Autologous lipoinjection of the patulous Eustachian tube: Harvesting, cellular analysis, clinical application and preliminary outcome

Objective: Autologous lipoinjection for patulous Eustachian tube dysfunction was investigated. We studied the technique of fat harvesting, fat tissue changes due to processing, clinical application and preliminary outcomes. Design: Prospective pilot cohort study. Methods: Transnasal endoscopic injection of autologous lipoinjection into the posterior cushin was performed in 8 patients as a new treatment option for patulous Eustachian tube. All patients were followed up 6 months after treatment. For each intervention, 2-3 ml of injectable soft-tissue bulking agent was used. Fat tissue changes due to processing were studied by confocal laser scanning microscopy. Results: In 2 patients, more than one procedure was necessary. 6 out of 8 patients were satisfied with the result in the follow up and only 1 patient reported no improvement of symptoms. The procedure was minimally invasive, fast and easy to perform. Implications: There is no gold standard for the therapy of patulous Eustachian tube. Autologous lipoinjection into the posterior cushin of the Eustachian tube is a new minimally invasive therapeutic approach. Given the emerging discussion regarding the type of surgical treatment of patulous Eustachian tube dysfunction on functional outcomes, this is an area for further research. Correspondence to: Prof. Holger Sudhoff, Department of Otolaryngology, Head and Neck Surgery, Bielefeld Academic Teaching Hospital, Teutoburger Str. 50, 33604 Bielefeld, Germany; Tel: +49 521/581-3301; Fax: +49 521/581-3399; E-mail: [email protected]