Balloon Eustachian tuboplasty (BET) in children with general or localized retractions of the tympanic membrane: subgroup analysis of a retrospective multicenter study

Introduction General or localized retractions of the tympanic membrane are frequently seen in children. They pose a challenge to therapeutic decision making. On the one hand a significant proportion of retractions lingers stable. On the other hand, other retractions do progress to cholestatoma. Furthermore, recurrences after surgery, like ventilation tube placement or tympanoplasty, develop. Balloon Eustachian tuboplasty (BET) now presents a causal treatment approach to address the underlying Eustachian tube dysfunction.

Methods Retrospective multicenter study (9 tertiary care ENT departments). Patients: 4-12 year-old children with tympanic membrane retractions. Treatment: BET, alone or synchronously with paracentesis (PC), ventilation tube (VT) insertion or tympanoplasty (TPL), during 3/2011 and 8/2014. Outcome criteria: tympanic membrane appearance at microscopic otoscopy, type of tympanogram, hearing level, ability to perform Valsalva’s maneuver.

Results In total, 299 BETs were carried out in 167 children. In 88 children (140 ears), generalized or localized retraction of the tympanic membrane was given as reason for BET. 80 children (124 ears) still presented with tympanic membrane retractions at the time of surgery. They were therefore subjected to the present subgroup analysis. In 61 ears BET was the only intervention. 63 ears were treated with additional PC, VT insertion, or TPL. All outcome criteria improved in both groups treated either with BET-only or with BET and PC, PD or TPL.

Conclusion The treatment effects observed need to be surveyed in prospective clinical trials.

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Publication History

Article published online:
10 June 2020