Balloon Dilation With Tympanostomy Enhances Outcomes in Adult Chronic Otitis Media With Effusion

This study aimed to comparatively evaluate the therapeutic efficacy of balloon dilation eustachian tuboplasty (BDET) versus tympanostomy tube insertion (TTI) in adult patients with unilateral chronic otitis media with effusion (COME), and to assess potential synergistic effects when combining both procedures (BDET + TTI).

We conducted a retrospective cohort study of 46 adult COME patients from the Eye and ENT Hospital of Fudan University who had failed a standardized 3-month non-surgical interventions and underwent one of three interventions: (1) TTI alone, (2) BDET + TTI, or (3) BDET alone. Preoperative evaluations included otoscopy, pure-tone audiometry (PTA), tympanometry, nasopharyngeal endoscopy, eustachian Tube Dysfunction Questionnaire (ETDQ-7), and temporal bone CT scans. Postoperative evaluation incorporated PTA, tympanometry, and ETDQ-7 assessment. Statistical analysis incorporated both within-group (pre-post) and between-group comparisons of therapeutic outcomes.

All interventions demonstrated therapeutic safety with no postoperative complications. While all groups showed hearing improvement, the BDET group failed to achieve statistically significant improvement in air conduction (AC) thresholds. The BDET + TTI combination yielded superior outcomes to TTI alone in AC thresholds, air-bone gap (ABG), and ETDQ-7 scores improvements. Tympanometric normalization was significant in both TTI-containing groups but not in the BDET-alone group.

While BDET monotherapy shows limited efficacy in adult COME management, its combination with TTI produces superior therapeutic outcomes compared to either procedure alone. These results position BDET as a potentially valuable adjunct to conventional TTI rather than an independent treatment modality for this patient population.