The Experts below are selected from a list of 252 Experts worldwide ranked by ideXlab platform
Vijay K. Anand - One of the best experts on this subject based on the ideXlab platform.
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balloon dilation of the Eustachian Tube for dilatory dysfunction a randomized controlled trial
Laryngoscope, 2018Co-Authors: Dennis S. Poe, Vijay K. Anand, Marc Dean, William Roberts, Jose Pablo Stolovitzky, Karen K Hoffmann, Nathan E Nachlas, Joshua P Light, Mark H Widick, John SugrueAbstract:Objectives/Hypothesis To assess balloon dilation of the Eustachian Tube with Eustachian Tube balloon catheter in conjunction with medical management as treatment for Eustachian Tube dilatory dysfunction. Study Design In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older with Eustachian Tube dilatory dysfunction refractory to medical therapy to undergo balloon dilation of the Eustachian Tube with balloon catheter in conjunction with medical management or medical management alone. Methods The primary endpoint was normalization of tympanogram at 6 weeks. Additional endpoints were normalization of Eustachian Tube Dysfunction Questionaire-7 symptom scores, positive Valsalva maneuver, mucosal inflammation, and safety. Results Primary efficacy results demonstrated superiority of balloon dilation of the Eustachian Tube with balloon catheter + medical management compared to medical management alone. Tympanogram normalization at 6-week follow-up was observed in 51.8% (72/139) of investigational patients versus 13.9% (10/72) of controls (P < .0001). Tympanogram normalization in the treatment group was 62.2% after 24 weeks. Normalization of Eustachian Tube Dysfunction Questionaire-7 Symptom scores at 6-week follow-up was observed in 56.2% (77/137) of investigational patients versus 8.5% (6/71) controls (P < .001). The investigational group also demonstrated substantial improvement in both mucosal inflammation and Valsalva maneuver at 6-week follow-up compared to controls. No device- or procedure-related serious adverse events were reported for those who underwent balloon dilation of the Eustachian Tube. Conclusions This study demonstrated superiority of balloon dilation of the Eustachian Tube with balloon catheter + medical management compared to medical management alone to treat Eustachian Tube dilatory dysfunction in adults. Level of evidence 1b Laryngoscope, 2017
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Validating the clinical assessment of Eustachian Tube dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7).
The Laryngoscope, 2012Co-Authors: Edward D. Mccoul, Vijay K. Anand, Paul J. ChristosAbstract:Objectives/Hypothesis Eustachian Tube dysfunction (ETD) is a common condition that is associated with otologic and rhinologic symptoms. The complete assessment of ETD is limited without a valid symptom score. We developed and conducted initial validation of the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), a disease-specific instrument to assess symptoms with respect to ETD.
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Evolution of Eustachian Tube Surgery
The Laryngoscope, 2011Co-Authors: Edward D. Mccoul, Frank E. Lucente, Vijay K. AnandAbstract:Eustachian Tube dysfunction (ETD) is a common condition that lacks a widely accepted treatment. Attempts to address ETD surgically have spanned several centuries and have often fallen short of success. It is probable that occult anatomic position, unclear function, and misunderstood physiology have contributed to the delayed development of effective interventions for ETD. This article traces the evolution of therapeutic interventions of the Eustachian Tube through the present day. Reasons for success and failure are highlighted, with implications for the future of Eustachian Tube surgery.
Edward D. Mccoul - One of the best experts on this subject based on the ideXlab platform.
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Validating the clinical assessment of Eustachian Tube dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7).
The Laryngoscope, 2012Co-Authors: Edward D. Mccoul, Vijay K. Anand, Paul J. ChristosAbstract:Objectives/Hypothesis Eustachian Tube dysfunction (ETD) is a common condition that is associated with otologic and rhinologic symptoms. The complete assessment of ETD is limited without a valid symptom score. We developed and conducted initial validation of the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), a disease-specific instrument to assess symptoms with respect to ETD.
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Evolution of Eustachian Tube Surgery
The Laryngoscope, 2011Co-Authors: Edward D. Mccoul, Frank E. Lucente, Vijay K. AnandAbstract:Eustachian Tube dysfunction (ETD) is a common condition that lacks a widely accepted treatment. Attempts to address ETD surgically have spanned several centuries and have often fallen short of success. It is probable that occult anatomic position, unclear function, and misunderstood physiology have contributed to the delayed development of effective interventions for ETD. This article traces the evolution of therapeutic interventions of the Eustachian Tube through the present day. Reasons for success and failure are highlighted, with implications for the future of Eustachian Tube surgery.
James R. Tysome - One of the best experts on this subject based on the ideXlab platform.
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The effect of topical xylometazoline on Eustachian Tube function.
The Journal of laryngology and otology, 2020Co-Authors: K S Joshi, Matthew E. Smith, James R. TysomeAbstract:Background Topical nasal decongestants are frequently used as part of the medical management of symptoms related to Eustachian Tube dysfunction. Objective This study aimed to assess the effect of topical xylometazoline hydrochloride sprayed in the anterior part of the nose on Eustachian Tube active and passive opening in healthy ears. Methods Active and passive Eustachian Tube function was assessed in healthy subjects before and after intranasal administration of xylometazoline spray, using tympanometry, video otoscopy, sonotubometry, tubo-tympano-aerodynamic-graphy and tubomanometry. Results Resting middle-ear pressures were not significantly different following decongestant application. Eustachian Tube opening rate was not significantly different following the intervention, as measured by all function tests used. Sonotubometry data showed a significant increase in the duration of Eustachian Tube opening following decongestant application. Conclusion There remains little or no evidence that topical nasal decongestants improve Eustachian Tube function. Sonotubometry findings do suggest that further investigation with an obstructive Eustachian Tube dysfunction patient cohort is warranted.
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Advances in Eustachian Tube function testing
World journal of otorhinolaryngology - head and neck surgery, 2019Co-Authors: Matthew E. Smith, Manohar Bance, James R. TysomeAbstract:Obstructive and patulous Eustachian Tube dysfunction provide a significant diagnostic and management challenge. The development of new treatments such as balloon Eustachian tuboplasty has generated renewed interest in measuring Eustachian Tube function, as a method of selecting appropriate patients for intervention, and measuring their treatment outcomes. This review summarises recent findings relating to Eustachian Tube function assessment. Increasingly it is recognised that patient reported outcome measures based on symptoms are highly non-specific and non-diagnostic, and clinical assessment alone may not permit the selection of individuals with abnormal Eustachian Tube opening. Tests of Eustachian Tube opening therefore may represent a practical and objective addition to patient assessment in clinic, allowing the identification of individuals with abnormal (patulous or obstructive) Eustachian Tube function. A diagnostic pathway is described on this basis. More work is required to validate the described Eustachian Tube function tests, and there remain individuals, such as those with dysfunction limited to pressure challenges, in whom function tests have yet to fully characterise the disorder.
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The Role of the Eustachian Tube in Middle Ear Disease.
Advances in oto-rhino-laryngology, 2018Co-Authors: James R. Tysome, Holger SudhoffAbstract:The Eustachian Tube is a complex structure connecting the middle ear to the nasopharynx that contributes to the normal function of the middle ear. Eustachian Tube dysfunction (ETD) is thought to contribute to the majority of middle ear pathology, although the mechanisms and the degree to which it contributes to middle ear disease is poorly understood. We describe the anatomy and physiology of the Eustachian Tube, define ETD, discuss the methods for measuring ETD and describe recent advances in treatment.
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Imaging of the Eustachian Tube and its function: a systematic review
Neuroradiology, 2016Co-Authors: Matthew E. Smith, Daniel Scoffings, James R. TysomeAbstract:Introduction The Eustachian Tube is a complex and inaccessible structure, which maintains middle ear ventilation to facilitate transmission of sound from the tympanic membrane to the cochlea. A renewed interest in treatments for Eustachian Tube dysfunction has led to a demand for methods of imaging the Eustachian Tube, and assessing Tube opening non-invasively. This review aims to summarise the use of imaging in the anatomical assessment of the Eustachian Tube, and to explore how radiological techniques can be used to assess Tube function. Methods A systematic review of the literature was performed with narrative data analysis. Results With high-resolution images, the soft and bony anatomy of the Eustachian Tube can be assessed in detail. CT and MRI are best suited to identifying features associated with obstructive or patulous Eustachian Tube dysfunction, though true assessments of function have only been achieved with contrast enhanced radiographs and scintigraphy. A single modality has yet to provide a complete assessment. No test has entered routine clinical use, but further development and research is underway. Conclusion Significant information can be gained from imaging the Eustachian Tube, and as faster acquisition techniques are developed, it is possible that dynamic imaging of tubal opening could play an important role in the assessment of patients with ET dysfunction.
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Imaging of the Eustachian Tube and its function: a systematic review
Neuroradiology, 2016Co-Authors: Matthew E. Smith, Daniel Scoffings, James R. TysomeAbstract:Introduction The Eustachian Tube is a complex and inaccessible structure, which maintains middle ear ventilation to facilitate transmission of sound from the tympanic membrane to the cochlea. A renewed interest in treatments for Eustachian Tube dysfunction has led to a demand for methods of imaging the Eustachian Tube, and assessing Tube opening non-invasively. This review aims to summarise the use of imaging in the anatomical assessment of the Eustachian Tube, and to explore how radiological techniques can be used to assess Tube function.
Paul J. Christos - One of the best experts on this subject based on the ideXlab platform.
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Validating the clinical assessment of Eustachian Tube dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7).
The Laryngoscope, 2012Co-Authors: Edward D. Mccoul, Vijay K. Anand, Paul J. ChristosAbstract:Objectives/Hypothesis Eustachian Tube dysfunction (ETD) is a common condition that is associated with otologic and rhinologic symptoms. The complete assessment of ETD is limited without a valid symptom score. We developed and conducted initial validation of the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7), a disease-specific instrument to assess symptoms with respect to ETD.
Matthew E. Smith - One of the best experts on this subject based on the ideXlab platform.
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The effect of topical xylometazoline on Eustachian Tube function.
The Journal of laryngology and otology, 2020Co-Authors: K S Joshi, Matthew E. Smith, James R. TysomeAbstract:Background Topical nasal decongestants are frequently used as part of the medical management of symptoms related to Eustachian Tube dysfunction. Objective This study aimed to assess the effect of topical xylometazoline hydrochloride sprayed in the anterior part of the nose on Eustachian Tube active and passive opening in healthy ears. Methods Active and passive Eustachian Tube function was assessed in healthy subjects before and after intranasal administration of xylometazoline spray, using tympanometry, video otoscopy, sonotubometry, tubo-tympano-aerodynamic-graphy and tubomanometry. Results Resting middle-ear pressures were not significantly different following decongestant application. Eustachian Tube opening rate was not significantly different following the intervention, as measured by all function tests used. Sonotubometry data showed a significant increase in the duration of Eustachian Tube opening following decongestant application. Conclusion There remains little or no evidence that topical nasal decongestants improve Eustachian Tube function. Sonotubometry findings do suggest that further investigation with an obstructive Eustachian Tube dysfunction patient cohort is warranted.
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Advances in Eustachian Tube function testing
World journal of otorhinolaryngology - head and neck surgery, 2019Co-Authors: Matthew E. Smith, Manohar Bance, James R. TysomeAbstract:Obstructive and patulous Eustachian Tube dysfunction provide a significant diagnostic and management challenge. The development of new treatments such as balloon Eustachian tuboplasty has generated renewed interest in measuring Eustachian Tube function, as a method of selecting appropriate patients for intervention, and measuring their treatment outcomes. This review summarises recent findings relating to Eustachian Tube function assessment. Increasingly it is recognised that patient reported outcome measures based on symptoms are highly non-specific and non-diagnostic, and clinical assessment alone may not permit the selection of individuals with abnormal Eustachian Tube opening. Tests of Eustachian Tube opening therefore may represent a practical and objective addition to patient assessment in clinic, allowing the identification of individuals with abnormal (patulous or obstructive) Eustachian Tube function. A diagnostic pathway is described on this basis. More work is required to validate the described Eustachian Tube function tests, and there remain individuals, such as those with dysfunction limited to pressure challenges, in whom function tests have yet to fully characterise the disorder.
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Imaging of the Eustachian Tube and its function: a systematic review
Neuroradiology, 2016Co-Authors: Matthew E. Smith, Daniel Scoffings, James R. TysomeAbstract:Introduction The Eustachian Tube is a complex and inaccessible structure, which maintains middle ear ventilation to facilitate transmission of sound from the tympanic membrane to the cochlea. A renewed interest in treatments for Eustachian Tube dysfunction has led to a demand for methods of imaging the Eustachian Tube, and assessing Tube opening non-invasively. This review aims to summarise the use of imaging in the anatomical assessment of the Eustachian Tube, and to explore how radiological techniques can be used to assess Tube function. Methods A systematic review of the literature was performed with narrative data analysis. Results With high-resolution images, the soft and bony anatomy of the Eustachian Tube can be assessed in detail. CT and MRI are best suited to identifying features associated with obstructive or patulous Eustachian Tube dysfunction, though true assessments of function have only been achieved with contrast enhanced radiographs and scintigraphy. A single modality has yet to provide a complete assessment. No test has entered routine clinical use, but further development and research is underway. Conclusion Significant information can be gained from imaging the Eustachian Tube, and as faster acquisition techniques are developed, it is possible that dynamic imaging of tubal opening could play an important role in the assessment of patients with ET dysfunction.
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Imaging of the Eustachian Tube and its function: a systematic review
Neuroradiology, 2016Co-Authors: Matthew E. Smith, Daniel Scoffings, James R. TysomeAbstract:Introduction The Eustachian Tube is a complex and inaccessible structure, which maintains middle ear ventilation to facilitate transmission of sound from the tympanic membrane to the cochlea. A renewed interest in treatments for Eustachian Tube dysfunction has led to a demand for methods of imaging the Eustachian Tube, and assessing Tube opening non-invasively. This review aims to summarise the use of imaging in the anatomical assessment of the Eustachian Tube, and to explore how radiological techniques can be used to assess Tube function.
