Cross-hatching Eustachian Tuboplasty Long Term Outcomes

Abstract

Objective: To review the long term outcomes of Cross-hatching Eustachian Tuboplasty (ChEt) in patients with Chronic Obstructive Eustachian Tube Dysfunction (COETD), as well as assess the clinical factors associated with surgical success. Study design: Retrospective case series review. Setting: Tertiary healthcare institution. Methods: This is a retrospective review by the senior author of all cases of non-revision ChEt for COETD. Follow-up period was 5 years. The curvature of the posterior cushion was modified using an argon laser to alter the spring of the cartilage alleviating the obstructed valve's aperture. Several clinical factors were reviewed in relation to the successful opening of Eustachian tube valve. Results: One hundred and twenty patients, 72 males/48 females, average age 42.4+2 years old, met study inclusion criteria. COETD patients/obstructive causes were: Posterior cushion hypertrophy, 68(56.6%). Tensor Veli and Levator Veli Palatini muscles hypertrophy, 15(12.5%). Remarkable mucosal hypertrophic disease, 37(30.8%). Total of ET tubes was 198. Bilateral 143(72.2%), 55 unilateral (27.7%) ET Valve was seen more open postoperatively on Simple Endoscopy (SE) and Slow Motion Video Analysis (SMVEA). There were no complications. Mean pure tone average improved by 20 dB postoperatively; P=0.015. Mean immitance changes in tympanometric measurements improved postoperatively at least 0.10 mmhos in 91% of the patients (P=.010). Resolution of symptoms was considered a successful outcome. Failure correlated with the severity of disease. Conclusion: High rates of improvement (96%) were achieved. ChEt is a promising technique for the treatment of COETD.