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Balloon Eustachian Tuboplasty (BET) in Children: A Retrospective Multicenter Analysis
Matthias Tisch1, Susanne Maier1,2, Serena Preyer3
1Department of Otorhinolaryngology, Head- and Neck Surgery, Bundeswehrkrankenhaus Ulm.
Insights
Balloon Eustachian Tuboplasty (BET) effectively treats children with Eustachian tube dysfunction, improving ear health and hearing. This study provides data for future BET research in pediatric populations.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Medical Engineering
Background:
- Dilatory Eustachian tube (ET) dysfunction is a common pediatric ear condition.
- Chronic otitis media with effusion (COME) and recurrent acute otitis media are frequent sequelae.
- Standard surgical therapies often fail, necessitating alternative treatments like Balloon Eustachian Tuboplasty (BET).
Purpose of the Study:
- To generate pilot data for planning prospective studies on BET in children.
- To evaluate the efficacy of BET in treating dilatory ET dysfunction in pediatric patients.
- To assess outcomes related to tympanic membrane appearance, tympanometry, and hearing thresholds post-BET.
Main Methods:
- Retrospective multicenter analysis of 299 ETs from 167 children (aged 4-12 years).
- Patients had COME or recurrent acute otitis media refractory to prior surgery.
- Interventions included BET, with or without paracentesis, ventilation tube insertion, or tympanoplasty.
Main Results:
- BET treatment led to significant improvements in tympanic membrane appearance (65.6%) and hearing thresholds (median improvement to 10 dB HL).
- Tympanometry showed a positive shift towards normal (Type A) and Type C tympanograms post-treatment.
- Improvements were consistent across subgroups, including BET-only treatment and COME indication.
Conclusions:
- Balloon Eustachian Tuboplasty (BET) demonstrates efficacy in managing various pediatric Eustachian tube dysfunction-related ear diseases.
- The study provides valuable data for the design and planning of future prospective research on BET in children.
- BET offers a promising therapeutic option for children with persistent ET dysfunction and associated middle ear pathologies.
Objective:
Generation of pilot data for planning of prospective BET-studies for treatment of dilatory Eustachian tube (ET) dysfunction in children.
Study Design:
Retrospective multicenter analysis.
Setting:
Nine ENT departments at tertiary care teaching hospitals.
Patients:
4-12-year-old children with chronic otitis media with effusion (COME) for more than 3 months or more than 3 episodes of acute otitis media during the last year, having failed standard surgical therapy at least once.
Intervention:
BET with or without paracentesis, ventilation tube insertion, or tympanoplasty.
Main Outcome Measures:
Tympanic membrane appearance, tympanometry, and hearing threshold.
Results:
Two hundred ninety-nine ETs of 167 children were treated. Mean age was 9.1 years (95% confidence interval [95% CI]: 8.7-9.4 yr). In 249 ears (83.3%), COME and/or retraction of the tympanic membrane were the indication for BET. Median hearing threshold was 20 dB HL (95% CI: 0-46 dB). One hundred fifty-five ears (51.8%, 95% CI: 46.1-57.4%) showed a tympanogram type B. Treatment consisted of BET without other interventions ("BET-only") in 70 children, 128 ears. Median length of follow-up for 158 (94.6%) children was 2.6 months (95% CI: 0.3-16.1 mo). After treatment, the tympanic membrane appeared normal in 196 ears (65.6%, 95% CI: 60.0-70.8%, p < 0.001). Median hearing threshold improved to 10 dB HL (95% CI: 0-45 dB, p < 0.001). Tympanograms shifted toward type A and C (type A: 39.1%, 95% CI: 33.7-44.7, p < 0.001). These improvements were also observed in subgroup analyses of "BET-only" treatment and the indication of "COME" respectively.
Conclusion:
BET is improving a variety of dilatory ET dysfunction-related ear diseases in children. This study provides detailed data for design and planning of prospective studies on BET in children.
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