Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial

Objectives/Hypothesis To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. Study Design In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2...

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Veröffentlicht in:The Laryngoscope 2018-05, Vol.128 (5), p.1200-1206
Hauptverfasser: Poe, Dennis, Anand, Vijay, Dean, Marc, Roberts, William H., Stolovitzky, Jose Pablo, Hoffmann, Karen, Nachlas, Nathan E., Light, Joshua P., Widick, Mark H., Sugrue, John P., Elliott, C. Layton, Rosenberg, Seth I., Guillory, Paul, Brown, Neil, Syms, Charles A., Hilton, Christopher W., McElveen, John T., Singh, Ameet, Weiss, Raymond L., Arriaga, Moises A., Leopold, John P.
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container_end_page 1206
container_issue 5
container_start_page 1200
container_title The Laryngoscope
container_volume 128
creator Poe, Dennis
Anand, Vijay
Dean, Marc
Roberts, William H.
Stolovitzky, Jose Pablo
Hoffmann, Karen
Nachlas, Nathan E.
Light, Joshua P.
Widick, Mark H.
Sugrue, John P.
Elliott, C. Layton
Rosenberg, Seth I.
Guillory, Paul
Brown, Neil
Syms, Charles A.
Hilton, Christopher W.
McElveen, John T.
Singh, Ameet
Weiss, Raymond L.
Arriaga, Moises A.
Leopold, John P.
description Objectives/Hypothesis To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. Study Design In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older with Eustachian tube dilatory dysfunction refractory to medical therapy to undergo balloon dilation of the Eustachian tube with balloon catheter in conjunction with medical management or medical management alone. Methods The primary endpoint was normalization of tympanogram at 6 weeks. Additional endpoints were normalization of Eustachian Tube Dysfunction Questionaire‐7 symptom scores, positive Valsalva maneuver, mucosal inflammation, and safety. Results Primary efficacy results demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone. Tympanogram normalization at 6‐week follow‐up was observed in 51.8% (72/139) of investigational patients versus 13.9% (10/72) of controls (P 
doi_str_mv 10.1002/lary.26827
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Layton ; Rosenberg, Seth I. ; Guillory, Paul ; Brown, Neil ; Syms, Charles A. ; Hilton, Christopher W. ; McElveen, John T. ; Singh, Ameet ; Weiss, Raymond L. ; Arriaga, Moises A. ; Leopold, John P.</creator><creatorcontrib>Poe, Dennis ; Anand, Vijay ; Dean, Marc ; Roberts, William H. ; Stolovitzky, Jose Pablo ; Hoffmann, Karen ; Nachlas, Nathan E. ; Light, Joshua P. ; Widick, Mark H. ; Sugrue, John P. ; Elliott, C. Layton ; Rosenberg, Seth I. ; Guillory, Paul ; Brown, Neil ; Syms, Charles A. ; Hilton, Christopher W. ; McElveen, John T. ; Singh, Ameet ; Weiss, Raymond L. ; Arriaga, Moises A. ; Leopold, John P.</creatorcontrib><description>Objectives/Hypothesis To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. Study Design In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older with Eustachian tube dilatory dysfunction refractory to medical therapy to undergo balloon dilation of the Eustachian tube with balloon catheter in conjunction with medical management or medical management alone. Methods The primary endpoint was normalization of tympanogram at 6 weeks. Additional endpoints were normalization of Eustachian Tube Dysfunction Questionaire‐7 symptom scores, positive Valsalva maneuver, mucosal inflammation, and safety. Results Primary efficacy results demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone. Tympanogram normalization at 6‐week follow‐up was observed in 51.8% (72/139) of investigational patients versus 13.9% (10/72) of controls (P &lt; .0001). Tympanogram normalization in the treatment group was 62.2% after 24 weeks. Normalization of Eustachian Tube Dysfunction Questionaire‐7 Symptom scores at 6‐week follow‐up was observed in 56.2% (77/137) of investigational patients versus 8.5% (6/71) controls (P &lt; .001). The investigational group also demonstrated substantial improvement in both mucosal inflammation and Valsalva maneuver at 6‐week follow‐up compared to controls. No device‐ or procedure‐related serious adverse events were reported for those who underwent balloon dilation of the Eustachian tube. Conclusions This study demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone to treat Eustachian tube dilatory dysfunction in adults. Level of Evidence 1b. Laryngoscope, 128:1200–1206, 2018</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.26827</identifier><identifier>PMID: 28940574</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>balloon catheter ; Catheters ; Eustachian tube dysfunction ; normalization of tympanogram</subject><ispartof>The Laryngoscope, 2018-05, Vol.128 (5), p.1200-1206</ispartof><rights>2017 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2018 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3937-84edbe807d83435c437c4c024c1146444046c207997c2b578fe027c0d15db0c43</citedby><cites>FETCH-LOGICAL-c3937-84edbe807d83435c437c4c024c1146444046c207997c2b578fe027c0d15db0c43</cites><orcidid>0000-0002-8641-7370</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.26827$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.26827$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28940574$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Poe, Dennis</creatorcontrib><creatorcontrib>Anand, Vijay</creatorcontrib><creatorcontrib>Dean, Marc</creatorcontrib><creatorcontrib>Roberts, William H.</creatorcontrib><creatorcontrib>Stolovitzky, Jose Pablo</creatorcontrib><creatorcontrib>Hoffmann, Karen</creatorcontrib><creatorcontrib>Nachlas, Nathan E.</creatorcontrib><creatorcontrib>Light, Joshua P.</creatorcontrib><creatorcontrib>Widick, Mark H.</creatorcontrib><creatorcontrib>Sugrue, John P.</creatorcontrib><creatorcontrib>Elliott, C. Layton</creatorcontrib><creatorcontrib>Rosenberg, Seth I.</creatorcontrib><creatorcontrib>Guillory, Paul</creatorcontrib><creatorcontrib>Brown, Neil</creatorcontrib><creatorcontrib>Syms, Charles A.</creatorcontrib><creatorcontrib>Hilton, Christopher W.</creatorcontrib><creatorcontrib>McElveen, John T.</creatorcontrib><creatorcontrib>Singh, Ameet</creatorcontrib><creatorcontrib>Weiss, Raymond L.</creatorcontrib><creatorcontrib>Arriaga, Moises A.</creatorcontrib><creatorcontrib>Leopold, John P.</creatorcontrib><title>Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. Study Design In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older with Eustachian tube dilatory dysfunction refractory to medical therapy to undergo balloon dilation of the Eustachian tube with balloon catheter in conjunction with medical management or medical management alone. Methods The primary endpoint was normalization of tympanogram at 6 weeks. Additional endpoints were normalization of Eustachian Tube Dysfunction Questionaire‐7 symptom scores, positive Valsalva maneuver, mucosal inflammation, and safety. Results Primary efficacy results demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone. Tympanogram normalization at 6‐week follow‐up was observed in 51.8% (72/139) of investigational patients versus 13.9% (10/72) of controls (P &lt; .0001). Tympanogram normalization in the treatment group was 62.2% after 24 weeks. Normalization of Eustachian Tube Dysfunction Questionaire‐7 Symptom scores at 6‐week follow‐up was observed in 56.2% (77/137) of investigational patients versus 8.5% (6/71) controls (P &lt; .001). The investigational group also demonstrated substantial improvement in both mucosal inflammation and Valsalva maneuver at 6‐week follow‐up compared to controls. No device‐ or procedure‐related serious adverse events were reported for those who underwent balloon dilation of the Eustachian tube. Conclusions This study demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone to treat Eustachian tube dilatory dysfunction in adults. Level of Evidence 1b. Laryngoscope, 128:1200–1206, 2018</description><subject>balloon catheter</subject><subject>Catheters</subject><subject>Eustachian tube dysfunction</subject><subject>normalization of tympanogram</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp90MtKAzEUBuAgitbqxgeQgBsRRnNtJu5q8QYFQRR0FTJJBkfSiSYzSH16U6e6cOHqHDgfP4cfgAOMTjFC5MzruDwlk5KIDTDCnOKCSck3wSgfaVFy8rQDdlN6RQgLytE22CGlZIgLNgLqQnsfQgtt43XX5CXUsHtx0PWp0-al0S3s-srBOsTBhLiEdpnqvjUrfw6nMOrWhkXz6Sw0oe1i8D6vXWy03wNbtfbJ7a_nGDxeXT7Mbor53fXtbDovDJVUFCVztnIlErakjHLDqDDMIMIMxmzCGENsYggSUgpDKi7K2iEiDLKY2wplPgbHQ-5bDO-9S51aNMk473XrQp8UlowIJDEnmR79oa-hj23-TpEcykuJGc3qZFAmhpSiq9VbbBa5aYWRWtWuVrWr79ozPlxH9tXC2V_603MGeAAfjXfLf6LUfHr_PIR-AXDFjJc</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Poe, Dennis</creator><creator>Anand, Vijay</creator><creator>Dean, Marc</creator><creator>Roberts, William H.</creator><creator>Stolovitzky, Jose Pablo</creator><creator>Hoffmann, Karen</creator><creator>Nachlas, Nathan E.</creator><creator>Light, Joshua P.</creator><creator>Widick, Mark H.</creator><creator>Sugrue, John P.</creator><creator>Elliott, C. Layton</creator><creator>Rosenberg, Seth I.</creator><creator>Guillory, Paul</creator><creator>Brown, Neil</creator><creator>Syms, Charles A.</creator><creator>Hilton, Christopher W.</creator><creator>McElveen, John T.</creator><creator>Singh, Ameet</creator><creator>Weiss, Raymond L.</creator><creator>Arriaga, Moises A.</creator><creator>Leopold, John P.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8641-7370</orcidid></search><sort><creationdate>201805</creationdate><title>Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial</title><author>Poe, Dennis ; Anand, Vijay ; Dean, Marc ; Roberts, William H. ; Stolovitzky, Jose Pablo ; Hoffmann, Karen ; Nachlas, Nathan E. ; Light, Joshua P. ; Widick, Mark H. ; Sugrue, John P. ; Elliott, C. Layton ; Rosenberg, Seth I. ; Guillory, Paul ; Brown, Neil ; Syms, Charles A. ; Hilton, Christopher W. ; McElveen, John T. ; Singh, Ameet ; Weiss, Raymond L. ; Arriaga, Moises A. ; Leopold, John P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3937-84edbe807d83435c437c4c024c1146444046c207997c2b578fe027c0d15db0c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>balloon catheter</topic><topic>Catheters</topic><topic>Eustachian tube dysfunction</topic><topic>normalization of tympanogram</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Poe, Dennis</creatorcontrib><creatorcontrib>Anand, Vijay</creatorcontrib><creatorcontrib>Dean, Marc</creatorcontrib><creatorcontrib>Roberts, William H.</creatorcontrib><creatorcontrib>Stolovitzky, Jose Pablo</creatorcontrib><creatorcontrib>Hoffmann, Karen</creatorcontrib><creatorcontrib>Nachlas, Nathan E.</creatorcontrib><creatorcontrib>Light, Joshua P.</creatorcontrib><creatorcontrib>Widick, Mark H.</creatorcontrib><creatorcontrib>Sugrue, John P.</creatorcontrib><creatorcontrib>Elliott, C. Layton</creatorcontrib><creatorcontrib>Rosenberg, Seth I.</creatorcontrib><creatorcontrib>Guillory, Paul</creatorcontrib><creatorcontrib>Brown, Neil</creatorcontrib><creatorcontrib>Syms, Charles A.</creatorcontrib><creatorcontrib>Hilton, Christopher W.</creatorcontrib><creatorcontrib>McElveen, John T.</creatorcontrib><creatorcontrib>Singh, Ameet</creatorcontrib><creatorcontrib>Weiss, Raymond L.</creatorcontrib><creatorcontrib>Arriaga, Moises A.</creatorcontrib><creatorcontrib>Leopold, John P.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Poe, Dennis</au><au>Anand, Vijay</au><au>Dean, Marc</au><au>Roberts, William H.</au><au>Stolovitzky, Jose Pablo</au><au>Hoffmann, Karen</au><au>Nachlas, Nathan E.</au><au>Light, Joshua P.</au><au>Widick, Mark H.</au><au>Sugrue, John P.</au><au>Elliott, C. Layton</au><au>Rosenberg, Seth I.</au><au>Guillory, Paul</au><au>Brown, Neil</au><au>Syms, Charles A.</au><au>Hilton, Christopher W.</au><au>McElveen, John T.</au><au>Singh, Ameet</au><au>Weiss, Raymond L.</au><au>Arriaga, Moises A.</au><au>Leopold, John P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2018-05</date><risdate>2018</risdate><volume>128</volume><issue>5</issue><spage>1200</spage><epage>1206</epage><pages>1200-1206</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. Study Design In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older with Eustachian tube dilatory dysfunction refractory to medical therapy to undergo balloon dilation of the Eustachian tube with balloon catheter in conjunction with medical management or medical management alone. Methods The primary endpoint was normalization of tympanogram at 6 weeks. Additional endpoints were normalization of Eustachian Tube Dysfunction Questionaire‐7 symptom scores, positive Valsalva maneuver, mucosal inflammation, and safety. Results Primary efficacy results demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone. Tympanogram normalization at 6‐week follow‐up was observed in 51.8% (72/139) of investigational patients versus 13.9% (10/72) of controls (P &lt; .0001). Tympanogram normalization in the treatment group was 62.2% after 24 weeks. Normalization of Eustachian Tube Dysfunction Questionaire‐7 Symptom scores at 6‐week follow‐up was observed in 56.2% (77/137) of investigational patients versus 8.5% (6/71) controls (P &lt; .001). The investigational group also demonstrated substantial improvement in both mucosal inflammation and Valsalva maneuver at 6‐week follow‐up compared to controls. No device‐ or procedure‐related serious adverse events were reported for those who underwent balloon dilation of the Eustachian tube. Conclusions This study demonstrated superiority of balloon dilation of the Eustachian tube with balloon catheter + medical management compared to medical management alone to treat Eustachian tube dilatory dysfunction in adults. Level of Evidence 1b. Laryngoscope, 128:1200–1206, 2018</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28940574</pmid><doi>10.1002/lary.26827</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-8641-7370</orcidid><oa>free_for_read</oa></addata></record>
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subjects balloon catheter
Catheters
Eustachian tube dysfunction
normalization of tympanogram
title Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial
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