Abstract
Objective
To evaluate the effect of the combination of balloon Eustachian tuboplasty (BET) and tympanic paracentesis (TP) on intractable chronic otitis media with effusion (COME).
Methods
Ninety patients with intractable COME were included and randomly assigned to three groups: BET only (30 patients), BET + paracentesis (30 patients), and paracentesis only (30 patients). Otic endoscopic findings and tympanograms were recorded before the surgery and at the month 1, month 3, and month 6 follow-up evaluations.
Results
Both the BET only and BET + paracentesis groups achieved better outcomes than the paracentesis group. The BET + paracentesis group exhibited better otic endoscopic scores than the BET only group ( p < 0.05) at 1 month post-operation. However, no significant difference was found at month 3 or month 6 post-operation. No significant difference in the tympanograms was observed between these two groups at month 1, month 3, or month 6 post-operation. The otic endoscopic sign scores improved from month 1 to month 6 in the BET only group and from month 1 to month 3 in the BET + paracentesis group. The conversion of type B tympanograms improved from month 1 to month 6 in the BET and BET + paracentesis groups but not in the paracentesis only group.
Conclusions
Our results suggested that the combination of BET and TP was effective for intractable COME and can help shorten the recovery period for middle ear effusion.
1
Introduction
Otitis media with effusion (OME) is a common disorder in ENT clinics and is found mostly in children. In adults, OME has a low prevalence (approximately 0.55–1%) . Although it does not induce speech disturbances in adults, the symptoms of aural fullness and hearing loss can significantly affect patient quality of life. Specifically, OME can cause tympanic atelectasis and even adhesive otitis media. It has been reported that OME can induce sensorial hearing loss in 14% of patients .
In adults, OME is commonly caused by nasopharyngeal obstruction. However, it has also been estimated that 46% of OME cases are caused by Eustachian tube dysfunction (ETD) . For patients with OME caused by ETD, traditional treatment includes medicine such as antibiotics, nasal steroids, and decongestants, physical training such as a Valsalva maneuver, or a surgical process such as tympanic paracentesis (TP) or placement of a grommet . However, traditional treatment has limited success in a portion of patients with intractable chronic otitis media with effusion (COME) likely due to ETD .
Recently, balloon Eustachian tuboplasty (BET) had emerged as a therapeutic option that has shown promising short-term results for ETD. Good outcomes for OME using BET have been reported . However, most studies have not reported whether the OME patients enrolled had intractable COME. Some patients might be cured with only traditional treatment and not undergo BET. Regrettably, few studies have reported processes performed in addition to BET. Because reports have shown that middle ear effusion can affect normal ciliary function , we assumed that TP could help to reduce the burden of the Eustachian tube (ET) and shorten the course of the disease.
This study was performed to evaluate the effect of the combination of BET and TP on intractable COME.
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