Obstructive Eustachian tube dysfunction (OETD) is a common condition resulting from inadequate opening of the Eustachian tube (ET). A new surgical treatment involves high-pressure inflation of a balloon within the ET, with the aim of dilating the soft tissue structure. However, the mechanical effects of this intervention have not been established, nor the impact of changing device size or other technical parameters. A novel experimental technique allowed quantification of plastic and elastic tissue deformation in model materials and then human cadaver ETs during balloon dilation, based on the measured balloon inflation pressure-volume relationship. Plastic tissue deformation was found to be greater using larger balloons and deeper device insertion, but increasing the inflation pressure had a more limited effect, with most deformation occurring well below the clinically used pressures. Histological assessment of ET tissue suggested that mucosal tearing and cartilage cracking were in part responsible for the mechanical changes. Balloon dilation of the ET has huge potential if found to be clinically effective, but currently there is a need to understand and develop the technique further. The novel methods employed in this study will be valuable in future laboratory and in vivo studies of ET balloon dilation. Pressures are reported in Bar as this unit is used for medical balloon dilation procedures in clinical practice. 1 Bar = 100,000 Pa. Graphical abstract caption Dilation of the Eustachian tube for obstructive dysfunction is performed clinically with 3- and 6-mm-diameter balloons of approximately the same overall length. Our data suggest that dilation with a 6-mm balloon causes greater deformation of the soft tissue structure than dilation with a 3-mm balloon. This difference has yet to be demonstrated clinically. Plastic deformation was measured in terms of energy (J) dissipated during balloon inflation.

中文翻译：

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球囊咽鼓管成形术的机制：一项生物力学研究。

阻塞性咽鼓管功能障碍（OETD）是由于咽鼓管（ET）开口不充分导致的常见病状。一种新的外科治疗方法是在ET内对球囊进行高压充气，目的是扩张软组织结构。但是，尚未确定这种干预的机械效果，也没有确定更改设备尺寸或其他技术参数的影响。一种新的实验技术，可以根据测得的球囊充气压力-体积关系，对模型材料中的塑性和弹性组织变形进行量化，然后对人体尸体ET进行量化。发现使用较大的球囊和更深的设备插入时，塑性组织变形会更大，但增加充气压力的效果更有限，大多数变形远低于临床使用的压力。ET组织的组织学评估表明，粘膜撕裂和软骨破裂是造成机械变化的部分原因。如果发现ET球囊扩张术具有临床潜力，则具有巨大潜力，但是目前需要进一步了解和发展该技术。这项研究中使用的新方法将在未来的ET球囊扩张的实验室和体内研究中有价值。压力以巴表示，因为该单位用于临床实践中的医疗球囊扩张手术。1 Bar = 100,000 Pa。图形说明咽鼓管扩张术用于梗阻性功能障碍的临床方法是，使用直径大致相同的3毫米和6毫米气球。我们的数据表明，用6毫米球囊扩张比使用3毫米球囊扩张引起的软组织结构变形更大。这种差异尚待临床证明。根据气球膨胀过程中耗散的能量（J）来测量塑性变形。