmann, M, Gehl, H-B, Ebmeyer, J, Sudhoff, H. Computed tomography before balloon eustachian tuboplasty–a true necessity? Otol Neurotol 2014;35:635–810.1097/MAO.0000000000000214CrossRefGoogle ScholarPubMed
Poe, D, Anand, V, Dean, M, Roberts, WH, Stolovitzky, JP, Hoffmann, K et al. Balloon dilation of the eustachian tube for dilatory dysfunction: a randomized controlled trial. Laryngoscope 2018;128:1200–6Google ScholarPubMed
Meyer, TA, O'Malley, EM, Schlosser, RJ, Soler, ZM, Cai, J, Hoy, MJ et al. A randomized controlled trial of balloon dilation as a treatment for persistent eustachian tube dysfunction with 1-year follow-up. Otol Neurotol 2018;39:89490210.1097/MAO.0000000000001853CrossRefGoogle ScholarPubMed
Shapiro, GG, Bierman, CW, Furukawa, CT, Pierson, WE, Berman, R, Donaldson, J et al. Treatment of persistent eustachian tube dysfunction in children with aerosolized nasal dexamethasone phosphate versus placebo. Ann Allergy 1982;49:81–5Google ScholarPubMed
Gluth, MB, McDonald, DR, Weaver, AL, Bauch, CD, Beatty, CW, Orvidas, LJ. Management of Eustachian tube dysfunction with nasal steroid spray. Arch Otolaryngol Head Neck Surg 2011;137:449–5510.1001/archoto.2011.56CrossRefGoogle ScholarPubMed
Williamson, I, Vennik, J, Harnden, A, Voysey, M, Perera, R, Kelly, S et al. Effect of nasal balloon autoinflation in children with otitis media with effusion in primary care: an open randomized controlled trial. Can Med Assoc J 2015;187:961–910.1503/cmaj.141608CrossRefGoogle Scholar
Schmitt, D, Akkari, M, Mura, T, Mondain, M, Uziel, A, Venail, F. Medium-term assessment of Eustachian tube function after balloon dilation. Eur Ann Otorhinolaryngol Head Neck Dis 2018;135:105–1010.1016/j.anorl.2017.09.008CrossRefGoogle ScholarPubMed
Anand, V, Poe, D, Dean, M, Roberts, W, Stolovitzky, P, Hoffmann, K et al. Balloon dilation of the Eustachian tube: 12-month follow-up of the randomized controlled trial treatment group. Otolaryngol Head Neck Surg 2019;160:687–9410.1177/0194599818821938CrossRefGoogle ScholarPubMed
Schröder, S, Lehmann, M, Ebmeyer, J, Upile, T, Sudhoff, H. Balloon Eustachian tuboplasty: a retrospective cohort study. Clin Otolaryngol 2015;40:629–3810.1111/coa.12429CrossRefGoogle ScholarPubMed
Wang, T-C, Lin, C-D, Shih, T-C, Chung, H-K, Wang, C-Y, Tsou, Y-A et al. Comparison of balloon dilation and laser eustachian tuboplasty in patients with eustachian tube dysfunction: a meta-analysis. Otolaryngol Neck Surg 2018;158:617–2610.1177/0194599817753609CrossRefGoogle ScholarPubMed
Li, Y, Chen, Y, Yin, G, Zeng, X. Effect of balloon dilation eustachian tuboplasty combined with tympanic tube insertion in the treatment of chronic recurrent secretory otitis media. Eur Arch Otorhinolaryngol 2019;276:2715–2010.1007/s00405-019-05512-7CrossRefGoogle ScholarPubMed
Huisman, JML, Verdam, FJ, Stegeman, I, de Ru, JA. Treatment of Eustachian tube dysfunction with balloon dilation: a systematic review. Laryngoscope 2018;128:237–4710.1002/lary.26800CrossRefGoogle ScholarPubMed
Dalchow, CV, Loewenthal, M, Kappo, N, Jenckel, F, Loerincz, BB, Knecht, R. First results of endonasal dilatation of the Eustachian tube (EET) in patients with chronic obstructive tube dysfunction. Eur Arch Otorhinolaryngol 2016;273:607–1310.1007/s00405-015-3602-0CrossRefGoogle ScholarPubMed
Bowles, PF, Agrawal, S, Salam, MA. Balloon tuboplasty in patients with Eustachian tube dysfunction: a prospective study in 39 patients (55 ears). Clin Otolaryngol 2017;42:1057–6010.1111/coa.12812CrossRefGoogle Scholar
Van Rompaey, V, Yung, M, Van de Heyning, P. Auditing in middle ear surgery, feasibility of the common otology database. B-ENT 2010;6:189–94Google ScholarPubMed