Long-term Changes of Hearing Thresholds and Eustachian Tube Function after Balloon Dilation of the Eustachian Tube in Patients with Chronic Otitis Media

Objectives: To evaluate long-term changes after balloon dilation of eustachian tube (BDET) in chronic otitis media (COM) patients with ET dysfunction which was persistent after tympanomastoidectomy (TM op).Methods: We retrospectively reviewed the medical records of consecutive patients who were diagnosed with COM and ET dysfunction and underwent TM op in Asan Medical Center from 2016 to 2017. The tympanic membrane status, the presence of ventilation tube, ability to perform a Valsalva maneuver, and audiologic changes by dilation of ET were observed.Results: Twenty-one ears with 20 patients who had underwent TM op but could not perform a Valsalva maneuver with a persistent air-bone gap and eventually underwent BDET (M:F=8:13, right:left=11:10). Four ears showed perforation of the tympanic membrane after TM op. Among 17 ears, 15 ears underwent VT insertion before BDET, while 2 ears underwent VT insertion and BDET simultaneously. Although none of the patients were capable of the Valsalva maneuver before BDET, 13 ears (62%) were able to perform a Valsalva maneuver successfully after BDET. When evaluating the tympanic membrane status at the latest follow-up, ventilation tubes were still present in 8 cases. In the other 13 cases, intact tympanic membranes were present in 9 out of 11 in the successful Valsalva group, whereas none of them were intact in the unsuccessful Valsalva group (p=0.014). The successful Valsalva group after BDET showed improved air-bone gap of 8.9