Jeoung Sarah, Man Li-Xing, Mandych Alexander K, Schmale Isaac L
University of Rochester School of Medicine and Dentistry University of Rochester Rochester New York USA.
Department of Otolaryngology-Head and Neck Surgery University of Rochester Medical Center Rochester New York USA.
OTO Open. 2023 Aug 9;7(3):e70. doi: 10.1002/oto2.70. eCollection 2023 Jul-Sep.
Eustachian tube balloon dilation is a minimally invasive technique used to improve persistent Eustachian tube dysfunction. Currently, the US Food and Drug Administration (FDA) has approved the use of balloon dilation devices produced by three manufacturers, but little is known about associated adverse events and subsequent management.
Case series.
FDA Manufacturer and User Facility Device Experience (MAUDE) database.
Reports submitted to the FDA using the MAUDE database searched from January 2000 to July 2022 were analyzed for adverse events and management.
A total of 13 adverse events were found in the database. Subcutaneous emphysema (n = 8) was the most common event. Other less frequent events included patulous Eustachian tube (n = 2), vascular dissection (n = 1), nasopharyngeal mucocele (n = 1), and tinnitus (n = 1). A majority of patients who experienced subcutaneous emphysema received antibiotics (n = 5) and were admitted to the hospital (n = 4). The patient with a carotid dissection 7 days postprocedure presented with a stroke and fully recovered after stent placement. There was limited preprocedure information in the MAUDE database. There were 2 patients who did not fully recover after a complication. Three patients underwent corrective surgical interventions. No one company had more associated adverse events reported.
Subcutaneous emphysema is the most common adverse event after Eustachian tube dilation. Further studies exploring potential balloon dilation adverse events to allow for better patient counseling are warranted.
咽鼓管球囊扩张术是一种用于改善持续性咽鼓管功能障碍的微创技术。目前,美国食品药品监督管理局(FDA)已批准使用三家制造商生产的球囊扩张装置,但对于相关不良事件及后续处理知之甚少。
病例系列。
FDA制造商和用户设施设备经验(MAUDE)数据库。
分析2000年1月至2022年7月期间使用MAUDE数据库向FDA提交的报告中的不良事件及处理情况。
数据库中总共发现13例不良事件。皮下气肿(n = 8)是最常见的事件。其他较罕见的事件包括咽鼓管异常开放(n = 2)、血管夹层(n = 1)、鼻咽黏液囊肿(n = 1)和耳鸣(n = 1)。大多数发生皮下气肿的患者接受了抗生素治疗(n = 5)并住院(n = 4)。术后7天发生颈动脉夹层的患者出现中风,支架置入后完全康复。MAUDE数据库中的术前信息有限。有2例患者在出现并发症后未完全康复。3例患者接受了矫正性手术干预。没有一家公司报告的相关不良事件更多。
皮下气肿是咽鼓管扩张术后最常见的不良事件。有必要进行进一步研究以探索球囊扩张潜在的不良事件,以便为患者提供更好的咨询服务。