Objectives: Cochlear implantation (CI) has been successfully used to restore hearing in patients with severe to profound hearing loss. In addition to hearing loss, irradiated patients with nasopharyngeal carcinoma (NPC) also often have chronic otitis media and Eustachian tube (ET) dysfunction. These features may result in difficulties in CI. We conducted this study to review the management options for irradiated patients with NPC undergoing CI. Furthermore, we investigated the results of CI in irradiated patients with NPC with chronic otitis media and obstructive ET dysfunction, accordingly to different treatment strategies. Methods: We retrospectively reviewed the data of patients with NPC who underwent CI in our hospital between 2006 and 2020. All subjects were found to be eligible according to the following inclusion criteria: had NPC, received irradiation, underwent cochlear implant surgery, and had chronic otitis media with obstructive ET dysfunction. Results: A total of 9 patients with obstructive ET dysfunction and chronic otitis media underwent cochlear implant surgery. Seven patients with an inflamed ETs underwent a 2-stage operation. Two patients with obliterated ETs, we performed a single-stage CI surgery. Only 1 patient had otitis media effusion after the surgery. Conclusion: With the proper management of chronic otitis media and ET dysfunction, cochlear implant is an effective treatment for irradiated patients with NPC when conventional hearing aids failed.

Rhinosinusitis is common in patients with nasopharyngeal carcinoma (NPC). Our study aimed to explore the role of rhinosinusitis severity in NPC prognosis. Medical records and radiologic examinations of 90 patients with NPC at a single medical center from 2009–2016 were retrospectively analyzed. The Lund–Mackay (L–M) score was obtained for each patient before and after 6 months of treatment. Rhinosinusitis diagnosis was based on L–M scores of ≥4. L–M score differences were calculated as pre-treatment rhinosinusitis (PRRS) minus post-treatment rhinosinusitis (PSRS). L–M score difference was sub-grouped into “L–M scores > 0”, “L–M scores = 0”, and “L–M scores < 0”. Clinical staging of our patients based on the American Joint Committee on Cancer 7th edition were: stage I in nine, stage II in seventeen, stage III in twenty-two, and stage IV in forty-two patients; twenty-seven (30%) patients had died. PRRS incidence was 34.4%, and PSRS was 36.7%. Median of L–M scores difference was 0 (−2.2). L–M score difference was an independent prognostic factor for the overall survival of patients with NPC (p < 0.05). Therefore, worsening rhinosinusitis was a prognostic factor for patients with NPC. Clinicians should consider NPC as a warning sign of poor prognosis during routine follow-ups.

Background: Eustachian tube dysfunction (ETD) is a common disorder causing ear pressure, pain, and hearing loss. Balloon Eustachian tuboplasty (BET) is an emerging technique for dilating the Eustachian tube and treating ETD. Whether adding myringotomy improves BET efficacy is controversial. Methods: This retrospective study included 95 ETD patients undergoing BET alone (n = 44) or BET with myringotomy (BET + M; n = 51) between June 2020 and August 2021 at a single medical center. The primary outcome was the change in ETDQ-7 symptom scores from baseline to 6 months after treatment. Secondary outcomes included audiometry, endoscopy, Valsalva maneuver, and complications. Results: The ETDQ-7 scores improved significantly after treatment in both groups (p < 0.001), without significant between-group differences (p = 0.417). No significant differences occurred in the audiometry, endoscopy, and Valsalva results or in most complications between groups. One BET + M patient had a persistent tympanic membrane perforation. Conclusions: Both BET alone and BET + M effectively and safely improved the subjective and objective ETD outcomes. However, adding myringotomy did not further improve the outcomes over BET alone, while it incurred risks such as persistent perforation. BET alone may sufficiently treat ETD without requiring myringotomy in this cohort. Further randomized controlled trials should identify optimal candidates for BET alone versus combined approaches.

Objective: This study investigated the effects of concurrent inferior turbinectomy and balloon Eustachian tuboplasty on symptoms related to Eustachian tube dysfunction. Methods: This comparative case-control study prospectively enrolled 50 patients who underwent balloon Eustachian tuboplasty with inferior turbinectomy between September 2020 and March 2021. Retrospectively, an additional 50 patients who underwent balloon Eustachian tuboplasty without inferior turbinectomy between June 2019 and August 2020 were enrolled as the control group after frequency-matching by age and sex. The Eustachian Tube Dysfunction Questionnaire-7 and the nasal obstruction symptom evaluation scores were compared between the 2 groups. Results: The Eustachian Tube Dysfunction Questionnaire-7 scores significantly differed between patients who underwent a balloon Eustachian tuboplasty with inferior turbinectomy and those who underwent a balloon Eustachian tuboplasty without inferior turbinectomy (preoperative: 24.9 ± 5.91 vs. 25.3 ± 6.91 (P=.79); postoperative: 13.7 ± 4.75 vs. 17.2 ± 5.71 (P=.02)). The nasal obstruction symptom evaluation scores also significantly differed between patients who underwent a balloon Eustachian tuboplasty with inferior turbinectomy and those who underwent a balloon Eustachian tuboplasty without inferior turbinectomy (preoperative: 74 ± 13.45 vs. 77 ± 14.29, (P=.26); postoperative: 25.9 ± 4.7 vs. 75.9 ± 8.7 (P < .0001)). Conclusion: Concurrent balloon Eustachian tuboplasty with inferior turbinectomy is safe and can improve subjective Eustachian tube function in patients with nasal obstruction and Eustachian tube dysfunction. Moreover, it may be an optional technique for surgeons to ameliorate Eustachian tube dysfunction. Cite this article as: Lin W, Hsieh C, Yu S, Chang Y, Hsu C, Wu H. Balloon eustachian tuboplasty with or without inferior turbinectomy for chronic nasal obstruction with obstructive eustachian tube dysfunction. B-ENT. 2022;18(4):232-238.