Effects of combination of balloon Eustachian tuboplasty with methylprednisolone irrigation on treatment of chronic otitis media with effusion in adults

Purpose: Adult chronic otitis media with effusion (COME) is characterized by Eustachian tube dysfunction and mucosal inflammation, which management has long been a challenge because of high recurrence. This study was to investigate the pathological changes of Eustachian tube mucosa and optimized treatment.

Materials and methods: Retrospective study of four groups: I: tympanic paracentesis, II: balloon Eustachian tuboplasty (BET), III: BET plus tympanic paracentesis, IV: BET and tympanic paracentesis with methylprednisolone irrigation. Biopsy of Eustachian tube mucosa was obtained preoperative and 1 month post. Recurrence ratio and Eustachian tube scores (ETS) were used to evaluate the effect of treatments.

Results: All patients showed narrowed with edematous and thickened Eustachian tube mucosa. At 1 month post-treatment, BET with methylprednisolone irrigation significantly decreased intraepithelial inflammation and restored the quality of epithelium and cilia. For group II to IV, The recurrence rate was significantly lower in group IV compared with the other two, but only significantly lower in group IV VS group II at 3 months and 6 months, no significant difference at 12 months. The recurrence rate was significantly higher in group I during follow-up. The ETS were improved in group II, III and IV after treatment. At 1 month and 3 months posttreatment, group IV had significant higher ETS compared with other groups (P < 0.05). There was no serious complications occurred.

Conclusion: Methylprednisolone irrigation could help to recover mucosal function. BET and tympanic paracentesis with methylprednisolone irrigation could be regarded as a good choice for COME in adults, which has less recurrence rate and prompt recovery of ET function.