Combining Balloon Eustachian Tuboplasty With Tympanoplasy: Initial Report

By June 7, 2019

Handzel, Ophir1,2; Ungar, Omer1,2; Oron, Yahav1,2; Cavel, Oren1,2
1 Depratment of Otolaryngology/Head, Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Israel;
2 Sackler Faculty of Medicince, Tel-Aviv University, Israel.

Long term success of tympanoplasty requires sufficient ventilation of the middle ear cleft by the Eustachian tube. For patients with Eustachian tube dysfunction (ETD) in need for tympanoplasty, balloon dilation of the ET (BET) may improve outcome.

Case series of patients undergoing primary or revision tympanoplasty with dilatory ETD in a tertiary academic center. Eight patients met the inclusion criteria. Age range was 12 to 52 years. Patients with correctable risk factors for ETD were excluded. Five had perforated drums and baro-challenge ETD in the contralateral ear. Three had progressively retracted drums, two in a primary procedure and the third in a revision intervention.

Tympanoplasty was performed either by transcanal endoscopic or a retroauricular approaches. As an adjunct to tympanoplasty, trans-nasal BET was performed. Spiggle and Thies (n=6) and Entellus (n=2) systems were utilized.

All drum were closed and in normal during last follow-up available. Residual air bone gaps averaged 11dB (range 0-25dB). Tympanometry was A (n=6) or B (n=2 both with with cartilage). None of the patients required additional procedures. Follow up was 3-15 months.

Initial experience, in a small cohort of patients, supports adding BET as an adjunct to tympanoplasty. It may improve results in patients with dilatory ETD.