Effect of laser uvulopalatoplasty on middle ear function

Eustachian Tube Function Symptoms in Palatal Surgeries for OSA: 3-Month Postoperative Analysis

OBJECTIVES

To assess the influence of different soft palate surgeries for obstructive sleep apnea (OSA) on eustachian tube function symptoms, considering various potential factors.

METHODS

A prospective, cohort study was conducted on patients who underwent isolated palatal surgeries for OSA at a single academic medical center between 2017 and 2022. Eustachian Tube Dysfunction Questionnaire (ETDQ-7) were assessed at baseline, 1-month, 2-month, and 3-month time points. Patients with retropalatal obstruction underwent tailored surgeries: anterior palatoplasty (AP), expansion sphincter palatoplasty (ESP), or barbed palatoplasty (BP). Baseline OSA severity between baseline and follow-up time points were also examined.

RESULTS

In this study, 96 patients with OSA were enrolled and allocated to three surgical groups: AP (n = 30), ESP (n = 32), and BP (n = 34). The mean age was 44.3 ± 10.2 years, with 86% male participants. No significant differences were found between the groups in terms of age, sex, and BMI. A two-way repeated measures ANOVA revealed a significant main effect of time on ETDQ-7 scores (p < 0.001), but no significant main effect of groups (p = 0.109) or interaction between time and groups (p = 0.082). Subgroup analysis showed a significant interaction for the 3-month change in ETDQ-7 scores by OSA severity (p = 0.046). In post hoc analysis, the BP group exhibited a higher mean ETDQ-7 score compared with the AP group at the 3-month follow-up.

CONCLUSION

This study highlights the importance of considering individual patient factors, such as OSA severity and eustachian tube function symptoms, when selecting the most appropriate surgical treatment to optimize outcomes.

LEVEL OF EVIDENCE

4 Laryngoscope, 134:2471-2477, 2024.

The immediate effect of adenotonsillectomy on Eustachian tube function in children

OBJECTIVES

The aim of this study was to evaluate the effect of adenotonsillectomy on immediate Eustachian tube (E-tube) function in children with adenotonsillar hypertrophy.

METHODS

All children who were scheduled to undergo adenotonsillectomy were assessed. Physical examinations were performed on the preoperative day, and on postoperative days 1 and 2. Exams included visual inspection of the tympanic membrane and tympanometry including measurement of middle ear pressure (MEP) (daPa). The children were divided into four types (AA, CA, CC, and BB types) based on the tympanometric results of postoperative days 1 and 2.

RESULTS

A total of 50 ears from 25 children (mean age±standard deviation [SD]=8.6±3.2; male/female=10/15; mean body mass index±SD [kg/m(2)]=18.5±3.7) were included. The rates of AA, CA, CC, and BB types were 10% (5/50), 14% (7/50), 74% (37/50), and 2% (1/50), respectively. On postoperative day 2, 76% of cases were abnormal or unresolved (38/50), while 24% were normal or resolved (12/50). There were significant decreases in MEP both before and after adenotonsillectomy (p's<0.001). However, there were no significant differences in the MEPs measured on postoperative days 1 and 2. There were no significant differences between the right and left ears with regard to the MEPs on the preoperative day, or postoperative days 1 and 2.

CONCLUSIONS

Immediate E-tube dysfunction is a relatively common complication in children after adenotonsillectomy. Therefore, in the setting of immediate E-tube dysfunction, it is important to properly plan postoperative care and management.