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Fluoroscopic Balloon Dilation Using a Flexible Guide Wire to Treat Obstructive Eustachian Tube Dysfunction.

Ho-Young Song1, Hong Ju Park2, Woo Seok Kang2

  • 1Department of Radiology and Research, Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.

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|August 15, 2019
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Fluoroscopic balloon dilation of the Eustachian tube (E-tube) using a flexible guide wire is a safe and effective procedure. This method successfully opened 78.1% of E-tubes at 3 months, with a 2-year patency rate of 84%.

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Area of Science:

  • Otolaryngology
  • Interventional Radiology

Background:

  • Obstructive Eustachian tube dysfunction (E-TD) can lead to persistent otitis media.
  • Current management options for E-TD may have limitations.

Purpose of the Study:

  • To evaluate the midterm outcomes of fluoroscopic Eustachian tube (E-tube) balloon dilation.
  • To assess the efficacy of using a flexible guide wire in this procedure for obstructive E-TD.

Main Methods:

  • Prospective enrollment of adult outpatients with persistent otitis media and inability to perform the Valsalva maneuver.
  • 32 E-tubes in 31 patients underwent fluoroscopic balloon dilation using a 0.035-inch flexible guide wire and a 6 x 20-mm balloon catheter.
  • Clinical assessments, including Valsalva maneuver testing and otomicroscopy, were performed at multiple follow-up intervals up to 18 months.

Main Results:

  • Technical success of balloon dilation was achieved in all 32 E-tubes.
  • The Valsalva maneuver was successful in opening 78.1% of E-tubes at 3 months post-procedure.
  • A 2-year patency rate of 84% was observed, with 16% of initially improved E-tubes failing during follow-up.

Conclusions:

  • Fluoroscopic Eustachian tube balloon dilation using a flexible guide wire demonstrates encouraging midterm outcomes.
  • The technique proved safe, with no instances of false passage reported.
  • This method offers a promising minimally invasive approach for managing obstructive E-TD.