Endoscopic Transtympanic Eustachian Tube Catheter Insertion for Chronic Patulous Eustachian Tube: A Review of 157 Cases

By June 7, 2019

Kong, Sookeun1; Choi, Sungwon1; Oh, Sejoon1; Lee, Ilwoo2
1 Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea;
2 Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, South Korea.

Symptoms of patulous Eustachian tube (PET) vary widely from transient to everyday life. In the abscence of transient symptoms, the patient’s social activities will be significantly impaired. We introduce a endoscopic transtympanic Eustachian tube catheter insertion (TCI) technique based on PET obstruction. This study was undertaken to evaluate the safety and efficacy of endoscopic TCI in patients with chronic PET.

– Study Design: retrospective case review
– Setting: tertiary referral center
– Patients: unsuccessful conservative treatment with saline nasal irrigation and an anticholinergic nasal spray for at least 6 months was stipulated before surgical intervention. Patients who had undergone any other surgical procedure related to PET were excluded. Endoscopic TCI was attempted in 157 ears with chronic PET.
-Intervention: The catheter was inserted under 30 degree endoscope through the bony orifice of the ET to occlude the isthmus. The catheter applied was modified to hang at the bony orifice of ET. The 18 gauge and 25 mm catheters were cut into 5 mm posterior segments to prevent escape to the nasopharynx, and inserted into the ET via the myringotomy site on the tympanic membrane.

-Results: Follow-up durations ranged from 8 to 46 months, with an average of 28.3 months. Successful treatment of subjective autophony was achieved in 134 ears (82.8%). Ventilation tube placement was performed in 15 ears (9.5%) because of otitis media with effusion after insertion.
-Conclusion: Endoscopic TCI seems to be a minimally invasive and is used successfully to treat chronic PET. The procedure had a good overall success rate and complications were rare in the long term.