Assessment the impact of the torus tubarius correction by power-assisted technique on the equipressor eustachian tube function

Authors

DOI:

https://doi.org/10.15574/SP.2023.133.80

Keywords:

children, torus tubarius, adenoidectomy, upper respiratory tract, pharyngeal tonsil hypertrophy, adenoid vegetations, microdebridger, tympanometry, endoscopic rhinosurgery

Abstract

Purpose of the research is to evaluate the impact of the torus tubarius correction by microdebrider technique on the eustachian tube function in children without middle ear pathology.

Materials and methods. 115 children aged 3 to 12 years participated in the study. All children underwent endoscopic modified microdebridement adenotomy for the first time, which, in the case of tubal hypertrophy (we analyzed the frequency of this phenomenon), was combined with its correction by the microdebridement method. For the next stage of the research, we selected 19 children, who had preoperative intratympanic pressure monitoring results more than -100 daPa and who hadn’t concomitant tonsil hypertrophy (19 children). Control measurement was done on days 1 and 8-10 after the intervention. Depending on the presence/absence of concomitant hypertrophy of the torus tubarius, patients were divided into the main (11 patients) and control (8 patients) groups. The analysis was carried out using the STATISTICA program.

Results. 36 patients were diagnosed with torus tubarius hypertrophy. When comparing intratympanic pressure on the 1st day after the intervention in patients of the main and control groups, a significant difference in values was found (-144.37±41.09/-95.00±27.90 daPa). On day 8-10, the intratympanic pressure data in patients of both groups did not differ from each other
(-39.15±14.85 daPa in the main and -33.87±19.57 daPa in the control groups) and preoperative values in both groups.

Conclusions. Hypertrophy of the torus tubarius is noted in 31.3% of patients with primary adenotomy. The microdebrider technique method of torus tubarius correction is safe in view of the equipressor function of the auditory tube.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research.

No conflict of interests was declared by the authors.

Author Biographies

K.V. Liakh, Shupyk National Healthcare University of Ukraine, Kyiv

State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administration Department, Kyiv, Ukraine

Ya.V. Shkorbotun, Shupyk National Healthcare University of Ukraine, Kyiv

State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administration Department, Kyiv, Ukraine

References

Acar G. (2021). Surgical anatomy of the Tonsils. In Oral and Maxillofacial Surgery. London: 30; https://doi.org/10.5772/intechopen.93038

Alimova NP. (2021). Comparative characteristics of the anthropometric parameters of the head and maxillofacial region in children with Adenoids. New Day in Medicine. 1 (33): 203-208.

Aschan G. (1954). The Eustachian Tube: Histological Findings under Normal Conditions and in Otosalpingitis. Acta Oto-Laryngologica. 44 (4): 295-311. https://doi.org/10.3109/00016485409128712; PMid:13227981

Atilla MH, Kaytez SK, Kesici GG, Baştimur S, Tuncer S. (2020). Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction. Braz J Otorhinolaryngolю 86 (1): 38-43. Epub 2018 Sep 25. https://doi.org/10.1016/j.bjorl.2018.08.004; PMid:30322828 PMCid:PMC9422505

Awad Ali AH, Youssif MA. (2017). The Immediate Effect of Power Assisted Endoscopic Adeno with Microdebrider on Eustachian Tube Function in Children. Otolaryngology online journal. 7 (3): 162.

Botev I, Karchev T, Botev B, Tsenova V. (2011). Tubal tonsil - review. MB - otolaryngology. 2: 11-14. https://doi.org/10.14748/orl.v7i2.7005

Dange PS, Bhat VK, Yadav M. (2022). Adenoid Morphology and Other Prognostic Factors for Otitis Media with Effusion in School Children. Indian J Otolaryngol Head Neck Surg. 74 (3): 3649-3653. Epub 2021 Jan 7. PMCID: PMC9895436. https://doi.org/10.1007/s12070-020-02332-8; PMid:36742487

Gülşen S, Çikrikçi S. (2020). Comparison of Endoscope-Assisted Coblation Adenoidectomy to Conventional Curettage Adenoidectomy in Terms of Postoperative Eustachian Tube Function. J Craniofac Surg. 31 (4): 919-923. https://doi.org/10.1097/SCS.0000000000006039; PMid:31764564

Gusakov A, Zheltov A, Kokorkin D. (2016). Comparative effectiveness of the methods adenoidectomy in children with exudative otitis media. Sovremennaya pediatriya. 2 (74): 151-154. https://doi.org/10.15574/SP.2016.74.151

Hong SC, Min HJ, Kim KS. (2017). Refractory sleep apnea caused by tubal tonsillar hypertrophy. Int J Pediatr Otorhinolaryngol. 95: 84-86. Epub 2017 Feb 11. https://doi.org/10.1016/j.ijporl.2017.02.010; PMid:28576540

Juneja R, Meher R, Raj A, Rathore P, Wadhwa V, Arora N. (2019). Endoscopic assisted powered adenoidectomy versus conventional adenoidectomy - a randomised controlled trial. J Laryngol Otol. 133: 289-293. https://doi.org/10.1017/S0022215119000550; PMid:31046870

Kim JW, Rhee CS, Jung HJ. (2020). Partial resection of hypertrophic torus tubarius for recurred snoring: Case series. Medicine (Baltimore). 99 (10): e19329. https://doi.org/10.1097/MD.0000000000019329; PMid:32150069 PMCid:PMC7478779

Kosakovskyi AL, Gavrilenko YV. (2014). Modern approach to the treatment of acute and chronic adenoiditis in children. Ukrayins'kyy medychnyy chasopys. 2 (100): 71-76.

Kоsakivska IA. (2017). Application of electrothermoadhesion in surgical intervention for the diseases of lymphatic pharyngeal ring in children. Klinicheskaia Khirugiia. 2: 31-33.

Mansour S, Magnan J, Ahmad HH, Nicolas K, Louryan S. (2019). The Eustachian Tube. In: Comprehensive and Clinical Anatomy of the Middle Ear. Springer, Cham. https://doi.org/10.1007/978-3-030-15363-2_7

McCoul ED, Lucente FE, Anand VK. (2011). Evolution of Eustachian tube surgery. Laryngoscope. 121 (3): 661-666. Epub 2011 Feb 8. https://doi.org/10.1002/lary.21453; PMid:21305559

Metson R, Pletcher SD, Poe DS. (2007). Microdebrider eustachian tuboplasty: A preliminary report. Otolaryngol Head Neck Surg. 136 (3): 422-427. https://doi.org/10.1016/j.otohns.2006.10.031; PMid:17321871

Rajan N, Saxena SK, Parida PK, Alexander A, Ganesan S. (2020). Comparison of middle ear function and hearing thresholds in children with adenoid hypertrophy after microdebrider and conventional adenoidectomy: a randomised controlled trial. Eur Arch Otorhinolaryngol. 277 (11): 3195-3203. Epub 2020 Jul 14. https://doi.org/10.1007/s00405-020-06197-z; PMid:32666291

Ruben RJ. (2017). The adenoid: Its history and a cautionary tale. Laryngoscope. 127; 2: 13-28. https://doi.org/10.1002/lary.26634; PMid:28543437

Unlu I, Unlu EN, Kesici GG, Guclu E, Yaman H, Ilhan E et al. (2015). Evaluation of middle ear pressure in the early period after adenoidectomy in children with adenoid hypertrophy without otitis media with effusion. Am J Otolaryngol. 36 (3): 377-381. Epub 2015 Jan 13. https://doi.org/10.1016/j.amjoto.2015.01.005; PMid:25766622

Varadharajan R, Thingujam S. (2020). Prevalence of Gerlach tonsil: a mucosa associated lymphoid tissue aggregation in the nasopharynx. International Journal of Otorhinolaryngology and Head and Neck Surgery. 7; 1. https://doi.org/10.18203/issn.2454-5929.ijohns20205399

Yanagisawa E, Joe JK. (1999). Endoscopic view of the torus tubarius. ENT-Ear, Nose & Throat Journal. 6: 404-406. https://doi.org/10.1177/014556139907800605

Yang SZ, Zhou CY, Wang ZL et al. (2022). Preliminary experience of surgical treatment for torus tubarius hypertrophy in children. Zhonghua er bi yan hou tou Jing wai ke za zhi = Chinese Journal of Otorhinolaryngology Head and Neck Surgery. 57 (4): 505-509. doi: 10.3760/cma.j.cn115330-20210412-00196. PMID: 35527449.

Zheltov AYa. (2019). Diagnosis and treatment of the diseases of nasopharyngeal lymphoid tissue in children with exudative otitis media. Qualification scientific work on the rights of the manuscript. Zaporizhzhia: 175.

Downloads

Published

2023-09-28

Issue

Section

Original articles