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CT imaging of the Eustachian tube using focal contrast medium administration: a feasibility study in humans.
Acta Radiol Open. 2020 Jan; 9(1):2058460119900435.AR

Abstract

Several methods of imaging the Eustachian tube have been tested in the last century, although neither has led to an established method. The introduction of balloon Eustachian tuboplasty (BET) has revived the request for Eustachian tube (ET) visualization in patients with chronic Eustachian tube dysfunction. Many institutions perform preoperative computed tomography (CT) scans of the temporal bone and epipharynx before BET. Purpose We hypothesize that the injection of a contrast medium into the tympanic cavity is safe and feasible and can evolve the CT scan by visualizing the ET lumen and, potentially, the level of obstruction. This study is the initial feasibility study for such a human application. Material and Methods Ten minutes before a CT scan, diluted iodixanol was injected into the middle ear in 18 patients planned for BET due to otitis media with effusion. Five patients with Meniere's disease were controls. Any immediate or delayed adverse events were recorded. Masking of adjacent bony structures in the middle ear on the CT images was evaluated and the most caudally visible contrast medium between the middle ear and epipharynx recorded. Results There were no serious adverse events. One patient reported transitory vertigo. The contrast medium did not mask middle ear structures, apart from the tympanic membrane. The level of contrast medium passage could be assessed. Conclusion Visualizing the ET lumen in humans using intratympanic contrast medium is feasible and safe and does not obscure other valuable image information in a preoperative CT scan.

Authors+Show Affiliations

Division of Radiology and Nuclear Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway. Faculty of Medicine, Oslo University, Oslo, Norway.Faculty of Medicine, Oslo University, Oslo, Norway. Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway.Faculty of Medicine, Oslo University, Oslo, Norway. Department of Otolaryngology, Head and Neck Surgery, Akershus University Hospital, Oslo, Norway.Division of Radiology and Nuclear Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway.Division of Radiology and Nuclear Medicine, Rikshospitalet, Oslo University Hospital, Oslo, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32030198

Citation

Falkenberg-Jensen, Benedicte, et al. "CT Imaging of the Eustachian Tube Using Focal Contrast Medium Administration: a Feasibility Study in Humans." Acta Radiologica Open, vol. 9, no. 1, 2020, p. 2058460119900435.
Falkenberg-Jensen B, Jablonski GE, Silvola JT, et al. CT imaging of the Eustachian tube using focal contrast medium administration: a feasibility study in humans. Acta Radiol Open. 2020;9(1):2058460119900435.
Falkenberg-Jensen, B., Jablonski, G. E., Silvola, J. T., Kristiansen, J. F., & Hopp, E. (2020). CT imaging of the Eustachian tube using focal contrast medium administration: a feasibility study in humans. Acta Radiologica Open, 9(1), 2058460119900435. https://doi.org/10.1177/2058460119900435
Falkenberg-Jensen B, et al. CT Imaging of the Eustachian Tube Using Focal Contrast Medium Administration: a Feasibility Study in Humans. Acta Radiol Open. 2020;9(1):2058460119900435. PubMed PMID: 32030198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CT imaging of the Eustachian tube using focal contrast medium administration: a feasibility study in humans. AU - Falkenberg-Jensen,Benedicte, AU - Jablonski,Greg E, AU - Silvola,Juha T, AU - Kristiansen,Joanna F, AU - Hopp,Einar, Y1 - 2020/01/22/ PY - 2019/06/26/received PY - 2019/12/12/accepted PY - 2020/2/8/entrez PY - 2020/2/8/pubmed PY - 2020/2/8/medline KW - Ear nose and throat KW - Eustachian tube KW - balloon insertion KW - computed tomography KW - contrast agents SP - 2058460119900435 EP - 2058460119900435 JF - Acta radiologica open JO - Acta Radiol Open VL - 9 IS - 1 N2 - Several methods of imaging the Eustachian tube have been tested in the last century, although neither has led to an established method. The introduction of balloon Eustachian tuboplasty (BET) has revived the request for Eustachian tube (ET) visualization in patients with chronic Eustachian tube dysfunction. Many institutions perform preoperative computed tomography (CT) scans of the temporal bone and epipharynx before BET. Purpose We hypothesize that the injection of a contrast medium into the tympanic cavity is safe and feasible and can evolve the CT scan by visualizing the ET lumen and, potentially, the level of obstruction. This study is the initial feasibility study for such a human application. Material and Methods Ten minutes before a CT scan, diluted iodixanol was injected into the middle ear in 18 patients planned for BET due to otitis media with effusion. Five patients with Meniere's disease were controls. Any immediate or delayed adverse events were recorded. Masking of adjacent bony structures in the middle ear on the CT images was evaluated and the most caudally visible contrast medium between the middle ear and epipharynx recorded. Results There were no serious adverse events. One patient reported transitory vertigo. The contrast medium did not mask middle ear structures, apart from the tympanic membrane. The level of contrast medium passage could be assessed. Conclusion Visualizing the ET lumen in humans using intratympanic contrast medium is feasible and safe and does not obscure other valuable image information in a preoperative CT scan. SN - 2058-4601 UR - https://www.unboundmedicine.com/medline/citation/32030198/CT_imaging_of_the_Eustachian_tube_using_focal_contrast_medium_administration:_a_feasibility_study_in_humans L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32030198/ DB - PRIME DP - Unbound Medicine ER -
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