Prospective Evaluation of the Efficacy of Isolated Balloon Eustachian Tuboplasty: Short- and Medium-term Follow-up Results Based on Tubomanometry, ETDQ-7, Tympanometry, and Valsalva Maneuver

Abstract Introduction Balloon eustachian tuboplasty (BET) allows the treatment of the main etiology of eustachian tube disfunction (ETD). Objective To eval uate the ef ficacy of isolated BET, through objective and subjective results, in the short and medium term, in patients with chronic obstructive ETD. Methods Adult patients diagnosed with chronic obstructive ETD who underwent BET between January 2018 and December 2020 were enrolled in the study. We performeda prospective observational study of BET efficacy, by comparing subjective data, based on the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and objective data, obtained by tympanometry, objective Valsalva maneuver and tubomanometry, prior to BET with these outcome tools on postprocedure follow-up. Results In total, 30 BETs were performed and analyzed. There were no complications with the procedure. Analysis of BET efficacy was performed in the short-term (average of 7.5 weeks) and in the medium-term (average of 8 months). There was a significant reduction (p < 0.0001) in the total ETDQ-7 score from baseline to both follow-up periods. A normalization of the ETDQ-7 score was observed in 60 and 83.3% of the performed procedures, in the short- and medium-term, respectively. In tubomanometry, we verified a significant improvement (p < 0.0001) at all pressures, with a normalization of tubomanometry values in 53.3% and 43.3% of cases in the short-and medium-term, respectively. Tympanogram normalization occurred in 71.4% of patients with abnormal preoperative assessments. Conclusion As an isolated procedure, BET results in significant improvements in symptomatology and objective metric results. This, associated with its safety profile, currently makes BET the most indicated therapeutic option in refractory obstructive ETD.

Blastomicose articular / Articular blastomycosis

Os autores apresentam um caso de blatomicose sul-americana difusa e grave, cujo diagnóstico foi postergado pela falta de confirmaçäo laboratorial, sendo realizado posteriormente pela biópsia sinovial. Confirmada a etiologia, foi introduzido tratamento específico, com boa resposta e sem seqüelas

Poliarterite nodosa: comprometimento intestinal / Polyarteritis nodosa: intestinal compromising

Os autores descrevem um caso de poliarterite nodosa (PAN) evoluindo com abdome agudo e óbito por necrose e perfuraçäo de alça intestinal. Paciente do sexo masculino, com manifestaçöes clínicas iniciais de febre, emagrecimento e fraqueza muscular, foi diagnosticado como polimiosite (PM). Após dois anos de evoluçäo, apresentou manifestaçöes de abdome agudo por necrose segmentar de alça intestinal, cujo histopatológico foi compatível com PAN. Os autores discutem as diversas manifestaçöes clínicas da PAN, enfatizando o comprometimento muscular e gastrintestinal, neste com mortalidade de 75 a 100 por cento dos casos