Evaluation Of One-Stage Hearing Reconstruction Combined With Balloon Dilation Eustachian Tuboplasty By Modified Positive And Negative Pressure Equilibration Test

BackgroundEustachian tube dysfunction(ETD)is one of the most common diseases in otology,with a prevalence of about 1%in adults.However,there is no gold-standard objective test for ETD diagnosis..Balloon dilation Eustachian tuboplasty(BDET)is a minimally invasive technique used to treat ETD,and many studies have shown varying degrees of short term benefit in most patients.However,its long term effectiveness has not been conclusively established,and the population profile of the benefit is unclear yet.ObjectiveTo evaluate the prognosis of one-stage hearing reconstruction combined with BDET in chronic suppurative otitis media patients with chronic otitis media and to explore the characteristics of the adult population benefiting from BDET by using modified positive and negative pressure equilibration test.MethodsA total of 97 Patients who were diagnosed with chronic suppurative otitis media undergoing modified radical mastoidectomy and tympanoplasty with one-stage hearing reconstruction which use Artificial hearing bone(PORP or TORP)or autogenous bone from January 2018 to November 2021 were selected for this study,with a total of 108 operated ears(49 on the left and 59 on the right),48 in men and 60 in women.All patients are required to complete the audiological examination and otoscopy before the surgery.They were objectively evaluated using a modified positive and negative pressure equilibration test before treatment to determine baseline data.Post-operative follow-up was performed at regular intervals using pure tone audiometry as well as endoscopy.The primary observation was improvement in short term and mid-long term postoperative hearing levels,and the secondary observation was postoperative tympanic membrane growth status.ResultsThose with good pre-operative eustachian tube function,as measured by the modified positive and negative pressure equilibration test showed varying degrees of postoperative hearing level improvement.Patients with ETD are all benefited from combined BDET treatment,with the most significant and definite benefit in patients with valsalva dysfunction.Patients with normal positive-pressure passive opening and valsalva function need to be evaluated with caution for BDET.ConclusionThe modified positive and negative pressure equilibration test provides a more comprehensive evaluation of ET function compared to the conventional test.What’s more,it’s effective in assessing ET function and postoperative expectations in patients undergoing one-stage hearing reconstruction surgery.Patients with valsalva dysfunction benefit clearly in BDET.