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Fluoroscopy-guided balloon dilation in patients with Eustachian tube dysfunction
Kun Yung Kim1, Jiaywei Tsauo1, Ho-Young Song2
1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olymic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
Objectives:
To prospectively evaluate the technical feasibility and safety of fluoroscopy-guided balloon dilation in patients with Eustachian tube (ET) dysfunction.
Methods:
Patients who could not do a Valsalva manoeuvre for more than 6 months and diagnosed with chronic otitis media or ET dysfunction were prospectively enrolled. A 0.035-in. guide wire and 6-mm long balloon catheter with a diameter of 2 mm were used to dilate the cartilaginous portion of the ET under fluoroscopic guidance. The balloon was inflated by manual injection twice for 1 min each time. Clinical outcomes were assessed by the patient's ability to perform a Valsalva manoeuvre, and symptoms were assessed using the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score.
Results:
Balloon dilation was attempted in a total of ten adult patients from October 2016 to March 2017. Technical success was achieved in all procedures (10/10). Ninety percent (9/10) of the balloons were fully dilated without waist deformity. There were no major complications. All patients were able to perform a Valsalva manoeuvre at the time of their last visit and/or improvement of at least one ETDQ-7 score.
Conclusion:
Fluoroscopy-guided balloon dilation seems to be technically feasible and safe in the treatment of ET dysfunction.
Key Points:
• Fluoroscopy-guided balloon dilation without general anaesthesia was well-tolerated in all patients. • Location of the balloon catheter can be monitored during the procedure. • Inflation state of the balloon catheter can be monitored during the procedure. • Using guide-wire during the procedure would prevent false passage creation. • All patients had clinical improvement within 3 months after balloon dilation.
