gms | German Medical Science

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.