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DOI: 10.1055/s-0043-1769503
CT and MRI in the Preoperative Planning of Balloon Dilation of the Eustachian Tube: Literature Review
Abstract
Balloon dilatation of the Eustachian tube (BET) is a surgical treatment method for Eustachian tube dysfunction (ETD), which relieves the symptoms in the majority of cases. However, there are potential intraoperative risks associated with BET; the decision-making process with regard to indications for BET is not standardized up to date. The objective of this study was to review the role of computed tomography (CT) and magnetic resonance imaging (MRI) in the preoperative planning of BET. The literature review is based on a database search performed in August 2022.
BET is classified into transtympanic and nasopharyngeal. CT of the temporal bone provides good visualization of the site of obstruction, which allows to choose the adequate approach. Transtympanic approach is associated with risks of internal carotid artery damage due to possible carotid canal anomalies. This risk can be prevented with preoperative CT scan of the temporal bone. In case of nasopharyngeal BET, there is no sufficient data considering risks of possible artery damage, although CT can provide accurate measurements of ET. MRI is useful for differential diagnosis of conditions imitating ETD, such as endolymphatic hydrops and nasopharyngeal carcinoma. Thus, it is feasible to perform CT and MRI before BET to personalize the management of ETD patients.
Publication History
Article published online:
01 June 2023
© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Holger Sudhoff Dienstort med, Bielefeld Hals-Nasen-Ohren Klinik K, Ockermann T. Die Ballondilatation der Eustachischen Röhre zur Behandlung der obstruktiven Tubendysfunktion; 2010
- 2 Kivekäs I, Chao WC, Faquin W. et al. Histopathology of balloon-dilation Eustachian tuboplasty. Laryngoscope 2015; 125 (02) 436-441
- 3 Smith ME, Weir AE, Prior DCC, Cope W, Tysome JR, Sutcliffe M. The mechanism of balloon Eustachian tuboplasty: a biomechanical study. Med Biol Eng Comput 2020; 58 (04) 689-699
- 4 Llewellyn A, Norman G, Harden M. et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Health Technol Assess 2014; 18 (46) 1-180 , v–vi
- 5 Formánek M, Formánková D, Školoudík L, Zeleník K, Chrobok V, Komínek P. Effect of balloon Eustachian tuboplasty in adults that only have symptoms of chronic eustachian tube dysfunction, with a 1-year follow-up: prospective clinical trial. Ear Nose Throat J 2020; x: 145561320980199
- 6 Alper CM, Teixeira MS, Rath TJ, Hall-Burton D, Swarts JD. Change in Eustachian tube function with balloon dilation in adults with ventilation tubes. Otol Neurotol 2020; 41 (04) 482-488
- 7 Jansen S, Peters N, Hinkelbein J, Klußmann JP, Beutner D, Meyer MF. Subjective and objective effectiveness of eustachian tube balloon dilatation for patients with Eustachian tube dysfunction-evaluation in a pressure chamber. Otol Neurotol 2020; 41 (06) 795-801
- 8 Froehlich MH, Le PT, Nguyen SA, McRackan TR, Rizk HG, Meyer TA. Eustachian tube balloon dilation: a systematic review and meta-analysis of treatment outcomes. Otolaryngol Head Neck Surg 2020; 163 (05) 870-882
- 9 Utz ER, LaBanc AJ, Nelson MJ, Gaudreau PA, Wise SR. Balloon dilation of the eustachian tube for baro-challenge-induced otologic symptoms in military divers and aviators: a retrospective analysis. Ear Nose Throat J 2020. Doi: 145561320938156
- 10 Anand V, Poe D, Dean M. et al. Balloon dilation of the Eustachian tube: 12-month follow-up of the randomized controlled trial treatment group. Otolaryngol Head Neck Surg 2019; 160 (04) 687-694
- 11 Meyer TA, O'Malley EM, Schlosser RJ. et al. A randomized controlled trial of balloon dilation as a treatment for persistent Eustachian tube dysfunction with 1-year follow-up. Otol Neurotol 2018; 39 (07) 894-902
- 12 Cutler JL, Meyer TA, Nguyen SA, O'Malley EM, Thackeray L, Slater PW. Long-term outcomes of balloon dilation for persistent Eustachian tube dysfunction. Otol Neurotol 2019; 40 (10) 1322-1325
- 13 Luukkainen V, Vnencak M, Aarnisalo AA, Jero J, Sinkkonen ST. Patient satisfaction in the long-term effects of Eustachian tube balloon dilation is encouraging. Acta Otolaryngol 2018; 138 (02) 122-127
- 14 Choi SW, Oh SJ, Kim Y. et al. A multicenter, randomized, active-controlled, clinical trial study to evaluate the efficacy and safety of navigation guided balloon Eustachian tuboplasty. Sci Rep 2021; 11 (01) 23296
- 15 Bouthillier A, van Loveren HR, Keller JT. Segments of the internal carotid artery: a new classification. Neurosurgery 1996; 38 (03) 425-432 , discussion 432–433
- 16 Jufas N, Treble A, Newey A, Patel N. Endoscopically guided transtympanic balloon catheter dilatation of the Eustachian tube: a cadaveric pilot study. Otol Neurotol 2016; 37 (04) 350-355
- 17 Kepchar J, Acevedo J, Schroeder J, Littlefield P. Transtympanic balloon dilatation of eustachian tube: a human cadaver pilot study. J Laryngol Otol 2012; 126 (11) 1102-1107
- 18 Kapadia M, Tarabichi M, Najmi M, Hamza M. Safety of carotid canal during transtympanic dilatation of the Eustachian tube: a cadaver pilot study. Indian J Otolaryngol Head Neck Surg 2018; 70 (02) 211-217
- 19 Kapadia M, Arsiwala Z, Tarabichi M. Endoscopic transtympanic Eustachian tube dilatation: an overview of evaluation methods and dilatation technique. World J Otorhinolaryngol Head Neck Surg 2019; 5 (03) 152-159
- 20 Tarabichi M, Najmi M. Site of eustachian tube obstruction in chronic ear disease. Laryngoscope 2015; 125 (11) 2572-2575
- 21 Tisch M, Störrle P, Danz B, Maier H. Zum Stellenwert der Bildgebung vor Tubendilation mit dem Bielefelder Tubenkatheter. HNO 2013; 61 (06) 488-491
- 22 Swain SK, Janardan S, Mohanty JN. Endoscopy guided Eustachian tube balloon dilation: our experiences. Iran J Otorhinolaryngol 2020; 32 (112) 287-294
- 23 Abdel-Aziz T, Schröder S, Lehmann M, Gehl HB, Ebmeyer J, Sudhoff H. Computed tomography before balloon Eustachian tuboplasty–a true necessity?. Otol Neurotol 2014; 35 (04) 635-638
- 24 Lee S, Oh SJ, Choi SW. et al. The usefulness of Valsalva computed tomography as an assessment tool for the Eustachian tube. Am J Otolaryngol 2020; 41 (04) 102499
- 25 El-Anwar MW, Eldib DB, Nofal AAF, Khazbak AO. Eustachian tube: computed tomography analysis. J Craniofac Surg 2020; 31 (06) 1763-1765
- 26 Falkenberg-Jensen B, Hopp E, Jablonski GE, Pripp AH, Silvola JT. The cartilaginous Eustachian tube: reliable CT measurement and impact of the length. Am J Otolaryngol 2018; 39 (04) 436-440
- 27 Grimmer JF, Poe DS. Update on eustachian tube dysfunction and the patulous eustachian tube. Curr Opin Otolaryngol Head Neck Surg 2005; 13 (05) 277-282
- 28 Aydın N, Saylısoy S, Adapınar B, Arslantas D. A comparative evaluation of the Eustachian tube cartilage between healthy and diseased ears using a 3 Tesla MRI. Pol J Radiol 2020; 85 (01) e581-e585
- 29 Lükens A, Dimartino E, Günther RW, Krombach GA. Functional MR imaging of the eustachian tube in patients with clinically proven dysfunction: correlation with lesions detected on MR images. Eur Radiol 2012; 22 (03) 533-538
- 30 Gürkov R, Jerin C, Flatz W, Maxwell R. Clinical manifestations of hydropic ear disease (Menière's). Eur Arch Otorhinolaryngol 2019; 276 (01) 27-40
- 31 Levo H, Kentala E, Rasku J, Pyykkö I. Aural fullness in Ménière's disease. Audiol Neurotol 2014; 19 (06) 395-399
- 32 Bächinger D, Eckhard AH, Röösli C, Veraguth D, Huber A, Dalbert A. Endolymphatic hydrops mimicking obstructive Eustachian tube dysfunction: preliminary experience and literature review. Eur Arch Otorhinolaryngol 2021; 278 (02) 561-565