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Patulous Eustachian tube obliteration using endovascular coils: a novel technique

Published online by Cambridge University Press:  11 June 2018

K Jolly ,
A Darr ,
S V Chavda  and
S K Ahmed
K Jolly*
Affiliation:
Department of Otolaryngology, Princess Royal Hospital, Telford, UK
A Darr
Affiliation:
Department of Otolaryngology, Princess Royal Hospital, Telford, UK
S V Chavda
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, UK
S K Ahmed
Affiliation:
Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, UK
*
Address for correspondence: Ms Karan Jolly, Department of Otolaryngology, Princess Royal Hospital, Telford TF1 6TF, UK E-mail: Kjolly@nhs.net
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Abstract

Background

Patulous Eustachian tube is a distressing condition characterised by chronic patency of the Eustachian tube and its failure to close. Patients typically present with symptoms of autophony and aural fullness. In patients requiring surgical intervention, a variety of different procedures have been demonstrated (both transtympanic and endonasal), with limited success. Evidence of the effectiveness of a number of surgical interventions is limited to small case series only.

Objective

This paper describes a novel treatment for patulous Eustachian tube using a 3 mm VortX Diamond endovascular coil.

Case report

A transnasal endoscopic approach was adopted, with cannulation of the Eustachian tube orifice using a Relieva sinus guide suction tube from a balloon sinuplasty set. The coil was deployed 1.5 cm deep into the Eustachian tube. Post-operative imaging was used to confirm correct positioning. Regular follow up was arranged. The patient reported complete resolution of her symptoms.

Conclusion

The technique has so far proved highly effective and minimally invasive. It will be employed in more patients to fully establish its effectiveness in treating patulous Eustachian tube.

Keywords

Patulous Eustachian TubeEndovascular CoilEndoscopic Surgical Procedure
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 6 , June 2018 , pp. 564 - 566
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr K Jolly takes responsibility for the integrity of the content of the paper

References

1DiBartolomeo, JR, Henry, DF. A new medication to control patulous Eustachian tube disorders. Am J Otol 1992;13:323–7Google Scholar
2O'Connor, AF, Shea, JJ. Autophony and the patulous Eustachian tube. Laryngoscope 1981;91:1427–35CrossRefGoogle ScholarPubMed
3Yoshida, H, Kobayashi, T, Takasaki, K, Takahashi, H, Ishimaru, H, Morikawan, M et al. Imaging of the patulous Eustachian tube: high-resolution CT evaluation with multiplanar reconstruction technique. Acta Otolaryngol 2004;124:918–23CrossRefGoogle ScholarPubMed
4Plate, S, Johnsen, NJ, Nodskov Pedersen, S, Thomsen, KA. The frequency of patulous eustachian tubes in pregnancy. Clin Otolaryngol Allied Sci 1979;4:393–400Google Scholar
5Pulec, JL. Abnormally patent eustachian tubes: treatment with injection of polytetrafluoroethylene (Teflon) paste. Laryngoscope 1967;77:1543–54Google Scholar
6Ikeda, R, Oshima, T, Oshima, H, Miyazaki, M, Kikuchi, T, Kawase, T et al. Management of patulous eustachian tube with habitual sniffing. Otol Neurotol 2011;32:790–3Google Scholar
7Oshima, T, Kikuchi, T, Kawase, T, Kobayashi, T. Nasal instillation of physiological saline for patulous eustachian tube. Acta Otolaryngol 2010;130:550–3Google Scholar
8Luu, K, Remillard, A, Fandino, M, Saxby, A, Westerberg, BD. Treatment effectiveness for symptoms of patulous Eustachian tube: a systematic review. Otol Neurotol 2015;36:1593–600CrossRefGoogle ScholarPubMed
9Thaler, S, Yanagisawa, E. The abnormally patent eustachian tube. Arch Otolaryngol 1966;84:418–21CrossRefGoogle ScholarPubMed
10Chen, DA, Luxford, WM. Myringotomy and tube for relief of patulous eustachian tube symptoms. Am J Otol 1990;11:272–3Google ScholarPubMed
11Bartlett, C, Pennings, R, Ho, A, Kirkpatrick, D, Van Wijhe, R, Bance, M. Simple mass loading of the tympanic membrane to alleviate symptoms of patulous Eustachian tube. J Otolaryngol Head Neck Surg 2010;39:259–68Google Scholar
12Boedts, M. Paper patching of the tympanic membrane as a symptomatic treatment for patulous eustachian tube syndrome. J Laryngol Otol 2014;128:228–35Google Scholar
13Kikuchi, T, Ikeda, R, Oshima, H, Takata, I, Kawasw, T, Oshima, T et al. Effectiveness of Kobayashi plug for 252 ears with chronic patulous Eustachian tube. Acta Otolaryngol 137;3:253–8Google Scholar
14Robinson, PJ, Hazell, JW. Patulous eustachian tube syndrome: the relationship with sensorineural hearing loss. Treatment by Eustachian tube diathermy. J Laryngol Otol 1989;103:739–42Google Scholar
15Yanez, C, Pirron, JA, Mora, N. Curvature inversion technique: a novel tuboplastic technique for patulous eustachian tube—a preliminary report. Otolaryngol Head Neck Surg 2011;145:446–51CrossRefGoogle ScholarPubMed