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Introduction: Balloon Eustachian tuboplasty (BET) is used to treat obstructive Eustachian tube dysfunction (OETD) and recurrent otitis media with effusion (OME). However, there are no indisputable evidence of its efficacy. Here, we present a multicenter, double‐blinded, randomized, placebo‐controlled trial (MDRCT) design to evaluate the efficacy of BET, and the results of a pilot trial with 3‐ and 12‐months' follow‐up. Material and Methods: This was a prospective MDRCT. For a pilot study, OETD (n = 10) and OME (n = 5) patients were recruited and followed. Detailed inclusion and exclusion criteria were used. Participants were randomized at beginning of the operation to active or sham surgery. All procedures were performed under local anesthesia. Controls were performed in double‐blinded manner (both patient and physician), at 3 and 12 months after the procedure. Results: Altogether, 20 ears were treated and followed for 12 months, including 14 active BETs and 6 sham surgeries. Both the active and sham surgery were performed under local anesthesia without problems or deviations from the protocol. There were no differences in the preoperative symptoms (ETDQ‐7) or objective measures (tympanometry, Valsalva and Toynbee maneuvers, tubomanometry, Eustachian tube score) between active and sham surgery arms. During follow‐up, we noticed largely similar reduction in subjective symptoms and improvement in Eustachian tube score both in active and sham surgery arms. Conclusions: The pilot study demonstrates that our MDRCT protocol is feasible, and that blinded RCTs are dearly needed to objectively measure the efficacy of BET. Level of Evidence: 2 Laryngoscope, 134:1874–1881, 2024 [ABSTRACT FROM AUTHOR]

Objective: Detecting bacteria as a causative pathogen of acute rhinosinusitis (ARS) is a challenging task. Electronic nose technology is a novel method for detecting volatile organic compounds (VOCs) that has also been studied in association with the detection of several diseases. The aim of this pilot study was to analyze maxillary sinus secretion with differential mobility spectrometry (DMS) and to determine whether the secretion demonstrates a different VOC profile when bacteria are present. Methods: Adult patients with ARS symptoms were examined. Maxillary sinus contents were aspirated for bacterial culture and DMS analysis. k -Nearest neighbor and linear discriminant analysis were used to classify samples as positive or negative, using bacterial cultures as a reference. Results: A total of 26 samples from 15 patients were obtained. After leave-one-out cross-validation, k -nearest neighbor produced accuracy of 85%, sensitivity of 67%, specificity of 94%, positive predictive value of 86%, and negative predictive value of 84%. Conclusions: The results of this pilot study suggest that bacterial positive and bacterial negative sinus secretion release different VOCs and that DMS has the potential to detect them. However, as the results are based on limited data, further conclusions cannot be made. DMS is a novel method in disease diagnostics and future studies should examine whether the method can detect bacterial ARS by analyzing exhaled air. [ABSTRACT FROM AUTHOR]

Objectives: Acoustic rhinometry is widely used in evaluating patients with nasal congestion, but it only has a partial correlation with patient symptoms. The use and focus of cone beam computed tomography (CBCT) scans are mainly on the paranasal sinuses and less on the nasal cavities. Therefore, information acquired from CBCT scans is not used to its full extent. In our present study, we have studied patients with enlarged inferior turbinates. Our aim was to investigate and compare the use of 3D volumetric measurements and cross-sectional area measurements taken from CBCT scans to results obtained from acoustic rhinometry. Material and methods: In total, 25 patients with enlarged inferior turbinates were studied. CBCT scans were obtained preoperatively and at twelve months postoperatively. 3D volumetric and cross-sectional area measurements were compared to results from acoustic rhinometry, the visual analogue scale (VAS) and Glasgow Health Status Inventory (GHSI) questionnaires. Results: A statistically significant change in 3D volume and cross-sectional area was measured in the anterior part of the inferior turbinate and surrounding air space after inferior turbinate surgery. VAS and GHSI results had mild correlations with the 3D volume and cross-sectional area measurements of the anterior part of the inferior turbinate. Acoustic rhinometry correlated with the air space 3D volume measurements in the anterior part. Conclusions: Fully utilized CBCT scans provide more comprehensive and accurate information. Furthermore, 3D analysis of the inferior turbinates provides valuable information and more precise measurements compared to acoustic rhinometry. [ABSTRACT FROM AUTHOR]

Objective: To study whether balloon Eustachian tuboplasty (BET) is a feasible and safe procedure under local anesthesia.Study Design: Prospective multicenter case-control study.Methods: Patients undergoing either BET (n = 13) or endoscopic sinus surgery (ESS) (n = 12) under local anesthesia, with the possibility of sedation and analgesia, were monitored during the procedure and recovery period for possible adverse effects. After the procedure, the patients responded to a questionnaire assessing their experience.Results: No adverse effects were detected in the BET group. Patients in the BET group reported similar Visual Analog Scale scores for pain during the operation as the ESS group (5.0 ± 0.7 vs. 3.2 ± 0.7, mean ± standard error of the mean). However, patients in the BET group experienced more discomfort (4.2 ± 0.6 vs. 2.5 ± 0.3, respectively, P = 0.049). Seventy-seven and 92% of the patients in the BET and ESS groups, respectively, considered the anesthesia and pain relief to be sufficient. Patients from both the BET and ESS groups were almost devoid of pain 1 to 2 hours postoperatively (0.8 ± 0.2 and 1.4 ± 0.3, respectively). In total, 12 of 13 patients in the BET group, and all 12 patients in the ESS group, would choose local anesthesia with sedation and analgesia if they needed to undergo the same procedure again.Conclusion: BET is a safe and feasible procedure under monitored anesthesia care, including local anesthesia along with sedation and analgesia. There is need for further methodological improvement to reduce pain and discomfort during the operation.Level Of Evidence: 4. Laryngoscope, 127:1021-1025, 2017. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: The aim of this study was to evaluate statistically the effects of radiofrequency ablation, diode laser, and microdebrider-assisted inferior turbinoplasty techniques on ciliated epithelium and mucociliary function.Study Design: Prospective randomized study.Methods: A total of 66 consecutively randomized adult patients with enlarged inferior turbinates underwent either a radiofrequency ablation, diode laser, or microdebrider-assisted inferior turbinoplasty procedure. Assessments were conducted prior to surgery and 3 months subsequent to the surgery. The effect on ciliated epithelium was evaluated using a score based on the blinded grading of the preoperative and postoperative scanning electron microscopy images of mucosal samples. The effect on mucociliary function, in turn, was evaluated using saccharin transit time measurement.Results: The score of the number of cilia increased statistically significantly in the radiofrequency ablation (P = .03) and microdebrider-assisted inferior turbinoplasty (P = .04) groups, but not in the diode laser group. The score of the squamous metaplasia increased statistically significantly in the diode laser group (P = .002), but not in the other two groups. There were no significant changes found between the preoperative and postoperative saccharin transit time values in any of the treatment groups.Conclusions: Radiofrequency ablation and microdebrider-assisted inferior turbinoplasty are more mucosal preserving techniques than the diode laser, which was found to increase the amount of squamous metaplasia at the 3-month follow-up. The number of cilia seemed to even increase after radiofrequency ablation and microdebrider-assisted inferior turbinoplasty procedures, but not after diode laser. Nevertheless, the mucociliary transport was equally preserved in all three groups.Level Of Evidence: 1b Laryngoscope, 129:18-24, 2019. [ABSTRACT FROM AUTHOR]