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January 2016Treating the Pediatric Population
The most common and only proven method to treat Eustachian tube dysfunction manifestations, in both adults and children, is ventilation tube placement. “Although this doesn’t change Eustachian tube function, it eliminates the symptoms and results of Eustachian tube dysfunction, such as negative pressure, pain, popping, fluid buildup and ear infections,” said Cuneyt M. Alper, MD, professor of otolaryngology at Children’s Hospital of Pittsburgh—University of Pittsburgh Medical Center.
Dr. Alper sees both adults and children in the Eustachian tube dysfunction specialty clinic, where patients are evaluated using methods that include testing inside a pressure chamber. Both types of patients may also be enrolled in research protocols on Eustachian tube dysfunction funded by the National Institutes of Health.
If the condition recurs after extrusion of tubes in children, Dr. Alper will reinsert the tubes and consider removing the adenoids and evaluating and treating common risk factors of Eustachian tube dysfunction, including nasal allergies, sinus infections, and gastroesophageal reflux disease.
Although there aren’t any recent developments in treating pediatric patients, Dr. Alper said, “Incomplete removal or regrowth of adenoids may impinge the Eustachian tube opening.” In these instances, he removes the tissue in addition to medical management—resulting in improved function.
At this time, there are no controlled studies to support the efficacy of any alternative treatments for Eustachian tube dysfunction, including balloon dilation, reported Dr. Alper, who is in the process of conducting research on this method in adults. “Efficacy and safety of new treatment methods ethically requires testing in adults first,” he said.—KA