Fluoroscopic subtraction Eustachian tubography: initial feasibility test in a cadaver model

Area of Science:

• Otolaryngology
• Medical Imaging
• Anatomy

Background:

• The Eustachian tube (ET) plays a crucial role in middle ear pressure regulation.
• Accurate assessment of ET anatomy and function is vital for diagnosing and treating related pathologies.

Purpose of the Study:

• To assess the technical feasibility of direct Eustachian tube catheterisation.
• To evaluate the utility of subtraction Eustachian tubography in a cadaver model.

Main Methods:

• Direct catheterisation of the Eustachian tube was performed in six human cadavers.
• Both endoscopy- and fluoroscopy-guided techniques were employed for ET selection.
• Contrast media was injected for Eustachian tubography, with image quality assessed using native and subtraction techniques.

Main Results:

• Successful ET selection was achieved in 83.3% of sessions.
• Subtraction images yielded significantly higher tubography quality scores (p=0.04) compared to native images.
• No significant differences were observed between guidance methods regarding procedure time or contrast leak.

Conclusions:

• Direct Eustachian tube catheterisation and subtraction tubography are technically feasible.
• This technique allows for comprehensive visualization of the Eustachian tube.
• Subtraction Eustachian tubography serves as a valuable tool for objective assessment of ET function and anatomy.