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Comprehensive Otolaryngology

Surgical Management of Obstructive Eustachian Tube Dysfunction

Sunday, October 1, 2023
11:00 AM - 12:00 PM East Coast USA Time
Location: Ballroom C1

    Lead Presenter(s)

  • Dennis S. Poe, MD, PhD

    Professor of Otolaryngology
    Boston Children’s Hospital, Harvard Medical School
    Boston, MA, United States

    • Co-Presenter(s)

  • RM

    Ralph B. Metson, MD

    Professor of Otolaryngology
    Mass Eye and Ear/Harvard Medical School
    Boston, MA, United States

Disclosure(s):
Dennis S. Poe, MD, PhD: No relevant relationships to disclose.
Ralph B. Metson, MD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: This course will discuss the nature of Eustachian tube dysfunction (ETD), pathophysiology and medical/surgical treatment with a focus on the most common problem, obstructive ETD. There is increasing evidence that the middle ear and mastoid space is physiologically analogous to an accessory sinus, which shares similar respiratory mucosa and pathology with the nasal cavity and paranasal sinuses. The special sensory functions of the ear are optimized and protected by the Eustachian tube, which serves as a unique, long, curved and dynamic "ostium." The cartilaginous portion contains a functional valve that must open periodically to allow for ventilation and clearance of secretions. It must close competently in order to prevent reflux of material and sounds from the nasopharynx. Failure of one or more of these three functions, ventilation, clearance and prevention of reflux, constitutes Eustachian tube dysfunction (ETD), which represent a spectrum from obstructive to patulous dysfunction. The most common etiology of obstructive ETD is inflammation within the cartilaginous portion causing a functional obstruction. The initial management of obstructive ETD should be to try to identify its source and treat the inflammation appropriately if possible.

The course will emphasize endoscopic identification of pathology and targeted surgical treatment. It will build on the AAO-HNS Clinical Consensus Statement on balloon dilation of the Eustachian tube.

OUTCOME OBJECTIVE 1: Describe mechanisms of Eustachian tube pathophysiology and be able to diagnose disorders, including differential diagnosis of aural fullness/otalgia

OUTCOME OBJECTIVE 2: Treat Eustachian tube disorders with appropriate medical therapy

OUTCOME OBJECTIVE 3: Assess surgical anatomy, pathology and new surgical techniques

BACKGROUND STATEMENT: Surgical management of Eustachian tube obstructive dysfunction is a new field for otolaryngologic surgeons. This course will provide for more understanding of the pathophysiology, indications for surgery, surgical anatomy and techniques of surgery.