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European Archives of Oto-Rhino-Laryngology

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01-07-2021 | Local Anesthesia in Dentistry | Otology

A novel technique for patulous Eustachian tube augmentation

Authors: Holger Sudhoff, Nazli Ay, Ingo Todt, Odile Sauzet, Manuel Bernal-Sprekelsen, Lars-Uwe Scholtz

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2021

Abstract

Objective

To determine the effectiveness of a soft-tissue bulking agent comparing novel approaches of Eustachian tube (ET) augmentation procedures: transpalatinatal Eustachian tube augmentation in local and general anesthesia versus an augmentation with velotraction under general anesthesia. The clinical endpoint was the resolution of symptoms related to unilateral patulous Eustachian tube dysfunction (PETD) requiring no additional revision augmentations.

Study design

Combined retrospective clinical chart review. Setting: Tertiary referral center.

Methods

Patients suffering from PETD underwent one of the following procedures: Group (A) transpalatinatal soft-tissue bulking agent with infiltration/augmentation under local anesthesia in a sitting position, group (B) transpalatinatal soft-tissue bulking agent infiltration/augmentation under general anesthesia in the flat position or group (C) infiltration/transoral augmentation of the ET with velotraction under general anesthesia in a flat position. The requirement to repeat the procedure due to recurrence of any PETD-related symptoms was recorded and retrospectively analyzed.

Results

A total of 50 procedures were executed in 50 patients with unilateral PETD. The necessity to perform a second procedure has analyzed a mean of 6 months postoperatively (range: 6–17 months). Compared to the transpalatinatal augmentation in local anesthesia (group A) (100% success rate), the 6-month failure rate was significantly higher for transpalatinatal augmentation under general anesthesia (group B) (80% success rate) and velotraction augmentation under general anesthesia (group C) (67% success rate). Patient cohort with transpalatinatal augmentation under general anesthesia required 20% and augmentation with velotraction under general anesthesia in 33% revision augmentation procedures reviewed at 6 months follow-up (mean follow-up 11.2 months).

Conclusions

Although all different approaches resulted in a reduction of PETD related symptoms, the transpalatinatal ET augmentation in local anesthesia achieved a statistically significant superior clinical improvement. A complete resolution of PETD related symptoms was obtained and required additional procedures. This improvement may be related to the intraoperative “feedback” by the patients in local anesthesia in the sitting position eliminating the necessity for repeated procedures.

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Title: A novel technique for patulous Eustachian tube augmentation
Authors: Holger Sudhoff
Nazli Ay
Ingo Todt
Odile Sauzet
Manuel Bernal-Sprekelsen
Lars-Uwe Scholtz
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keywords: Local Anesthesia in Dentistry
General Anesthesia
Published in: European Archives of Oto-Rhino-Laryngology / Issue 7/2021
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-020-06277-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A novel technique for patulous Eustachian tube augmentation

Abstract

Objective

Study design

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Study design

Methods

Results

Conclusions

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