Cervicofacial and mediastinal emphysema after balloon eustachian tuboplasty (BET): a retrospective multicenter analysis
- 1 January 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Archives Of Oto-Rhino-Laryngology
- Vol. 275 (1), 81-87
- https://doi.org/10.1007/s00405-017-4805-3
Abstract
Balloon Eustachian tuboplasty (BET) is a new treatment modality addressing chronic obstructive dysfunction of the Eustachian tube (ET). So far, BET has been deemed a safe procedure under general anesthesia with only minor adverse effects. However, individual cases of postoperative emphysema have been reported. In the present retrospective multicenter analysis we determined the incidence rate of this potentially life threatening complication after BET. In total we collected data from 3,670 BET procedures performed on 2,272 patients in four tertiary care ENT departments. Ten cases of postoperative cervicofacial emphysema were documented, whereas only in 3 of them a pneumomediastinum was developed. None of the affected patients developed at any time serious clinical signs or symptoms besides cutaneous crepitations. A complete resolution and recovery of the emphysema occurred in all patients under antibiotic prophylaxis and abstinence from Valsalva maneuver within the first 2-6 postoperative days. Possible causes for the development of these postinterventional emphysemas are considered to be mucosal injuries of the ET during manipulations for the correct position of the insertion instrument, through a "kinking" of the balloon catheter or even due to the relative rigid catheter itself, although its form is regarded to be atraumatic. The complication rate of postoperative emphysema was 0.27% (95% CI 0.13-0.50%). The above facts in addition to only minor and transient overall complications after BET reported in literature, can label this procedure as a safe treatment with a low risk profile.Keywords
This publication has 37 references indexed in Scilit:
- Die Tubendilatation mit dem Bielefelder DilatationssystemHNO, 2013
- Therapie chronisch obstruktiver Funktionsstörungen der Tuba EustachiiHNO, 2013
- TubendilatationLaryngo-Rhino-Otologie, 2013
- Balloon Dilation of the Cartilaginous Eustachian TubeOtolaryngology -- Head and Neck Surgery, 2011
- Evolution of eustachian tube surgeryThe Laryngoscope, 2011
- Balloon Dilation Eustachian TuboplastyOtology & Neurotology, 2010
- Balloon dilatation eustachian tuboplasty: A clinical studyThe Laryngoscope, 2010
- Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patientsEuropean Journal of Cardio-Thoracic Surgery, 2010
- Pre-operative Evaluation of Eustachian Tube Function Using a Modified Pressure Equilibration Test is Predictive of Good Postoperative Hearing and Middle Ear Aeration in Type 1 Tympanoplasty PatientsClinical and Experimental Otorhinolaryngology, 2009
- The prevalence of middle ear disease in the adult British populationClinical Otolaryngology, 1992