Refractory Eustachian Tube Dysfunction: Are the Symptoms Related to Endolymphatic Hydrops
The purpose of this study is to evaluate the benefit of treatment of refractory Eustachian tube dysfunction with standard treatment for endolymphatic hydrops. Eustachian tube dysfunction is a common diagnosis made in otolaryngology related to abnormal pressure equalization of the middle ear space related to a swollen, inflamed, or occluded Eustachian tube. The symptoms of this include perceived hearing loss, a feeling of fullness in the affected ear/ears, ear pain, ear popping, and occasionally imbalance. These symptoms overlap with a more rare and difficult to diagnose condition known as endolymphatic hydrops, or an overproduction to fluid in the inner ear. The treatment for these two conditions are distinct and traditionally, patients are treated for Eustachian tube dysfunction first as it is much more common and there are several treatments, namely nasal steroids, antihistamines, and pressure equalization tubes. For patients who do not improve with these treatments, they are often treated with diuretics and a low salt diet to treat for supposed endolymphatic hydrops. There has never been a study to investigate the utility of these treatments in patients with refractory Eustachian tube dysfunction. There is also reason to believe that chronic ETD with effusion can lead to both inner and middle ear dysfunction. Thus, this study aims to determine the benefit of standard endolymphatic hydrops treatment on patient with refractory Eustachian tube dysfunction symptoms in a prospective fashion.
Patients with refractory Eustachian tube dysfunction (patients with no or minimal symptom improvement despite nasal steroid and antihistamine treatment followed by myringotomy tube placement) have an element of endolymphatic hydrops and these patient's symptoms will improve with a low sodium diet and diuretic.
|Eustachian Tube Dysfunction Endolymphatic Hydrops||Drug: Nasal steroid Procedure: Myringotomy tube placement Drug: Diuretic Drug: Antihistamine Behavioral: Low salt diet|
|Study Design:||Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Refractory Eustachian Tube Dysfunction: Are the Symptoms Related to Endolymphatic Hydrops?|
- Improvement in patient ETD symptoms with nasal steroid and antihistamine alone [ Time Frame: 2 years ]Determine the degree to which ETD symptoms are relieved with nasal steroid and antihistamine alone.
- Improvement in patient ETD symptoms with pressure equalization tubes [ Time Frame: 2 years ]Determine the degree to which patient's symptoms related to ETD improve after placement of pressure equalization tubes.
- Improvement in patients with refractory ETD symptoms with treatment for endolymphatic hydrops with a diuretic and low salt diet [ Time Frame: 2 years ]Determine the degree of improvement of patient symptoms in the setting of refractory ETD after a low salt diet and diuretic treatment.
|Study Start Date:||August 2012|
|Study Completion Date:||August 2013|
|Primary Completion Date:||August 2013 (Final data collection date for primary outcome measure)|
Nasal steroid and Antihistamine
Patients with ETD will be given nasal steroid and antihistamine for 8 weeks.
|Drug: Nasal steroid Drug: Antihistamine|
Active Comparator: Myringotomy tubes
Patients who fail nasal steroid and antihistamine treatment will have myringotomy tubes placed.
|Procedure: Myringotomy tube placement|
Active Comparator: Low salt diet and diuretic
Patient's who fail to improve with myringotomy tubes will be treated with low salt det and diuretic
|Drug: Diuretic Behavioral: Low salt diet|
Please refer to this study by its ClinicalTrials.gov identifier: NCT01661777
|United States, Tennessee|
|Vanderbilt University Medical Center--Division of Neurotology|
|Nashville, Tennessee, United States, 37212|