Balloon Eustachian Tuboplasty (BET) – a critical analysis

Introduction:

In the last years there has been an increase of BET use in patients with Eustachian tube dysfunction (e.g. in cases with chronic otitis media with effusion (OME)). Despite of a successful treatment in some patients and optimistic study data, there is still a big amount of ears, which don't benefit from a BET. Aim of this study was to find a reason for these BET non-responders by analyzing the histopathology of temporal bones with OME.

Methods:

There were 23 temporal bone specimens with OME were identified within an institutional archived collection. Each specimen was inspected and the mucosa at the tubal orifice and the osseous part of the Eustachian tube was graded on a 4-point scale.

Results:

3 cases (13%) were normal (Grade 1), 6 cases (26%) were mildly thickened (Grade 2), 11 (48%) were severely thickened (Grade 3), and 3 (13%) were severely thickened with polypoid degeneration (Grade 4).

Conclusion:

In cases with OME the mucosa of the tympanal Eustachian tubal orifice is most often mildly or severely thickened. Normal mucosa or mucosa with polypoid changes are possible but uncommon. The thickened mucosa in the tubal orifice and in the osseous part of the Eustachian tube may act as a barrier to middle ear ventilation that would not be directly improved by the dilatation of the cartilaginous tube part. This might be a possible explanation for some non-responder cases after BET.

Publication History

Publication Date:
23 April 2019 (online)