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Saline injection to determine the volume required for personalised patulous Eustachian tube augmentation with long-standing material

  • D Jančatová (a1), K Zeleník (a1), P Komínek (a1) and M Formánek (a1)
Abstract
Objective

There is currently no general consensus on patulous Eustachian tube management. Injection of autologous fat, cartilage or hydroxylapatite has been described for Eustachian tube occlusion, with promising results. However, complete resolution of symptoms is not achieved in all cases. This could be connected to the amount of material injected into the surroundings of the Eustachian tube, as this greatly differs among existing studies. Identifying the appropriate volume of injected material could be challenging because anatomical conditions vary among patients, and there is always a risk of chronic Eustachian tube obstruction and its related complications when too much long-standing material is injected.

Case report

A case is presented wherein saline was injected under local anaesthesia to determine the volume required and to predict the success of patulous Eustachian tube augmentation with long-standing material.

Conclusion

This approach could allow more personalised treatment and help identify patients likely to benefit from the procedure.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Author for correspondence: Dr Martin Formánek, Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, 17 listopadu 1790, 708 52 Ostrava, Czech Republic E-mail: martin.formanek@fno.cz
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Dr M Formánek takes responsibility for the integrity of the content of the paper

Footnotes
References
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1Mondain, M, Vidal, D, Bouhanna, S, Uziel, A. Monitoring eustachian tube opening: preliminary results in normal subjects. Laryngoscope 1997;107:1414–19
2Bluestone, CD. Eustachian Tube: Structure, Function, Role in Otitis Media. Hamilton: BC Decker, 2005;219
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4Luu, K, Remillard, A, Fandino, M, Saxby, A, Westerberg, BD. Treatment effectiveness for symptoms of patulous Eustachian tube: a systematic review. Otol Neurotol 2015;36:1593–600
5Vaezeafshar, R, Turner, JH, Li, G, Hwang, PH. Endoscopic hydroxyapatite augmentation for patulous Eustachian tube. Laryngoscope 2014;124:62–6
6Schröder, S, Lehmann, M, Sudhoff, HH, Ebmeyer, J. Treatment of the patulous eustachian tube with soft-tissue bulking agent injections. Otol Neurotol 2015;36:448–52
7Kong, SK, Lee, IW, Goh, EK, Park, SH. Autologous cartilage injection for the patulous eustachian tube. Am J Otolaryngol 2011;32:346–8
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9Rodrigues, JC, Waddell, A, Cook, JL. A novel, computed tomography guided, trans-cutaneous approach to treat refractory autophony in a patient with a patulous eustachian tube. J Laryngol Otol 2014;128:182–4
10Wolraich, D, Zur, KB. Use of calcium hydroxylapatite for management of recalcitrant otorrhea due to a patulous eustachian tube. Int J Pediatr Otorhinolaryngol 2010;74:1455–7
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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