You would share your experience regarding Eustachian tuboplasty versus trans-tympanic ventilation tube insertion for treatment of Eustachian tube dysfunction.
Eustachian tuboplalsty not yet evidence based peocedure for treatment of Eustachian tube dysfunction
still ventilation tube insertion is the gold standard for treatment of Eustachian tube dysfunction
Eustachian tuboplasty is now growing step in releiving ETD , with controvesial opinions about the results but it is still not evidence based
Thanks so much Dr. Moustafa & Dr. Rafael for your sharing. I agree with you that Eustachian tuboplasty are promising but still not evidence based.
Many papers are trying to show the benefits of it. However, most of then are based on cadaver observations.
I would say it is evidence based medicine, yet the quality of the evidence is poor.
No studies have been reported yet with a clear description of how ETD was defined. No control group was used and the outcome parameter has been defined poorly as well. Mostly the outcome parameter uses a form of tubomanometry (which in itself has no clear standardisation or validation). Therefore studies showing results are often biased in several ways
In regard to ventilation tube being the golden standard we are looking at almost the same quality of evidence regarding that treatment.
Level 4 EBM is also EBM
Thank you so much Dr. Henrique for your sharing but I found that Eustachian tuboplasty was also applied on human being.
Thank you so much Dr. Er Van for your valuable sharing & I totally agree with you.
We need more estudies about procedure for treatment of Eustachian tube dysfunction. At the moment there,s no evidence and the gold standard is the ventilation tube. The future of middle ear chronic disease will change if we improve the management of ETD.
Lets start by defining ETD in a way that makes research actually possible.
How does one measure ETD objectively? Are we looking at a real disease entity or a collection of different causes of middle ear pressure problems?
This problem is also present in OSAS and ISSNHL research.
You are exactly right Dr. Er Van, we have to differentiate between primary ETD (of ET origin) & secondary ETD (of external origin e.g. nasal sinus or nasopharyngeal disease & may be systematic diseases). Then, we can direct Eustachian tuboplasty to primary ETD only so as to build up an accurate evidence based.
Look at this new article recently published. It may be helpful.
Excuse me, my topic is not about Baloon Eustachian Tuboplasty but on surgical Eustachian Tuboplasty.