Cross-hatching: A novel technique for Eustachian tuboplasty. Preliminary report

Abstract

Objective: To evaluate laser-assisted cross-hatching technique for treatment of patients with Eustachian tube dysfunction. Study Design: Prospective, institutional review board-approved surgical trial. Setting: Tertiary care medical center. Subjects and Methods: A total of 25 patients with Eustachian tube dysfunction underwent laser Eustachian tuboplasty with cross-hatching technique (CHT). Surgery involved use of the argon laser to cross-hatch the posterior cushion to modify the curvature of the cartilage of the posterior cushion and to alter the spring of the cartilage to make it wider and larger, thereby alleviating the obstructive dysfunction of the tube. None of the patients had any concurrent disease or surgical procedure. Results: There were no surgical complications. Following CHT, subjective symptoms of an ear blockage improved in 23 of 25 (92%) patients. Posterior cushion curvature became softer and wider, and the valve appeared more open postoperatively on simple endoscopy (SE) and slow motion video endoscopic analysis (SMVEA). Mean pure-tone average improved by 10 dB (30 dB preoperatively vs 20 dB postoperatively; P = 0.015). Abnormal tympanogram improved in 24 of 25 (96%) patients. Failure of the procedure correlated with severity of cartilage deformation and valve obstruction as measured by both SE and SMVEA. Mean follow-up was 15 months (range 3-37 months). Conclusion: Cross-hatching technique for Eustachian tuboplasty appears to be a safe and useful technique for treatment of Eustachian tube dysfunction.