Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P223

(TTAG), but there was no correlation with sonotubometry.
TTAG was the significant examination that can predict
aggravation of the auditory tube mechanism. It became
clear that auditory tube dysfunction recovered naturally by
follow-up, by 3.48 days.
Autophagy Acceleration Attenuates
Endoplasmic Stress-Induced Cell Death in
Auditory Cells
Akihiro Kishino (Presenter); Ken Hayashi, MD, PhD;
Takeshi Ohshima, MD, PhD
Objectives: This study aimed to uncover the association
between endoplasmic reticulum (ER) stress-induced auditory
cell death and autophagy, assuming the novel therapeutic target for sensorineural hearing loss.
Methods: HEI-OC1 was cultured in the presence of tunicamycin, an ER stress inducer. The cell viability was evaluated
by Trypan Blue exclusion method. Western blot analysis was
performed to detect cell death-signaling pathways. Small
interfering (si)-RNA was transfected into cells by lipofection.
The ultrastructure of cells was observed under transmission
electron microscope (TEM).
Results: Tunicamycin-treated cells showed decreased cell
viability time dependently. The typical morphologic changes
of apoptosis in nuclear and autophagic vesicles in cytoplasm
were observed in tunicamycin-treated cells under TEM. The
expression of cleaved-caspase-3 was increased time dependently, and LC3-II was induced at the peak of 24 hours in
tunicamycin-treated cells. The autophagy-related gene, Atg7
or Beclin-1 knockdown (KD) cells showed the decrease of
LC3-II and the significantly higher increase of p62 than sicontrol cells. The number of autophagic vesicles were
decreased in Atg7 or Beclin-1 KD cells. The cell viability was
also decreased in Atg7 or Beclin-1 KD cells. However, the cell
viability was more increased in rapamycin (an autophagy
inducer)-treated cells. The expression of LC3-II was significantly increased in rapamycin-treated cells and p62 was significantly decreased.
Conclusions: Our study uncovered that the acceleration of
autophagy attenuates ER-induced cell death in auditory cells.
This study also contributes to the development of novel therapeutics targeting the efficient autophagy induction for treating
sensorineural hearing loss.
Balloon Dilatation for Eustachian Tube
Dysfunction in Western Australia
Thomas Hendriks (Presenter); Jafri Kuthubutheen, MD;
Shane Ling, MD
Objectives: There is emerging overseas evidence that balloon dilatation of the Eustachian tube (ET) can be an effective
treatment for Eustachian tube dysfunction (ETD) as compared
with medical therapy. Balloon dilatation has not yet been performed in Western Australia (WA) until now and we present
the results of our pilot study.

P223

Methods: A prospective cohort study was conducted in
Perth, WA, between 2018 and 2019. Fifteen adult patients were
identified who had a clinical diagnosis of ETD and at least
1 symptom on the Eustachian Tube Dysfunction Questionnaire
(ETDQ) who had failed medical management of ETD. Primary
outcomes included assessment of ETDQ scores, tympanometry, and pure tone audiometry (PTA). At the time of writing,
12 patients had undergone transnasal balloon dilatation with
6-week and 6-month follow-up results available.
Results: Twelve patients were included and underwent balloon dilatation of the affected side/s; most were female (n = 8),
and the average age of the cohort was 52 years. Significant
improvement in ETDQ scores for the cohort was noted at both
the 6-week (P < .001) and 6-month (P = .04) follow-ups. All
patients with abnormal tympanometry (type B or C) had normalization (type A) postoperatively and those unable to
Valsalva (n = 4) were able to postoperatively. There were no
adverse events or complications.
Conclusions: Our early experiences with balloon dilatation
of the ET for ETD are encouraging, demonstrating significant
symptomatic relief 6 weeks and 6 months postprocedure. This
is the first study, to our knowledge, prospectively assessing
balloon dilatation of the ET in Australia.
Balloon Tuboplasty for Baro-Challenge
Eustachian Tube Dysfunction
Ophir Handzel, MD (Presenter); Omer Jacob Ungar, MD;
Yahav Oron
Objectives: Baro-challenge Eustachian tube (ET) dysfunction (BETD) is defined as the inability to adequately adjust
pressure in the middle ear cleft to a change in ambient pressure. Patients' symptoms are often limited to times of barochallenge. Balloon Eustachian tuboplasty (BET) has gained
popularity for the treatment of chronic ET dysfunction. The
aim of this talk is to report the outcome of BET in patients
with BETD, including the first series of divers.
Methods: Case series of patients undergoing BET for
BETD. Fifteen patients had the procedure. Four were divers: 3
were recreational SCUBA divers, and 1 was a Navy diver who
used closed breathing systems.
Results: Follow-up was 6 to 30 months. Patients were age
16 to 71 years. None had known risk factors for BETD.
Otoscopy and tympanometry were normal prior to the procedure. ETD-specific questionnaire scores averaged 4.32 (range,
2.86-7) before the intervention and 2.3 (1-3.86) after (P <
.001). The 3 recreational divers resumed diving without further issues. The Navy diver improved but remained symptomatic. Of the 11 other patients, symptoms were completely
resolved in 6 patients, symptoms were unchanged in 2 patients,
and 3 patients had partial relief from symptoms. The other
3 patients were happy to have undergone the procedure.
Conclusions: BET can be an effective treatment for BETD,
including in divers. The adequate diagnostic tools for BETD
have yet to be agreed on.

Otology/Neurotology

Poster Presentations

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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