Fluoroscopic subtraction Eustachian tubography: initial feasibility test in a cadaver model

Kun Yung Kim; Woo Seok Kang; Jung Hoon Park; Byung Chul Kang; Jun Woo Park; Min Tae Kim; Nader G. Bekheet; Seung Jun Hwang; Joonmyeong Choi; Kyu Jin Cho; Hong Ju Park; Ho Young Song

doi:10.1007/s00330-018-5392-4

Fluoroscopic subtraction Eustachian tubography: initial feasibility test in a cadaver model

Kun Yung Kim, Woo Seok Kang, Jung Hoon Park, Byung Chul Kang, Jun Woo Park, Min Tae Kim, Nader G. Bekheet, Seung Jun Hwang, Joonmyeong Choi, Kyu Jin Cho, Hong Ju Park, Ho Young Song

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objectives: To evaluate the technical feasibility of direct Eustachian tube catheterisation and subtraction Eustachian tubography in a cadaver model. Methods: A total of 12 separate sessions were performed on both sides of the Eustachian tube (ET) in six human cadavers. Cadavers were positioned for the submentovertical view on a fluoroscopy table. Endoscopy-guided ET selection was used in the first three cadavers, whereas fluoroscopy-guided ET selection was used in the remaining three. Eustachian tubography was performed by injecting 2 ml of contrast media through a 5-Fr catheter. We recorded the success of ET selection, number of attempts, procedure time, and tubography quality using native and subtraction images (range, 0–3). Results: Both endoscopy- and fluoroscopy-guided selections were successfully performed in five of six sessions (83.3%). There were no statistically significant differences between the endoscopy- and fluoroscopy-guided procedures in terms of the number of attempts, procedure time, rate of immediate contrast leak to the middle ear cavity, and quality of tubography (p > 0.05). An excellent quality of tubography was obtained in 83.3% (10 of 12 sessions) of subtraction images and in 33.3% (4 of 12 sessions) of native images. The tubography quality score was significantly higher for the subtraction images than for the native images (p = 0.04). Conclusion: Subtraction Eustachian tubography using direct catheterisation seems to be technically feasible. The entire ET can be well visualised; thus, this technique can be used as a simple tool for assessment of ET function and anatomy. Key Points: • Direct catheterisation of the Eustachian tube is technically feasible. • The entire Eustachian tube could be well visualised by direct Eustachian tubography. • Subtraction Eustachian tubography images have better image quality than native images. • Subtraction Eustachian tubography can provide objective assessment of ET function and anatomy.

Original language	English (US)
Pages (from-to)	3685-3691
Number of pages	7
Journal	European Radiology
Volume	28
Issue number	9
DOIs	https://doi.org/10.1007/s00330-018-5392-4
State	Published - Sep 1 2018
Externally published	Yes

Keywords

Constriction, pathological
Dilatation
Eustachian tube
Otitis media with effusion
Radiography, interventional

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1007/s00330-018-5392-4

Cite this

@article{51f222456f1646afb3ce2ece085869e4,

title = "Fluoroscopic subtraction Eustachian tubography: initial feasibility test in a cadaver model",

abstract = "Objectives: To evaluate the technical feasibility of direct Eustachian tube catheterisation and subtraction Eustachian tubography in a cadaver model. Methods: A total of 12 separate sessions were performed on both sides of the Eustachian tube (ET) in six human cadavers. Cadavers were positioned for the submentovertical view on a fluoroscopy table. Endoscopy-guided ET selection was used in the first three cadavers, whereas fluoroscopy-guided ET selection was used in the remaining three. Eustachian tubography was performed by injecting 2 ml of contrast media through a 5-Fr catheter. We recorded the success of ET selection, number of attempts, procedure time, and tubography quality using native and subtraction images (range, 0–3). Results: Both endoscopy- and fluoroscopy-guided selections were successfully performed in five of six sessions (83.3%). There were no statistically significant differences between the endoscopy- and fluoroscopy-guided procedures in terms of the number of attempts, procedure time, rate of immediate contrast leak to the middle ear cavity, and quality of tubography (p > 0.05). An excellent quality of tubography was obtained in 83.3% (10 of 12 sessions) of subtraction images and in 33.3% (4 of 12 sessions) of native images. The tubography quality score was significantly higher for the subtraction images than for the native images (p = 0.04). Conclusion: Subtraction Eustachian tubography using direct catheterisation seems to be technically feasible. The entire ET can be well visualised; thus, this technique can be used as a simple tool for assessment of ET function and anatomy. Key Points: • Direct catheterisation of the Eustachian tube is technically feasible. • The entire Eustachian tube could be well visualised by direct Eustachian tubography. • Subtraction Eustachian tubography images have better image quality than native images. • Subtraction Eustachian tubography can provide objective assessment of ET function and anatomy.",

keywords = "Constriction, pathological, Dilatation, Eustachian tube, Otitis media with effusion, Radiography, interventional",

author = "Kim, {Kun Yung} and Kang, {Woo Seok} and Park, {Jung Hoon} and Kang, {Byung Chul} and Park, {Jun Woo} and Kim, {Min Tae} and Bekheet, {Nader G.} and Hwang, {Seung Jun} and Joonmyeong Choi and Cho, {Kyu Jin} and Park, {Hong Ju} and Song, {Ho Young}",

note = "Funding Information: bony junction (asterisk), and bony portion (arrowhead) are well depicted. (c) Native Eustachian tubography in the oblique view. The cartilaginous portion (arrow) and bony portion (arrowhead) are depicted. Contrast media reflux is noted in the middle ear cavity (asterisk) of the Eustachian tube, shown in the oblique view Funding This study has received funding by Korea Health Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (HI17C0881). Publisher Copyright: {\textcopyright} 2018, European Society of Radiology.",

year = "2018",

month = sep,

day = "1",

doi = "10.1007/s00330-018-5392-4",

language = "English (US)",

volume = "28",

pages = "3685--3691",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer Verlag",

number = "9",

}

TY - JOUR

T1 - Fluoroscopic subtraction Eustachian tubography

T2 - initial feasibility test in a cadaver model

AU - Kim, Kun Yung

AU - Kang, Woo Seok

AU - Park, Jung Hoon

AU - Kang, Byung Chul

AU - Park, Jun Woo

AU - Kim, Min Tae

AU - Bekheet, Nader G.

AU - Hwang, Seung Jun

AU - Choi, Joonmyeong

AU - Cho, Kyu Jin

AU - Park, Hong Ju

AU - Song, Ho Young

N1 - Funding Information: bony junction (asterisk), and bony portion (arrowhead) are well depicted. (c) Native Eustachian tubography in the oblique view. The cartilaginous portion (arrow) and bony portion (arrowhead) are depicted. Contrast media reflux is noted in the middle ear cavity (asterisk) of the Eustachian tube, shown in the oblique view Funding This study has received funding by Korea Health Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (HI17C0881). Publisher Copyright: © 2018, European Society of Radiology.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Objectives: To evaluate the technical feasibility of direct Eustachian tube catheterisation and subtraction Eustachian tubography in a cadaver model. Methods: A total of 12 separate sessions were performed on both sides of the Eustachian tube (ET) in six human cadavers. Cadavers were positioned for the submentovertical view on a fluoroscopy table. Endoscopy-guided ET selection was used in the first three cadavers, whereas fluoroscopy-guided ET selection was used in the remaining three. Eustachian tubography was performed by injecting 2 ml of contrast media through a 5-Fr catheter. We recorded the success of ET selection, number of attempts, procedure time, and tubography quality using native and subtraction images (range, 0–3). Results: Both endoscopy- and fluoroscopy-guided selections were successfully performed in five of six sessions (83.3%). There were no statistically significant differences between the endoscopy- and fluoroscopy-guided procedures in terms of the number of attempts, procedure time, rate of immediate contrast leak to the middle ear cavity, and quality of tubography (p > 0.05). An excellent quality of tubography was obtained in 83.3% (10 of 12 sessions) of subtraction images and in 33.3% (4 of 12 sessions) of native images. The tubography quality score was significantly higher for the subtraction images than for the native images (p = 0.04). Conclusion: Subtraction Eustachian tubography using direct catheterisation seems to be technically feasible. The entire ET can be well visualised; thus, this technique can be used as a simple tool for assessment of ET function and anatomy. Key Points: • Direct catheterisation of the Eustachian tube is technically feasible. • The entire Eustachian tube could be well visualised by direct Eustachian tubography. • Subtraction Eustachian tubography images have better image quality than native images. • Subtraction Eustachian tubography can provide objective assessment of ET function and anatomy.

AB - Objectives: To evaluate the technical feasibility of direct Eustachian tube catheterisation and subtraction Eustachian tubography in a cadaver model. Methods: A total of 12 separate sessions were performed on both sides of the Eustachian tube (ET) in six human cadavers. Cadavers were positioned for the submentovertical view on a fluoroscopy table. Endoscopy-guided ET selection was used in the first three cadavers, whereas fluoroscopy-guided ET selection was used in the remaining three. Eustachian tubography was performed by injecting 2 ml of contrast media through a 5-Fr catheter. We recorded the success of ET selection, number of attempts, procedure time, and tubography quality using native and subtraction images (range, 0–3). Results: Both endoscopy- and fluoroscopy-guided selections were successfully performed in five of six sessions (83.3%). There were no statistically significant differences between the endoscopy- and fluoroscopy-guided procedures in terms of the number of attempts, procedure time, rate of immediate contrast leak to the middle ear cavity, and quality of tubography (p > 0.05). An excellent quality of tubography was obtained in 83.3% (10 of 12 sessions) of subtraction images and in 33.3% (4 of 12 sessions) of native images. The tubography quality score was significantly higher for the subtraction images than for the native images (p = 0.04). Conclusion: Subtraction Eustachian tubography using direct catheterisation seems to be technically feasible. The entire ET can be well visualised; thus, this technique can be used as a simple tool for assessment of ET function and anatomy. Key Points: • Direct catheterisation of the Eustachian tube is technically feasible. • The entire Eustachian tube could be well visualised by direct Eustachian tubography. • Subtraction Eustachian tubography images have better image quality than native images. • Subtraction Eustachian tubography can provide objective assessment of ET function and anatomy.

KW - Constriction, pathological

KW - Dilatation

KW - Eustachian tube

KW - Otitis media with effusion

KW - Radiography, interventional

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U2 - 10.1007/s00330-018-5392-4

DO - 10.1007/s00330-018-5392-4

M3 - Article

C2 - 29619519

AN - SCOPUS:85044977769

VL - 28

SP - 3685

EP - 3691

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 9

ER -

Fluoroscopic subtraction Eustachian tubography: initial feasibility test in a cadaver model

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