Plug size selection protocol for the treatment of intractable patulous Eustachian tube with Kobayashi Plug

Abstract

Background: There have been no useful criteria for initial plug size selection protocol for the treatment of intractable patulous Eustachian tube (PET).

Aims/objectives: To establish a method for appropriate plug size selection using tubal function test and subjective symptom severity in PET patients who were treated by Kobayashi Plug insertion.

Material and methods: A retrospective survey of medical records identified 39 ears of 35 patients with PET who received insertion of the Kobayashi Plug and whose PET symptoms were thereafter controlled for at least 6 months after surgery.

Method: The evaluation scale of PET handicap inventory-10 (PHI-10) was used to indicate PET subjective symptom severity. Tubal function tests (sonotubometry and tubo-tympano-aerodynamic-graphy: TTAG) were performed.

Results: There was no correlation between the preoperative PHI 10 score and plug size (p = .157). There was a significant correlation between the preoperative sound attenuation from nostril to EAC measured by sonotubometry and plug size (p < .001). There was no correlation between the preoperative pressure transmission ratio estimated by TTAG and plug size (p = .271).

Conclusions and Significance: Sonotubometry which evaluates sound attenuation from nostril to EAC can be a useful tool for selecting plug size.

Chinese abstract

背景：对于难治性扩张性咽鼓管（PET）的治疗, 初始栓塞尺寸选择方案还没有可行的标准。

目的：根据对使用小林塞插入治疗的PET患者进行咽鼓管功能测试及其主观症状严重程度, 建立一种适当的栓塞大小选择方法。

材料和方法：对医疗记录的回顾性调查发现, 35名PET患者的39只耳朵接受了小林塞的插入, 其PET症状在手术后得到控制至少6个月。

方法：采用PET病症清单-10（PHI-10）的评价量表来指示PET主观症状的严重程度。进行咽鼓管功能测试（声压测量和咽鼓管 - 鼓室 - 空气动力学 - 图形：TTAG）。

结果：术前PHI 10评分与栓塞大小无关（p = .157）。通过声管测量法测量鼻孔至EAC的术前声音衰减与栓塞大小（p <.001）之间存在显著相关性。用 TTAG估计的术前压力传递率与栓塞尺寸之间没有相关性（p = .271）。

结论和意义：超声测量法用来评估从鼻孔到EAC的声音衰减, 可以是选择插头尺寸的有用工具。

Keywords:

• Patulous Eustachian tube
• sonotubometry
• plug surgery

Disclosure statement

The authors declare no conflict of interest.