Effectiveness of Kobayashi plug for 252 ears with chronic patulous Eustachian tube.
CONCLUSION Trans-tympanic insertion of a new silicone plug seems to be useful for controlling the distressing symptoms of patients with a chronic patulous Eustachian tube (PET). OBJECTIVE To evaluate the effectiveness of a new silicone plug for blocking the isthmus of a PET in patients whose symptoms were resistant to other therapies for > 6 months. MATERIAL AND METHODS The silicone plug (total length 23-25 mm; tip diameter 1.0-2.0 mm) was inserted in 44 ears of 37 patients with chronic PET. It was inserted through the tympanic orifice of the ET to obstruct the isthmus of the tube via an incision in the anterosuperior portion of the tympanic membrane. RESULTS Insertion of the plug was possible in all except two ears, in which it failed because of a narrow tympanic orifice of the ET. In 11 ears of 10 patients, the plug was replaced by a larger one using the same approach to improve efficacy. Of the 42 ears in which the silicone plug was successfully inserted, 30 (71.4%) achieved relief from symptoms of PET without additional treatment. In > 60% of these cases, the symptoms of PET were well controlled with an aerated middle ear. The follow-up period ranged from 6 to 68 months (mean 38.9 months).