Benedicte Falkenberg-Jensen1, Einar Hopp2, Greg E Jablonski3, Are Hugo Pripp4, Juha Tapio Silvola5. 1. Department of Radiology and Nuclear Medicine, Rikshospitalet, Oslo University Hospital, Norway; The faculty of Medicine, Oslo University, Norway. Electronic address: bfalke@ous-hf.no. 2. Department of Radiology and Nuclear Medicine, Rikshospitalet, Oslo University Hospital, Norway. 3. The faculty of Medicine, Oslo University, Norway; Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Norway. 4. Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Norway. 5. Department of Otolaryngology, Head and Neck Surgery, Akershus Universitetssykehus, Norway.
Abstract
PURPOSE: Balloon dilation of the Eustachian tube is a treatment option for obstructive Eustachian tube dysfunction. The desired balloon position is in the cartilaginous portion. However, the balloon catheter may slide into the bony portion without the surgeon's knowledge. Knowing the length of the cartilaginous portion may improve catheter positioning, but there is no published research on measuring this portion selectively or on whether the length has an impact on development of disease or treatment outcome. To evaluate whether a measurement obtained from CT images is valuable and accurate, to standardize the manner of which the length is measured, and to compare our radiologic measurements to procedural findings, we designed a combined study. Further, we tested the length's influence on development of disease and treatment outcome. METHODS: Anatomical end points of the cartilaginous part of the Eustachian tube were unambiguously defined. The length was retrospectively measured bilaterally in 29 CT examinations by two radiologists, and repeated by one after two weeks. New reformats and measurements were made after 18 months for 10 of the patients. Prospectively 10 patients were included in a study where the length measured on CT was compared to per-procedural measurements based on catheter insertion depth to isthmus. Various parameters including length and treatment outcome were measured in 69 patients and 34 controls. RESULTS: Correlation was adequate to excellent in all comparisons. The length of the cartilaginous Eustachian tube did not predict treatment outcome or disease development. The lengths were significantly shorter in females. CONCLUSION: Measuring the cartilaginous portion of the Eustachian tube on CT images is precise and reproducible, and reflects the length measured intraoperatively. However, it does not seem have a prognostic value.
PURPOSE: Balloon dilation of the Eustachian tube is a treatment option for obstructive Eustachian tube dysfunction. The desired balloon position is in the cartilaginous portion. However, the balloon catheter may slide into the bony portion without the surgeon's knowledge. Knowing the length of the cartilaginous portion may improve catheter positioning, but there is no published research on measuring this portion selectively or on whether the length has an impact on development of disease or treatment outcome. To evaluate whether a measurement obtained from CT images is valuable and accurate, to standardize the manner of which the length is measured, and to compare our radiologic measurements to procedural findings, we designed a combined study. Further, we tested the length's influence on development of disease and treatment outcome. METHODS: Anatomical end points of the cartilaginous part of the Eustachian tube were unambiguously defined. The length was retrospectively measured bilaterally in 29 CT examinations by two radiologists, and repeated by one after two weeks. New reformats and measurements were made after 18 months for 10 of the patients. Prospectively 10 patients were included in a study where the length measured on CT was compared to per-procedural measurements based on catheter insertion depth to isthmus. Various parameters including length and treatment outcome were measured in 69 patients and 34 controls. RESULTS: Correlation was adequate to excellent in all comparisons. The length of the cartilaginous Eustachian tube did not predict treatment outcome or disease development. The lengths were significantly shorter in females. CONCLUSION: Measuring the cartilaginous portion of the Eustachian tube on CT images is precise and reproducible, and reflects the length measured intraoperatively. However, it does not seem have a prognostic value.
Authors: Yuan Yu; Brent Geffen; Hilary McCrary; Gabriel Dunya; John Rampton; Chong Zhang; Angela P Presson; Dennis Poe; Albert H Park Journal: Laryngoscope Date: 2022-03-26 Impact factor: 2.970