Balloon eustachian tuboplasty: a systematic review

Area of Science:

• Otolaryngology
• Surgical Innovation
• Evidence-Based Medicine

Background:

• Eustachian tube dysfunction (ETD) significantly impacts patient quality of life.
• Balloon Eustachian tuboplasty (BET) is a minimally invasive procedure developed to treat ETD.
• A comprehensive review of existing evidence is needed to assess BET's efficacy and safety.

Purpose of the Study:

• To systematically review and meta-analyze the available evidence on BET for ETD.
• To evaluate the impact of BET on patient-reported symptoms, objective measures of Eustachian tube function, and quality of life.
• To identify potential benefits, risks, and limitations associated with BET.

Main Methods:

• Systematic review and meta-analysis following PRISMA guidelines.
• Searched 12 databases (including PubMed, Embase) for studies on BET from 2010 to 2014.
• Assessed study quality using the modified Delphi technique and risk of bias using Cochrane Collaboration's tool.

Main Results:

• Nine case series (443 patients, 642 tubes) were included; all were of poor quality with high risk of bias.
• Significant improvements observed in ETD questionnaire scores, tympanic membrane status, tympanometry, mucosal inflammation, Valsalva/Swallowing tests, Eustachian tube scores, SNOT-22 scores, and quality of life.
• No serious adverse events were reported.

Conclusions:

• Current evidence supporting BET for ETD is of poor quality and biased.
• Firm conclusions regarding patient selection and surgical outcomes cannot be drawn.
• High-quality randomized controlled trials or case-control studies are essential to validate BET's effectiveness.