Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review

Objectives: Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tubopl...

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Autores principales:	Waqas Jamil, Steve Izzat
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2021
Materias:	Eustachian tuboplasty Eustachian tube Treatment of Eustachian tube dysfunction Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/6e1871e8f19b42218eee7e6d3c7d558b
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spelling	oai:doaj.org-article:6e1871e8f19b42218eee7e6d3c7d558b2021-12-02T14:16:43ZLaser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review2095-881110.1016/j.wjorl.2020.04.004https://doaj.org/article/6e1871e8f19b42218eee7e6d3c7d558b2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881120300512https://doaj.org/toc/2095-8811Objectives: Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction. Data sources: A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language. References of included studies were checked. Methods: A systematic review was undertaken. Outcomes assessed were: primary outcomes-subjective improvement in symptoms (ETDQ-7), audiometric improvement of hearing, improvement of negative middle ear pressure noticed in tympanometry, objective improvement of tympanic membrane retraction. Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e. Valsalva manoeuvre, improved quality of life, passive tubal opening, tubomanometry, swallowing test, reduction in mucosal inflammation of Eustachian tube orifice in the nose, complications from the procedure, the need for further procedures. Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data. Results: Three studies were included. All included studies were small-scale case series (13–38 participants). Studies were conducted outside the UK. Subjective and objective improvement of Eustachian tube function was reported in all studies. But all included studies were at high risk of bias and subject to multiple limitations. No major complications were reported in either study. Conclusions: Based on current evidence, it is not possible to recommend the clinical use of either of these two interventions i.e. Laser or Microdebrider Eustachian tuboplasty. Lack of controlled studies was identified as a gap in the evidence. Future research should be directed toward designing randomised controlled trials. These trials should use strict standard methodology and reporting criteria. Future trials should make use of consensus statement document about Eustachian tube dysfunction definition, diagnostic methods, and outcome assessment criteria to design clinical trials.Waqas JamilSteve IzzatKeAi Communications Co., Ltd.articleEustachian tuboplastyEustachian tubeTreatment of Eustachian tube dysfunctionOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 7, Iss 1, Pp 54-62 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Eustachian tuboplasty Eustachian tube Treatment of Eustachian tube dysfunction Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Eustachian tuboplasty Eustachian tube Treatment of Eustachian tube dysfunction Otorhinolaryngology RF1-547 Surgery RD1-811 Waqas Jamil Steve Izzat Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review
description	Objectives: Multiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction. Data sources: A total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language. References of included studies were checked. Methods: A systematic review was undertaken. Outcomes assessed were: primary outcomes-subjective improvement in symptoms (ETDQ-7), audiometric improvement of hearing, improvement of negative middle ear pressure noticed in tympanometry, objective improvement of tympanic membrane retraction. Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e. Valsalva manoeuvre, improved quality of life, passive tubal opening, tubomanometry, swallowing test, reduction in mucosal inflammation of Eustachian tube orifice in the nose, complications from the procedure, the need for further procedures. Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data. Results: Three studies were included. All included studies were small-scale case series (13–38 participants). Studies were conducted outside the UK. Subjective and objective improvement of Eustachian tube function was reported in all studies. But all included studies were at high risk of bias and subject to multiple limitations. No major complications were reported in either study. Conclusions: Based on current evidence, it is not possible to recommend the clinical use of either of these two interventions i.e. Laser or Microdebrider Eustachian tuboplasty. Lack of controlled studies was identified as a gap in the evidence. Future research should be directed toward designing randomised controlled trials. These trials should use strict standard methodology and reporting criteria. Future trials should make use of consensus statement document about Eustachian tube dysfunction definition, diagnostic methods, and outcome assessment criteria to design clinical trials.
format	article
author	Waqas Jamil Steve Izzat
author_facet	Waqas Jamil Steve Izzat
author_sort	Waqas Jamil
title	Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review
title_short	Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review
title_full	Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review
title_fullStr	Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review
title_full_unstemmed	Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review
title_sort	laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: a systematic review
publisher	KeAi Communications Co., Ltd.
publishDate	2021
url	https://doaj.org/article/6e1871e8f19b42218eee7e6d3c7d558b
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Laser vs microdebrider eustachian tuboplasty for the treatment of chronic adult eustachian tube dysfunction: A systematic review

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