CT Imaging of Eustachian Tube Balloon Dilation: Method Development on Cadaver Heads

Area of Science:

• Otolaryngology
• Medical Imaging
• Anatomy

Background:

• The Eustachian tube (ET) plays a crucial role in middle ear pressure regulation.
• Balloon dilation (BD) is an emerging treatment for ET dysfunction.
• Quantifying the structural effects of BD on the ET is essential for evaluating treatment efficacy.

Purpose of the Study:

• To develop and validate a novel methodology for assessing the impact of balloon dilation (BD) on Eustachian tube (ET) structure.
• To utilize Computerized Tomography (CT) imaging for quantitative analysis of ET lumen changes post-BD.
• To establish a reliable method for measuring the success of ET balloon dilation.

Main Methods:

• BD was performed on human cadaver ETs.
• Axial CT images were acquired before, during, and after balloon dilation.
• ImageJ software and 3D volume viewer were used to match anatomical landmarks and capture serial ET images.
• Region of interest (ROI) histograms were analyzed to determine air density changes, serving as a measure of dilation.

Main Results:

• A small ROI effectively captured the most significant ET lumen dilation post-BD.
• Average air density increase in the small ROI was 64%, indicating successful dilation.
• Longer and longest ROI measurements showed air density increases of 56% and 44%, respectively.

Conclusions:

• A reproducible CT-based method was developed to image and quantify ET changes after BD.
• The methodology allows for objective measurement of BD outcomes using anatomical landmarks and air density analysis.
• This approach provides a valuable tool for evaluating the efficacy of Eustachian tube balloon dilation.