Browsing by Subject "Eustachian tube dysfunction"

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  • Luukkainen, Veera; Kivekäs, Ilkka; Silvola, Juha; Jero, Jussi; Sinkkonen, Saku T. (2018)
    Balloon Eustachian tuboplasty (BET) aims to improve the function of the Eustachian tube (ET). The objective of this study was to review the long-term outcome of BET and present the process and results of outlining indications for BET by the Finnish Otosurgical Society. The literature review is based on a database search performed in May 2017. The search resulted in 100 individual articles, which were screened for relevance. Five articles fulfilled the inclusion criteria (follow-up >= 12 months). Five additional articles (follow-up, 6-11 months) were analyzed to obtain supportive information. The proposed BET indications were constituted in the 2016 annual meeting of the Finnish Otosurgical Society. The workshop included a review of the Eustachian tube physiology, middle ear aeration mechanisms, and BET outcome studies. Thereafter, the members of the Society first voted and then discussed 14 cases in order to conclude whether BET was indicated in each case, and subsequently, a consensus statement on the indications for BET was outlined. The long-term follow-up studies were heterogeneous regarding the Eustachian tube dysfunction (ETD) definition, patient selection, follow-up duration, additional treatments, and outcome measures. The current, but limited, evidence suggests that BET is effective in the long-term. However, more long-term studies with uniform criteria and outcome measures as well as placebo-controlled studies are needed. The proposed indications for BET by the Finnish Otosurgical Society include chronic bothersome symptoms referring to ETD, ETD-related symptoms when pressure changes rapidly, or recurring serous otitis media. With the current evidence, we suggest treating only adults with BET.
  • Luukkainen, Veera; Vnencak, Matej; Aarnisalo, Antti A.; Jero, Jussi; Sinkkonen, Saku T. (2018)
    Object: To investigate the long-term effects of balloon Eustachian tuboplasty (BET) from patient's perspective and to discover which symptoms of Eustachian tube dysfunction (ETD) benefit the most from BET. Method: We designed a retrospective postal questionnaire based on the seven-item ETD questionnaire (ETDQ-7). Our questionnaire covered the severity of present ETD symptoms in comparison with the preoperative situation, the severity of current overall ear symptoms, and possible surgical interventions after BET. Forty-six patients treated in our institution between 2011 and 2013 fulfilled the inclusion criteria and 74% (34 patients; total 52 ears treated with BET) returned the questionnaire with a mean follow-up time of 3.1 years (range 1.8-4.6 years). Results: Pain in the ears, feeling of pressure in the ears, and feeling that ears are clogged had reduced in 75% of the ears that suffered from these symptoms preoperatively. Seventy-seven percent of all the responders felt that their overall ear symptoms were reduced. Altogether, 82% of all the patients stated that they would undergo BET again if their ear symptoms returned to the preoperative level. Conclusion: Patient satisfaction in the long-term effects of BET is encouraging. These results may help clinicians in preoperative patient selection and counselling.
  • Silvola, Juha T.; Sinkkonen, Saku T.; Wanscher, Jens; Westman, Eva; Holm, Niels H.; Ovesen, Therese (2019)
    There is no unanimous consensus for indications of eustachian tube balloon dilation (ETBD). Nordic countries have relatively similar hospital organizations and treatment guidelines. Therefore, it was logical to organize a consensus meeting of ETBD. The symposium: Nordic Experiences on Eustachian Tube Balloon Dilation, in Copenhagen, 30–31 March, 2017. The panellists from Denmark, Finland, Norway and Sweden and the attendees of the meeting agreed a consensus on the following issues: Candidates, Definition of Eustachian Tube Dysfunction, Diagnostic Work up, Differential Diagnosis, Contraindications, ETBD Procedure, Complications, Follow-up, and Outcomes. The article also presents the status for ETBD in each of these countries. Thereafter the consensus statement has been discussed in the national societies and meetings for ear surgeons in each of these countries. It can be assumed that surgeons in the hospitals of these Nordic countries generally follow the recommendations from the consensus meeting.
  • Lindfors, Oskari (Helsingin yliopisto, 2020)
    Tubomanometry (TMM) is used to investigate Eustachian tube opening by forming a pre-defined pressure (30, 40 or 50 mbar) in the nasopharynx and registering a pressure change in the external ear canal, caused by movement of the tympanic membrane. The objective of this study was to investigate problems in TMM use and interpretation in patients with Eustachian tube dysfunction (ETD) at a tertiary referral center. The secondary goal was to examine whether it would be possible to not use all pre-defined pressures. A retrospective chart review of all patients with a history of ETD treated at the Head and Neck Center of Helsinki University Hospital during 2016 - 2018 was conducted. The primary outcome was proportion of successful TMM measurements, including the reasons for unsuccessful measurements. In addition, the results of successful measurements were evaluated. TMM success rate was 91%, varying between 81 – 95% in different ETD patient groups and between 87 – 94% at different pressures. The reasons for unsuccessful measurements were air-leaks from the external ear canal, pressure changes in the external ear canal prior to changes in nasopharyngeal pressure, and insufficient rises in nasopharyngeal pressure. The results of successful TMM measurements were similar in 88% of cases at 30 and 40 mbars and in 86% of cases at 40 and 50 mbars. TMM is suitable for clinical use in ETD patients. The problems in TMM use and interpretation can be avoided by repeating the unsuccessful measurememts during patient examination. To maximize the amount of diagnostic information achievable, all three pressures should be used.