Skip to main content
SpringerLink
Log in

Chronisch obstruktive Tubenfunktionsstörung des Erwachsenen

Langzeitergebnisse der Ballondilatation der Tuba Eustachii

Chronic obstructive eustachian tube dysfunction in adults

Long-term results of balloon eustachian tuboplasty

  • Originalien
  • Published:
HNO Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Bisher gab es kaum zuverlässige diagnostische Verfahren und effektive Therapiemöglichkeiten zur Behandlung von chronischen obstruktiven Tubenventilationsstörungen.

Material und Methoden

Bis zum August 2011 wurden insgesamt 120 Patienten mit einer Ballondilatation der Eustachio-Röhre behandelt bzw. in 209 Fällen die Tuba auditiva dilatiert. Bei der Bielefelder Ballondilatation der Eustachio-Röhre wird transnasal-endoskopisch ein Ballonkatheter über das pharyngeale Tubenostium in den kartilaginären Anteil der Tuba Eustachii eingeführt und der Ballon mit einem Druck von 10 bar für 2 min dilatiert.

Ergebnisse

In der Nachuntersuchung der ersten 12 Patienten (20 Tubendilatationen) 12 Monate nach der Operation betrug der Tubenscore präoperativ 1,25 (± 1,83 SD) und 12 Monate postoperativ 6,2 (± 2,61 SD). Alle Patienten waren subjektiv mit der Verbesserung der chronisch obstruktiven Funktionsstörung zufrieden. Nachuntersucht wurden insgesamt 66 Patienten (115 Tubendilatationen) 2 Monate nach der Operation. Der durchschnittliche Tubenscore präoperativ betrug 2,21 (± 2,02 SD) und 2 Monate postoperativ 5,4 (± 2,53 SD).

Schlussfolgerung

Dieses neue Therapieverfahren stellte sich als nebenwirkungsarme und erfolgreiche Möglichkeit zur Behandlung der chronisch obstruktiven Tubenfunktionsstörungen dar.

Abstract

Background

Sufficient diagnostic tools and effective therapies for chronic obstructive eustachian tube dysfunction are lacking.

Patients and methods

A total of 120 patients (209 ears) with chronic obstructive eustachian tube dysfunction were treated over a 2-year period using transnasal endoscopic balloon dilatation of the cartilaginous part of the eustachian tube (balloon eustachian tuboplasty, BET). A balloon catheter is inserted into the eustachian tube via the pharyngeal opening and dilated with a pressure of 10 bar for 2 min.

Results

The first 12 patients (20 dilatations) had a pretreatment average tube score of 1.25 (± 1.83 SD), and1 year after treatment, the score improved to 6.2 (± 2.61 SD). Furthermore, the pretreatment and 2-month posttreatment data of 66 additional patients (115 dilatations) were analyzed. In these patients, the tube score improved significantly from 2.21 (± 2.02 SD) to 5.4 (± 2.53 SD).

Conclusion

The initial long-term results suggest that BET is feasible and safe for the treatment of chronic obstructive eustachian tube dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6

Literatur

  1. Caffier PP, Sedlmaier B, Haupt H et al (2011) Impact of laser eustachian tuboplasty on middle ear ventilation, hearing, and tinnitus in chronic tube dysfunction. Ear Hear 32(1):132–139

    PubMed  Google Scholar 

  2. Choi SH, Han JH, Chung JW (2009) Pre-operative evaluation of eustachian tube function using a modified pres sure equilibration test is predictive of good postoperative hearing and middle ear aeration in Typ1 tympanoplasty patients. Clin Exp Otorhinolaryngology 2(2):61–65

    Article  Google Scholar 

  3. Di Martino E, Krombach GA, Thaden R, Westhofen M (2004) Function tests for the eustachian tube. Current knowledge. HNO 52(11):1029–1040

    Article  Google Scholar 

  4. Dörrie A, Dommrich S, Pau HW (2003) Early postoperative middle-ear ventilation – risk for the transplant or guarantee for aeration of the tympanic cavity? Laryngorhinootologie 82(2):102–104

    Article  PubMed  Google Scholar 

  5. Esteve D (2003) Tubomanometry and pathology. In: Ars B (Hrsg) Fibrocartilaginous eustachian tube. Middle ear cleft. S 159–175

  6. Esteve D, Della Vedova C, Dubreuil C et al (2001) Evaluation par tubomanometrie de la fonction douverture tubaire et de la ré ponse tympanique chez le sujet normal et chez le sujet porteur dune otide séro-muqueuse chronique. J Fr ORL 50:223–231

    Google Scholar 

  7. Gluth MB, McDonald DR, Weaver AL et al (2011) Management of eustachian tube dysfunction with nasal steroid spray: a pros pective, randomized, placebo-controlled trial. Arch Otolaryngol Head Neck Surg 137(5):449–455

    Article  PubMed  Google Scholar 

  8. Hsu MM, Young YH, Lin KL (1995) Eustachian tube function of patients with nasopharyngeal carcinoma. Ann Otol Rhinol Laryngol 104(6):453–455

    PubMed  CAS  Google Scholar 

  9. Leuwer R, Koch U (1999) Anatomy and physiology of the auditory tube. Therapeutic possibilities in chronic disorders of tubal function. HNO 47(5):514–523

    Article  PubMed  CAS  Google Scholar 

  10. Lükens A, Dimartino E, Günther RW, Krombach GA (2011) Functional MR imaging of the eustachian tube in patients with clinically proven dysfunction: correlation with lesions detected on MR images. Eur Radiol. (E-Pub)

  11. Maier W, Beck C, Hinkelbein W, Richter B (1994) Effects of therapy of laryngeal and hypopharyngeal cancers on eustachian tube function. Laryngorhinootologie 73(3):164–168

    Article  PubMed  CAS  Google Scholar 

  12. McCoul ED, Lucente FE, Anand VK (2011) Evolution of eustachian tube surgery. Laryngoscope 121(3):661–666

    Article  PubMed  Google Scholar 

  13. Ockermann T (2009) Die Ballondilatation der Eustachischen Röhre zur Behandlung der obstruktiven Tubendysfunktion. Dissertationsschrift Ruhr-Universität Bochum

  14. Ockermann T, Reineke U, Upile T et al (2010) Baloondilatation eustachian tuboplasty: a feasibility study. Otol Neurotol 31(7):1100–1103

    Article  PubMed  Google Scholar 

  15. Ockermann T, Reineke U, Upile T et al (2010) Baloondilatation eustachian tuboplasty: a clinical study. Laryngoscope 120(7):1411–1416

    Article  PubMed  Google Scholar 

  16. Pau HW (2011) Eustachian tube and middle ear mechanics. HNO 59(10):953–963

    Article  PubMed  CAS  Google Scholar 

  17. Podoshin L, Fradis M, Malatskey S, Ben-David J (1996) Tympanoplasty in adults: a five-year survey. Ear Nose Throat J 75(3):149–152, 155–156

    PubMed  CAS  Google Scholar 

  18. Poe DS, Grimmer JF, Metson R (2007) Laser eustachian tuboplasty: two-year results. Laryngoscope 117(2):231–237

    Article  PubMed  Google Scholar 

  19. Poe DS, Hanna BM (2011) Balloon dilation of the cartilaginous portion of the eustachian tube: initial safety and feasibility analysis in a cadaver model. Am J Otolaryngol 32(2):115–123

    Article  PubMed  Google Scholar 

  20. Poe DS, Silvola J, Pyykkö I (2011) Balloon dilation of the cartilaginous eustachian tube. Otolaryngol Head Neck Surg 144(4):563–569

    Article  PubMed  Google Scholar 

  21. Sudhoff H, Ockermann T, Mikolajczyk R et al (2009) Clinical and experimental considerations for evaluation of eustachian tube physiology. HNO 57(5):428–435

    Article  PubMed  CAS  Google Scholar 

  22. Takasaki K, Hirsch BE, Sando I (2000) Histopathologic study of the human eustachian tube and its surrounding struc tures following irradiation for carcinoma of the oropharynx. Arch Otolaryngol Head Neck Surg 126(4):543–546

    PubMed  CAS  Google Scholar 

  23. Todd NW (2000) There are no accurate tests for eustachian tube function. Arch Otolaryngol Head Neck Surg 126(8):1041–1042

    PubMed  CAS  Google Scholar 

  24. Uzun C, Cavé-Thomasen P, Andersen J, Tos M (2004) Eustachian tube patency and function in tympanoplasty with cartilage pali sades or fascia after cholesteatoma surgery. Otol Neurotol 25(6):864–872

    Article  PubMed  Google Scholar 

  25. Xiao J, Luo ZQ, Shi DZ et al (2008) Short-term results of audiological change of nasopharyngeal carcinoma pa tient after radiotherapy and chemotherapy. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 43(12):906–909

    PubMed  Google Scholar 

Download references

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass für sie kein Interessenkonflikt besteht. M. Lehmann, J. Ebmeyer und H. Sudhoff erhalten Honorare für Vortragsleistungen sowie finanzielle Zuwendungen für Forschungsvorhaben.

Author information

Authors and Affiliations

  1. Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Klinikum Bielefeld, Teutoburger Str. 50, 33604, Bielefeld, Deutschland

    S. Schröder, U. Reineke, M. Lehmann, J. Ebmeyer & H. Sudhoff

Authors
  1. S. Schröder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Reineke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Lehmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Ebmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Sudhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Schröder.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schröder, S., Reineke, U., Lehmann, M. et al. Chronisch obstruktive Tubenfunktionsstörung des Erwachsenen. HNO 61, 142–151 (2013). https://doi.org/10.1007/s00106-012-2573-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00106-012-2573-3

Schlüsselwörter

Keywords

Search

Navigation