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Laser assisted eustachian tuboplasty: a case report

Year 2005, Volume: 15 Issue: 1, 30 - 35, 10.03.2005

Abstract

Surgical treatment of eustachian tube dysfunction is stili challenging. Placement of a transtympanic ventilation tube may not be successful and may require multiple applications. We presented a 47-year-old male patient with chronic recurrent otitis media with effusion and retraction due to eustachian tube dysfunction, in whom the number of previous transtympanic tube insertions amounted to 18. He undervvent laser assist­ ed eustachian tuboplasty in both ears with endoscopic guidance under general anesthesia. The mucosal, submucosal, and partially the cartilaginous tissues in the posterior pillow of the nasopharyngeal orifice of the eustachian tube were ablated by Nd:YAG and holmi­ um :YAG laser. Following surgery, air conduction thresholds decreased from 37 dB to 22 dB, and from 38 dB to 33 dB for the right and left ears, respectively.The preoperative tympanogram curve, which was of type B for both ears was found as type C-1 on the right side, and type C-2 on left. Limited improvement seen in the left ear was ascribed to insufficient ablation of the posterior pillow of the eustachian tube. No complications were encountered within a follow-up of 12 months.

References

  • Bluestone CD, Klein JO. Otitis media, atelectasis, and eustachian tube dysfunction. In: Bluestone CD, Stool SE, editors. Pediatric otolaryngology, 3rd ed. Philadelphia: W.B. Saunders; 1996. p. 388-582.
  • Poelmans J, Tack J, Feenstra L. Chronic middle ear dis- ease and gastroesophageal reflux disease: a causal relation? Otol Neurotol 2001;22:447-50.
  • Sade J, Ar A. Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation. Otolaryngol Head Neck Surg 1997;116:499-524.
  • Wullstein H. Eustachian tube in tympanoplasty. Arch Otolaryngol 1960;71:408-11.
  • House WF, Glasscock ME, Miles J. Middle fossa approach eustachian tuboplasty. Laryngoscope 1969;79:1765-82.
  • Misurya VK. Eustachian tuboplasty. J Laryngol Otol 1975;89:807-13.
  • Zollner F. Therapy of the eustachian tube. Arch Otolaryngol 1963;78:394-9.
  • Jansen CW. Functional repair of the eustachian tube. Am J Otol 1985;6:231-2.
  • Hopf J, Linnarz M, Gundlach P, Schafer E, Leege N, Scherer H, et al. Microendoscopy of the Eustachian tube and the middle ear. Indications and clinical appli- cation Laryngorhinootologie 1991;70:391-4. [Abstract]
  • Chays A, Cohen JM, Magnan J. Microfibroendoscopy of the eustachian tube. Presse Med 1995;29;24:773-4. [Abstract]
  • Poe DS, Metson RB, Kujawski O. Laser eustachian tuboplasty: a preliminary report. Laryngoscope 2003;113:583-91.
  • Kujawski O, Laser Eustachian Tuboplasty. Vol. 2. 4th ed. European Congress of EUFOS: Oto-Rhino- Laryngology Head and Neck Surgery; 2000. p. 835-42.
  • Kujawski OB, Poe DS. Laser eustachian tuboplasty. Otol Neurotol 2004;25:1-8.
  • Poe DS, Abou-Halawa A, Abdel-Razek O. Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 2001;22:590-5.

Lazer yardımlı östaki tuboplastisi: Olgu sunumu

Year 2005, Volume: 15 Issue: 1, 30 - 35, 10.03.2005

Abstract

Östaki tüpü disfonksiyonlarının cerrahi olarak tamiri ol- dukça zordur. Östaki disfonksiyonuna bağlı timpanik membran ve ortakulak komplikasyonlarını ventilasyon tüpü uygulaması ile çözmek her zaman mümkün ola- mamakta ve sıklıkla çok sayıda uygulama gerekmek- tedir. Bu yazıda, daha önce östaki tüpü disfonksiyonu- na bağlı olarak gelişen ve 18 kez ventilasyon tüpü uy- gulaması gerektiren kronik, tekrarlayıcı effüzyonlu oti- tis mediası olan 47 yaşında erkek hasta sunuldu. Has- taya genel anestezi altında ve endoskopi eşliğinde, her iki kulak için lazer yardımlı östaki tuboplastisi uygu- landı. Tuba östakinin nazofarenjeal ağzı posterior yas- tığındaki mukoza, altmukoza ve kısmen de kartilajinöz doku Nd-YAG ve Holmium lazerle ablate edildi. Hasta- nın sağ kulağında ameliyat öncesinde 37 dB olan ha- vayolu eşiği ameliyat sonrasında 22 dB’ye düştü; tip B olan timpanogram eğrisi ise tip C-1 haline geldi. Sol kulakta ise ameliyat öncesinde tip B olan timpanogram eğrisi ameliyat sonrasında tip C-2 bulundu; havayolu eşiği de 38 dB’den 33 dB’ye düştü. Sol kulakta elde edilen sınırlı iyileşme, östaki tüpü posterior yastığında- ki yetersiz ablasyona bağlandı. Ameliyattan sonra 12. ayda hastanın komplikasyonsuz olduğu görüldü

References

  • Bluestone CD, Klein JO. Otitis media, atelectasis, and eustachian tube dysfunction. In: Bluestone CD, Stool SE, editors. Pediatric otolaryngology, 3rd ed. Philadelphia: W.B. Saunders; 1996. p. 388-582.
  • Poelmans J, Tack J, Feenstra L. Chronic middle ear dis- ease and gastroesophageal reflux disease: a causal relation? Otol Neurotol 2001;22:447-50.
  • Sade J, Ar A. Middle ear and auditory tube: middle ear clearance, gas exchange, and pressure regulation. Otolaryngol Head Neck Surg 1997;116:499-524.
  • Wullstein H. Eustachian tube in tympanoplasty. Arch Otolaryngol 1960;71:408-11.
  • House WF, Glasscock ME, Miles J. Middle fossa approach eustachian tuboplasty. Laryngoscope 1969;79:1765-82.
  • Misurya VK. Eustachian tuboplasty. J Laryngol Otol 1975;89:807-13.
  • Zollner F. Therapy of the eustachian tube. Arch Otolaryngol 1963;78:394-9.
  • Jansen CW. Functional repair of the eustachian tube. Am J Otol 1985;6:231-2.
  • Hopf J, Linnarz M, Gundlach P, Schafer E, Leege N, Scherer H, et al. Microendoscopy of the Eustachian tube and the middle ear. Indications and clinical appli- cation Laryngorhinootologie 1991;70:391-4. [Abstract]
  • Chays A, Cohen JM, Magnan J. Microfibroendoscopy of the eustachian tube. Presse Med 1995;29;24:773-4. [Abstract]
  • Poe DS, Metson RB, Kujawski O. Laser eustachian tuboplasty: a preliminary report. Laryngoscope 2003;113:583-91.
  • Kujawski O, Laser Eustachian Tuboplasty. Vol. 2. 4th ed. European Congress of EUFOS: Oto-Rhino- Laryngology Head and Neck Surgery; 2000. p. 835-42.
  • Kujawski OB, Poe DS. Laser eustachian tuboplasty. Otol Neurotol 2004;25:1-8.
  • Poe DS, Abou-Halawa A, Abdel-Razek O. Analysis of the dysfunctional eustachian tube by video endoscopy. Otol Neurotol 2001;22:590-5.
There are 14 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Tamer Erdem This is me

Orhan Özturan This is me

Murat Cem Miman This is me

Murat Uğraş This is me

Publication Date March 10, 2005
Published in Issue Year 2005 Volume: 15 Issue: 1

Cite

APA Erdem, T., Özturan, O., Miman, M. C., Uğraş, M. (2005). Lazer yardımlı östaki tuboplastisi: Olgu sunumu. The Turkish Journal of Ear Nose and Throat, 15(1), 30-35.
AMA Erdem T, Özturan O, Miman MC, Uğraş M. Lazer yardımlı östaki tuboplastisi: Olgu sunumu. Tr-ENT. March 2005;15(1):30-35.
Chicago Erdem, Tamer, Orhan Özturan, Murat Cem Miman, and Murat Uğraş. “Lazer yardımlı östaki Tuboplastisi: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat 15, no. 1 (March 2005): 30-35.
EndNote Erdem T, Özturan O, Miman MC, Uğraş M (March 1, 2005) Lazer yardımlı östaki tuboplastisi: Olgu sunumu. The Turkish Journal of Ear Nose and Throat 15 1 30–35.
IEEE T. Erdem, O. Özturan, M. C. Miman, and M. Uğraş, “Lazer yardımlı östaki tuboplastisi: Olgu sunumu”, Tr-ENT, vol. 15, no. 1, pp. 30–35, 2005.
ISNAD Erdem, Tamer et al. “Lazer yardımlı östaki Tuboplastisi: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat 15/1 (March 2005), 30-35.
JAMA Erdem T, Özturan O, Miman MC, Uğraş M. Lazer yardımlı östaki tuboplastisi: Olgu sunumu. Tr-ENT. 2005;15:30–35.
MLA Erdem, Tamer et al. “Lazer yardımlı östaki Tuboplastisi: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat, vol. 15, no. 1, 2005, pp. 30-35.
Vancouver Erdem T, Özturan O, Miman MC, Uğraş M. Lazer yardımlı östaki tuboplastisi: Olgu sunumu. Tr-ENT. 2005;15(1):30-5.