Curvature inversion technique: a novel tuboplastic technique for patulous Eustachian tube--a preliminary report.

OBJECTIVE

To assess the laser-assisted curvature inversion technique for the treatment of patients with patulous Eustachian tube (PET).

STUDY

DESIGN

Case series with planned data collection.

SETTING

Tertiary care medical center.

SUBJECTS AND

METHODS

Eleven patients with Eustachian tube dysfunction underwent laser-assisted curvature inversion technique (CIT) of the medial and lateral lamina of the Eustachian tube. A KTP laser is used to cross-hatch the medial and lateral lamina of the tube to modify the curvature and to alter the spring of the posterior cushion. A change in the direction of the cartilaginous structure curvature is created to promote full closure of the patulous gap without interfering with the tube's muscular activity. None of the patients had any concurrent disease or additional surgical procedure.

RESULTS

There were no surgical complications. Following CIT, subjective symptoms of autophony on nasal breathing improved in 9 of 11 patients (81.8%), while voice autophony improved in 8 patients (72.7%); posterior cushion curvature became inverted and less wide, and the valve was seen more closed postoperatively on simple endoscopy and slow-motion video-endoscopic analysis. On otoscopy, abnormal tympanic membrane excursions disappeared in 10 of 11 patients (90.9%). Mean immittance changes in tympanometric measurements for the forced respiration conditions improved postoperatively at least 0.05 mmhos in 9 of 11 patients (81.1%; P = .015). The follow-up period was 24 months.

CONCLUSION

CIT appears to be a promising and relatively feasible technique for the treatment of PET.