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Outcomes and Prognostic Factors of Balloon Eustachian Tuboplasty Combined With Ventilation Tubes Insertion in
Desheng Jia1, Yongchao Chen1, Xin Wang1
1Department of Otolaryngology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Insights
Balloon eustachian tuboplasty combined with ventilation tube insertion effectively reduces the air-bone gap in pediatric patients with eustachian tube dysfunction. Prior ventilation tube insertion may predict recurrence in this group.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Devices
Background:
- Eustachian tube dysfunction (ETD) is common in children.
- Conventional treatments like ventilation tube (VT) insertion have limitations.
- Balloon eustachian tuboplasty (BET) is a newer intervention for ETD.
Purpose of the Study:
- To evaluate the efficacy and safety of BET combined with VT insertion in pediatric patients.
- To identify predictors of symptom recurrence after BET + VT.
- To compare outcomes of BET + VT versus VT insertion alone.
Main Methods:
- Retrospective study of pediatric patients undergoing BET + VT or VT alone.
- Data collected on efficacy, safety, and recurrence.
- Kaplan-Meier curves and multivariate Cox regression used for analysis.
Main Results:
- BET + VT showed high effectiveness rates (90.9% at first follow-up, 84.6% at 12 months).
- Significant decrease in air-bone gap (ABG) at 12 months in the BET + VT group compared to VT alone (13.7 ± 10.8 vs 6.4 ± 15.3).
- History of VT insertion was an independent predictor of recurrence in the BET + VT group (HR 3.177).
Conclusions:
- BET + VT insertion is effective in decreasing ABG for pediatric ETD patients without high-risk factors.
- Patients with prior VT insertion may have a higher recurrence rate.
- Further research is needed for ETD patients with coexisting risk factors.
Abstract:
Objective: To evaluate the efficacy and safety of balloon eustachian tuboplasty (BET) combined with ventilation tube (VT) insertion in pediatric population and to identify the predictive factors for symptom recurrence. Methods: We conducted a retrospective study between August 2018 and February 2022 at Shenzhen Children's Hospital. The study analyzed the data of pediatric patients who underwent BET + VT insertion, as well as the data of pediatric patients who underwent VT insertion alone. The outcomes were efficacy, safety, and predictive factors of BET combined with VT. Kaplan‒Meier curves were used to examine the failure-free survival rate. A multivariate Cox regression model was used to identify the independent predictors of BET failure. Results: We evaluated the data of 29 pediatric patients (48 ears) who underwent BET with VT insertion (BET + VT group) and the data of 29 pediatric patients (46 ears) who underwent VT insertion alone (VT group). The total effectiveness rates at the first follow-up after VT removal and at 12 months in the BET + VT group were 90.9% and 84.6%, respectively. The decrease in the air-bone gap (ABG) was more significant in the BET + VT group at 12 months (13.7 ± 10.8 vs 6.4 ± 15.3, P < .05). The subgroup analyses did not show any significant difference between the groups in high-risk. For non-high-risk patients, the decrease in the ABG was more significant in the BET + VT group (14.2 ± 10.6 vs 4.3 ± 13.1, P < .05) at 12 months. The multivariate analysis showed that a history of VT insertion was independently associated with a higher rate of recurrence in the BET + VT group (hazard ratio 3.177; 95% CI, 1.027-9.826; P < .05). Conclusions: BET + VT insertion is an effective procedure to decrease the ABG in pediatric patients with eustachian tube dysfunction (ETD) who have no risk factors for conventional therapy failure. Treatment of patients with ETDs who have coexisting risk factors remains a challenge that warrants further high-quality prospective research.
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