gms | German Medical Science

80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

Laser ablation of the epipharyngeal tube orifice – follow-up in a pressure chamber

Meeting Abstract

  • corresponding author Masen Dirk Jumah - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany
  • Erik Prilipp - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany
  • Miriam Schlachta - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany
  • Benedikt Sedlmaier - Hals-Nasen-Ohrenklinik und Poliklinik der Charité, Berlin, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno048

DOI: 10.3205/09hno048, URN: urn:nbn:de:0183-09hno0480

Published: July 22, 2009

© 2009 Jumah et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Impaired Eustachian tube function can lead to numerous middle ear pathologies. Surgical restoration often becomes necessary but is less successful in patients with tube dysfunction. Therapy should aim to achieve early improvement of tube function. One treatment modality is Laser ablation of the epipharyngeal tube orifice. A follow-up examination of tube function in a pressure chamber has not yet been published. In a prospective study, 26 subjects (42.5±10.6 years) with refractory chronic obstructive tube dysfunction were examined by a continuous impedance procedure while being exposed to ambient pressure changes in a pressure chamber. Treatment consisted in outpatient Laser ablation (810 nm diode laser) of the tube cushion under local anesthesia. Diagnostic tests in a pressure chamber were repeated after 16±7 weeks. Prior to the intervention, 62.9% of the patients had a blocked tube in the pressure chamber; the Valsalva maneuver was negative in 37.4%. Measurements revealed a tube opening duration of 471±184 ms, a tube opening pressure of 25.5±13.4 mbar, and a tube closing pressure of 6.2±2.8 mbar. Laser ablation was subjectively well tolerated, and only 14.8% of the patients still had a blocked tube thereafter. The tube closing pressure was significantly lower at 3.1±1.8 mbar (p=0.039) after the Laser intervention, but no significant differences were seen in the tube opening or closing pressures. The minimally invasive intervention significantly improves tube function in symptomatic patients. Diagnostic tests in a pressure chamber are well suited for identification and follow-up.