{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T17:54:41Z","timestamp":1772387681844,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"BMBF RESPONSE","doi-asserted-by":"publisher","award":["03ZZ0922E"],"award-info":[{"award-number":["03ZZ0922E"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"BMBF RESPONSE","doi-asserted-by":"publisher","award":["03ZZ0931E"],"award-info":[{"award-number":["03ZZ0931E"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"BMBF RESPONSE","doi-asserted-by":"publisher","award":["03ZZ0931B"],"award-info":[{"award-number":["03ZZ0931B"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"BMBF RESPONSE","doi-asserted-by":"publisher","award":["03ZZ0922B"],"award-info":[{"award-number":["03ZZ0922B"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Unmet needs in the treatment of chronic otitis media and Eustachian tube dysfunction (ETD) triggered the development of stents for the Eustachian tube (ET). In this study, for the first time, stents were placed in an artificially blocked ET to evaluate stent function. Eight adult female sheep were injected with stabilized hyaluronic acid (HA) on both sides to induce ETD. Subsequently, a tapered nitinol ET stent was inserted on one side, and animals were examined bilaterally by endoscopy, tympanometry, cone beam computed tomography, and final histology. Seven of the stents were placed in the desired cartilaginous portion of the ET. At the end of the study, one stented side appeared slightly open; all other ET orifices were closed. Tympanometry revealed re-ventilation of the middle ear in four out of seven correctly stented animals within 3 to 6 weeks after stent insertion. The major amount of HA was found at the pharyngeal orifice of the ET anterior to the stent. Thus, the stent position did not completely align with the HA position. While a functional analysis will require refinement of the experimental setup, this study provides first promising results for stent insertion in a sheep model of ETD.<\/jats:p>","DOI":"10.3390\/bioengineering11101015","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T04:02:58Z","timestamp":1728878578000},"page":"1015","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["First Investigation of a Eustachian Tube Stent in Experimentally Induced Eustachian Tube Dysfunction"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7259-3349","authenticated-orcid":false,"given":"Katharina","family":"Schmitt","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malena","family":"Timm","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"bess pro GmbH, Gustav-Krone-Str. 7, 14167 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels","family":"Oppel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Napp","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friederike","family":"Pohl","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-4566","authenticated-orcid":false,"given":"Robert","family":"Schuon","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"K\u00f6tter","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Bankstahl","sequence":"additional","affiliation":[{"name":"Institute for Laboratory Animal Science and Central Animal Facility, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Institute of Pharmacology and Toxicology, Department of Biological Sciences and Pathobiology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9307-5989","authenticated-orcid":false,"given":"Thomas","family":"Lenarz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Cluster of Excellence Hearing4all, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Stein","sequence":"additional","affiliation":[{"name":"bess pro GmbH, Gustav-Krone-Str. 7, 14167 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerrit","family":"Paasche","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Cluster of Excellence Hearing4all, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.otc.2016.05.002","article-title":"Anatomy of the Eustachian Tube","volume":"49","author":"Leuwer","year":"2016","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Schuon, R., Schwarzensteiner, J., Paasche, G., Lenarz, T., and John, S. (2021). Functional Aspects of the Eustachian Tube by Means of 3D-Modeling. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0244909"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1001\/archotol.1973.00780010006002","article-title":"Anatomy of the Eustachian Tube","volume":"97","author":"Proctor","year":"1973","journal-title":"Arch. Otolaryngol.-Head Neck Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1002\/lary.24894","article-title":"Histopathology of balloon-dilation eustachian tuboplasty","volume":"125","author":"Chao","year":"2015","journal-title":"Laryngoscope"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.anorl.2017.03.010","article-title":"Tubotympanic system functioning","volume":"134","author":"Martin","year":"2017","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00234-016-1663-4","article-title":"Imaging of the Eustachian tube and its function: A systematic review","volume":"58","author":"Smith","year":"2016","journal-title":"Neuroradiology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/coa.12475","article-title":"Eustachian tube dysfunction: Consensus statement on definition, types, clinical presentation and diagnosis","volume":"40","author":"Schilder","year":"2015","journal-title":"Clin. Otolaryngol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta18460","article-title":"Interventions for adult Eustachian tube dysfunction: A systematic review","volume":"18","author":"Llewellyn","year":"2014","journal-title":"Health Technol. Assess."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s00106-013-2692-5","article-title":"Aktueller Stand der Tubenfunktionsdiagnostik: Ein Update","volume":"61","year":"2013","journal-title":"HNO"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/01.mlg.0000246227.65877.1f","article-title":"Laser eustachian tuboplasty: Two-year results","volume":"117","author":"Poe","year":"2007","journal-title":"Laryngoscope"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1177\/0194599817753609","article-title":"Comparison of Balloon Dilation and Laser Eustachian Tuboplasty in Patients with Eustachian Tube Dysfunction: A Meta-analysis","volume":"158","author":"Wang","year":"2018","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1177\/0194599814567105","article-title":"Balloon Eustachian Tuboplasty: A Systematic Review","volume":"152","author":"Randrup","year":"2015","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1002\/lary.20950","article-title":"Balloon dilatation Eustachian Tuboplasty: A clinical study","volume":"120","author":"Ockermann","year":"2010","journal-title":"Laryngoscope"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1097\/MAO.0b013e3181e8cc6d","article-title":"Balloon dilation eustachian tuboplasty: A feasibility study","volume":"31","author":"Ockermann","year":"2010","journal-title":"Otol. Neurotol."},{"key":"ref_15","first-page":"104208","article-title":"Long-term efficacy of balloon dilation of the pediatric Eustachian tube: A six-year matched cohort study","volume":"45","author":"Gurberg","year":"2024","journal-title":"Am. J. Otolaryngol.-Head Neck Med. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Todt, I., Oppel, F., and Sudhoff, H. (2021). Sensorineural Hearing Loss After Balloon Eustachian Tube Dilatation. Front. Surg., 8.","DOI":"10.3389\/fsurg.2021.615360"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40463-016-0126-6","article-title":"Balloon dilation of the eustachian tube: A tympanometric outcomes analysis","volume":"45","author":"Williams","year":"2016","journal-title":"J. Otolaryngol.-Head Neck Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1017\/S0022215116008252","article-title":"Balloon dilation for eustachian tube dysfunction: Systematic review","volume":"130","author":"Hwang","year":"2016","journal-title":"J. Laryngol. Otol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1177\/01945998211037975","article-title":"Repeat Eustachian Tube Balloon Dilation Outcomes in Adults with Chronic Eustachian Tube Dysfunction","volume":"166","author":"Keschner","year":"2022","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3152","DOI":"10.1002\/lary.30659","article-title":"Patulous Eustachian Tube Dysfunction Symptoms Following Balloon Dilation","volume":"133","author":"Hubbell","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1002\/lary.30399","article-title":"Reconstruction of the Obliterated Eustachian Tube: A Pilot Case Series","volume":"133","author":"Toivonen","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1002\/lary.24320","article-title":"Stenting of the eustachian tube to prevent otitis media with effusion after maxillary swing approach nasopharyngectomy","volume":"124","author":"Ho","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1002\/alr.23223","article-title":"Endoscopic endonasal recanalization of the obliterated eustachian tube via ureteral stent","volume":"14","author":"Pool","year":"2024","journal-title":"Int. Forum Allergy Rhinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13005-018-0165-5","article-title":"Stenting the Eustachian tube to treat chronic otitis media\u2014A feasibility study in sheep","volume":"14","author":"Pohl","year":"2018","journal-title":"Head Face Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kang, J.M., Kim, S.H., Ryu, D.S., Park, Y., Won, D.-S., Kim, J.W., Zeng, C.H., Kang, W.S., Park, J.-H., and Park, H.J. (2022). Tapered self expandable metallic stent optimized for Eustachian tube morphology in a porcine ET model. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-24615-6"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Rosenbusch, L., Schuon, R., Wilfing, T., Kr\u00fcger, P., Lebahn, K., John, S., Sahmel, O., Grabow, N., Schulze, M., and Were, A. (2023). Investigation of Stent Prototypes for the Eustachian Tube in Human Donor Bodies. Bioengineering, 10.","DOI":"10.3390\/bioengineering10060743"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1016\/j.jvir.2018.03.029","article-title":"Transnasal Placement of a Balloon-Expandable Metallic Stent: Human Cadaver Study of the Eustachian Tube","volume":"29","author":"Park","year":"2018","journal-title":"J. Vasc. Interv. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Schmitt, K., Timm, M., Kr\u00fcger, P., Oppel, N., Napp, A., Pohl, F., Schuon, R., Kampmann, A., K\u00f6tter, L., and Bankstahl, M. (2024). Long-Term Preclinical Evaluation of a Permanent Stent Developed for the Human Eustachian Tube. Bioengineering, 11.","DOI":"10.3390\/bioengineering11080755"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Oppel, N., Ezzat, M., Kr\u00fcger, P., Schmitt, K., Napp, A., Pohl, F., Bleich, A., Lenarz, T., Stein, T., and Paasche, G. (2022). Development of an In Vivo Model for Eustachian Tube Dysfunction. Bioengineering, 9.","DOI":"10.3390\/bioengineering9070317"},{"key":"ref_30","first-page":"1225","article-title":"Restylane Lyft for Aesthetic Shaping of the Nasal Dorsum and Radix: A Randomized, No-Treatment Control, Multicenter Study","volume":"150","author":"Wang","year":"2022","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1111\/jocd.12916","article-title":"A multi-center comparative efficacy and safety study of two different hyaluronic acid fillers for treatment of nasolabial folds in a Chinese population","volume":"18","author":"Li","year":"2019","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1002\/lary.24250","article-title":"Endoscopic hydroxyapatite augmentation for patulous eustachian tube","volume":"124","author":"Vaezeafshar","year":"2014","journal-title":"Laryngoscope"},{"key":"ref_33","unstructured":"Hartog, J.F. (2018). Clinical Results of the Treatment of Patulous Eustachian Tube Byaugmentation of the Epipharyngeal Tubal Ostium with Hyaluronic Acid. [Ph.D. Thesis, Universit\u00e4tsklinikum Hamburg-Eppendorf]."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Miller, F., Burghard, A., Salcher, R., Scheper, V., Leibold, W., Lenarz, T., and Paasche, G. (2014). Treatment of middle ear ventilation disorders: Sheep as animal model for stenting the human Eustachian tube\u2014A cadaver study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0113906"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1080\/14992027.2016.1227480","article-title":"Tympanometric measurements in conscious sheep\u2014A diagnostic tool for pre-clinical middle ear implant studies","volume":"56","author":"Pohl","year":"2017","journal-title":"Int. J. Audiol."},{"key":"ref_36","unstructured":"Kr\u00fcger, P., Lange, S.K., Lenarz, T., Paasche, G., and Schuon, R. (2021). Applikator and Stent for a Eustachian Tube. (No. DE102020116795A1), Patent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/j.mri.2012.05.001","article-title":"3D Slicer as an image computing platform for the Quantitative Imaging Network","volume":"30","author":"Fedorov","year":"2012","journal-title":"Magn. Reson. Imaging"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Oppel, N., Paasche, G., Bleich, A., Lenarz, T., and Schuon, R. (2022). Intravascular Ultrasonography (IVUS)\u2014A Tool for Imaging the Eustachian Tube?. Bioengineering, 9.","DOI":"10.3390\/bioengineering9120733"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kang, J.M., Kim, S.H., Choi, Y.J., Park, Y., Ryu, D.S., Kang, W.S., Park, J.-H., and Park, H.J. (2022). Sirolimus-eluting cobalt\u2013chrome alloy stent suppresses stent-induced tissue hyperplasia in a porcine Eustachian tube model. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-07471-2"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/0091-6749(83)90027-1","article-title":"Eustachian tube function: Physiology, pathophysiology, and role of allergy in pathogenesis of otitis media","volume":"72","author":"Bluestone","year":"1983","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1097\/mao.0b013e31804d4998","article-title":"Diagnosis and management of the patulous eustachian tube","volume":"28","author":"Poe","year":"2007","journal-title":"Otol. Neurotol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kim, Y., Kang, J.M., Ryu, D.S., Park, J.-H., Kang, W.S., and Park, H.J. (2022). Serial histological changes in the cartilaginous eustachian tube in the rat following balloon dilation. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268763"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"380","DOI":"10.2460\/javma.254.3.380","article-title":"Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse","volume":"254","author":"Weisse","year":"2019","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1007\/s00270-019-02239-0","article-title":"Balloon-Expandable Biodegradable Stents Versus Self-Expandable Metallic Stents: A Comparison Study of Stent-Induced Tissue Hyperplasia in the Rat Urethra","volume":"42","author":"Park","year":"2019","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Han, K., Park, J.-H., Yang, S.-G., Lee, D.H., Tsauo, J., Kim, K.Y., Kim, M.T., Gang, S.G., Kim, D.-K., and Kim, D.-H. (2018). EW-7197 eluting nano-fiber covered self-expandable metallic stent to prevent granulation tissue formation in a canine urethral model. 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