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Eustachian tube balloon dilation for middle ear effusion in children with cleft lip and palate
Samuel Devanesan Abishegam1, Jeyasakthy Saniasiaya1, Jeyanthi Kulasegarah1
1Department of Otorhinolaryngology, Faculty of Medicine, Universiti Malaya, Jalan Universiti, Kuala Lumpur, Malaysia.
Insights
Eustachian tube balloon dilation shows promise for treating middle ear effusion in children with cleft lip and palate. This minimally invasive procedure improved hearing and reduced symptoms without major complications.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Surgical Innovation
Background:
- Middle ear effusion is common in children with cleft lip and palate.
- Eustachian tube dysfunction contributes to middle ear effusion in this population.
- Minimally invasive treatments are sought for this condition.
Purpose of the Study:
- To evaluate the efficacy and safety of Eustachian tube balloon dilation as an adjunctive treatment for middle ear effusion in children with cleft lip and palate.
- To compare outcomes between balloon dilation plus corticosteroids and corticosteroids alone.
Main Methods:
- Prospective evaluation of 14 children (28 ears) with cleft lip and palate and middle ear effusion.
- Intervention group: Eustachian tube balloon dilation with intranasal corticosteroids.
- Control group: Intranasal corticosteroids alone.
- Assessments included tympanometry, audiometry, and Eustachian Tube Dysfunction Questionnaire-7 pre- and post-intervention.
Main Results:
- Eustachian tube balloon dilation significantly improved hearing thresholds (p=0.03) and air-bone gap (p=0.04).
- Favorable tympanometric changes (p<0.05) and reduced symptom scores (Eustachian Tube Dysfunction Questionnaire-7) were observed.
- The procedure was safe and well-tolerated, with no major complications.
Conclusions:
- Eustachian tube balloon dilation is a safe and potentially effective adjunctive treatment for middle ear effusion in pediatric cleft lip and palate patients.
- Further validation through larger randomized controlled trials is warranted.
Problem:
Eustachian tube balloon dilation is increasingly recognised as a minimally invasive option for middle ear effusion. However, its role in children with cleft lip and palate remains under-explored.
Methods:
We prospectively evaluated 14 cleft lip and palate children (28 ears) with middle ear effusion. Group 1 (intervention) comprised 14 ears that underwent Eustachian tube balloon dilation with intranasal corticosteroids, while Group 2 (control) included 14 ears treated with intranasal corticosteroids alone. Tympanometry, pure-tone audiometry and Eustachian Tube Dysfunction Questionnaire-7 were administered before and six weeks after intervention.
Results:
Eustachian tube balloon dilation significantly improved hearing thresholds (p = 0.03) and air-bone gap (p = 0.04), with favourable tympanometric changes (p < 0.05) and a significant reduction in Eustachian Tube Dysfunction Questionnaire-7 scores, indicating symptom improvement. No major complications occurred.
Conclusion:
Eustachian tube balloon dilation is a safe, well-tolerated and potentially effective adjunctive procedure for cleft lip and palate children with middle ear effusion. Larger randomised controlled trials are needed to validate these findings.
