Toshiaki Kikuchi1,2, Ryoukichi Ikeda1,3, Hidetoshi Oshima1, Iori Takata1, Tetsuaki Kawase1, Takeshi Oshima4, Yukio Katori1, Toshimitsu Kobayashi1,3. 1. a Department of Otolaryngology-Head and Neck Surgery , Tohoku University Graduate School of Medicine , Sendai , Japan. 2. b Department of Otolaryngology , Japan Community Health Care Organization (JCHO) Sendai-Hospital , Sendai , Japan. 3. c Sen-En Rifu Otological Surgery Center , Miyagi , Japan. 4. d Department of Otolaryngology-Head and Neck Surgery , Nihon University , Tokyo , Japan.
Abstract
CONCLUSIONS: Trans-tympanic plugging of the Eustachian tube (ET) with the silicone plug (Kobayashi Plug) induced long-term effectiveness for over 80% of chronic and severe patulous ET (PET) patients. The New Kobayashi Plug was more effective with fewer complication of plug descent to the pharyngeal orifice. OBJECTIVE: To investigate the effectiveness and complications of trans-tympanic plugging of the ET using a Kobayashi Plug for chronic PET. METHOD: Trans-tympanic plugging of the ET using the Kobayashi Plug was performed for 252 ears of 191 patients. The Prototype Plug (115 ears of 82 patients in 2001-2007) and the New Plug (137 ears of 109 patients in 2008-2013) were inserted for chronic PET patients. RESULTS: The success rate of the Kobayashi Plug for PET was 83.0% of a total (Prototype Plug 80.0%, New Plug 85.4%). In 26 ears, the Prototype Plugs were found to have descended toward the nasopharynx. Conversely, this did not happen with the New Plug. The rate of TM perforation (Prototype 22.6%, New 17.5%), middle ear effusion (Prototype 20.2%, New 10.2%) and ventilation tube placement (Prototype 14.8%, New 4.4%) decreased after transition to the New Plug.
CONCLUSIONS: Trans-tympanic plugging of the Eustachian tube (ET) with the silicone plug (Kobayashi Plug) induced long-term effectiveness for over 80% of chronic and severe patulous ET (PET) patients. The New Kobayashi Plug was more effective with fewer complication of plug descent to the pharyngeal orifice. OBJECTIVE: To investigate the effectiveness and complications of trans-tympanic plugging of the ET using a Kobayashi Plug for chronic PET. METHOD: Trans-tympanic plugging of the ET using the Kobayashi Plug was performed for 252 ears of 191 patients. The Prototype Plug (115 ears of 82 patients in 2001-2007) and the New Plug (137 ears of 109 patients in 2008-2013) were inserted for chronic PET patients. RESULTS: The success rate of the Kobayashi Plug for PET was 83.0% of a total (Prototype Plug 80.0%, New Plug 85.4%). In 26 ears, the Prototype Plugs were found to have descended toward the nasopharynx. Conversely, this did not happen with the New Plug. The rate of TM perforation (Prototype 22.6%, New 17.5%), middle ear effusion (Prototype 20.2%, New 10.2%) and ventilation tube placement (Prototype 14.8%, New 4.4%) decreased after transition to the New Plug.
Entities:
Keywords:
Patulous Eustachian tube; silicone plug; trans-tympanic ET plugging