Prospective Study on the Results of the Tuboplasty in Rural Region in Germany

1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanostomy tube insertion, tuboplasty (TP) offers a less invasive option for treating this problem. The study should examine whether TP can be performed in a rural setting. 2) Material and methods: This is a prospective, monocentric study of patients scheduled for TP because of tubal ventilation disorder (TVD) in a rural region of Germany. The diagnosis was established after a thorough clinical examination and by assessing the possibility of performing the Valsalva maneuver, the tympanogram type, recording the middle ear pressure and air-bone gap. The subjective impairment caused by the TVD was evaluated using the EDTQ-7 questionnaire pre- and approximately 3 months postoperatively. 3) Results: Sixty-two patients with 92 TP were included with a mean age of 44.1 years. The EDTQ-7 score decreased highly significantly from 3.6 to 1.7 (p < 0.0001) without correlating with parameters such as age, sex, BMI, allergies or smoking. Middle ear pressure fell in average by ？87 daPa, resulting in an improvement of the tympanogram type. The preoperative air-bone gap of 10.2 dB also was reduced significantly in most patients to 8.0 dB after the procedure. No notable complications occurred beside a sore throat due to the use of a laryngeal mask for ventilation during anesthesia in two cases. 4) Conclusion: In our experience, TP represents a less invasive and, in many cases, successful alternative to the established tympanostomy tube insertion with the advantage of an intact eardrum. It can also be offered and successfully performed in a rural setting.