- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01661777
Refractory Eustachian Tube Dysfunction: Are the Symptoms Related to Endolymphatic Hydrops
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.
Hypothesis:
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.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Tennessee
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Nashville, Tennessee, United States, 37212
- Vanderbilt University Medical Center--Division of Neurotology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Any male or female patient 18-70 years old diagnosed with Eustachian tube dysfunction, as determined by clinical evaluation of symptoms and positive ETDQ-7.
- Non-smoker
- Normotensive or hypertensive (systolic blood pressure >115, diastolic blood pressure >75)
- Normal renal function (Cr <1.00)
- Not currently on acetazolamide
- Not currently on a low salt diet
- Competent in decision making process and able to sign a written informed consent form.
- No other previous alternative otologic diagnosis
Exclusion Criteria:
- Smoking
- Kidney disease (Cr >1.00)
- Hypotension (systolic blood pressure <115, diastolic blood pressure <75)
- Strong history of vascular disease (heart attack, stroke, heart failure, peripheral vascular disease i.e. claudication, gangrene, amputation)
- Alternative otologic diagnosis (Meniere's disease)
- Allergy or adverse reaction to previous administration of hydrochlorothiazide/triamterene
- Concurrent aspirin use
- Current or planned pregnancy during the course of the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Nasal steroid and Antihistamine
Patients with ETD will be given nasal steroid and antihistamine for 8 weeks.
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Active Comparator: Myringotomy tubes
Patients who fail nasal steroid and antihistamine treatment will have myringotomy tubes placed.
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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
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Improvement in patient ETD symptoms with nasal steroid and antihistamine alone
Time Frame: 2 years
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Determine the degree to which ETD symptoms are relieved with nasal steroid and antihistamine alone.
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2 years
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Improvement in patient ETD symptoms with pressure equalization tubes
Time Frame: 2 years
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Determine the degree to which patient's symptoms related to ETD improve after placement of pressure equalization tubes.
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2 years
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Improvement in patients with refractory ETD symptoms with treatment for endolymphatic hydrops with a diuretic and low salt diet
Time Frame: 2 years
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Determine the degree of improvement of patient symptoms in the setting of refractory ETD after a low salt diet and diuretic treatment.
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2 years
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- JR08012012112856
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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