International Journal of Medical Arts (Jan 2021)
Combined Endoscopic Sinus Surgery and Eustachian Tube Balloon dilatation improves Eustachian Tube Functions in patients had Chronic rhinosinusitis with nasal polyposis and Eustachian tube dysfunction
Abstract
Background: Chronic rhinosinusitis [CRS] is a distressing disease that affects patients' mental and physical health. Eustachian tube dysfunction [ETD] affects approximately 1% of the adult population, especially patients with rhinosinus diseases. Transnasal Balloon Eustachian tuboplasty [BET] is a safe intervention for adult patients with chronic ETD. Aim of the work: To evaluate the impact of combined Function endoscopic sinus surgery [FESS] for CRS and BET on ETD manifestations compared to FESS only. Patients and Methods: 45 patients were randomly allocated into Group C underwent FESS, and Group-I underwent FESS and BET. ETD was evaluated using the 7-item Eustachian Tube Dysfunction Questionnaire [ETDQ-7] score, Otoscopy, Valsalva maneuver, and tympanometry. BET was performed using the XprESS ENT Dilation System with balloon inflation to 12 atmospheres for 2-min. Study outcomes were determined after 6-wk. Results: At 6-wk, the frequency of normal TM position and positive Valsalva's maneuver was significantly higher, and ETDQ-7 scores were significantly improved in all patients, while the frequency of tympanogram type-A was significantly and non-significantly higher in groups I and C, respectively. ROC curve and Regression analyses defined the application of FESS with BET as the significant predictor for normalization of tympanogram to type-A. Conclusion: Coupling Balloon Eustachian tuboplasty with Function endoscopic sinus surgery provided outcome more superior to Function endoscopic sinus surgery alone. Balloon Eustachian tuboplasty in experienced hands can be performed with a 100% technical success rate
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