Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube

Otolaryngol Head Neck Surg. 2014 Jul;151(1):125-30. doi: 10.1177/0194599814529538. Epub 2014 Apr 4.


Objective: Studies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow-ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET.

Study design: A prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long-term follow-up.

Setting: Regional Academic Center.

Subjects and methods: Out of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects' inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy.

Results: All cases were dilated successfully, without significant complications. Mean follow-up was 2.5 years (range, 1.5-4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41).

Conclusion: The results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues and we are investigating possible reasons for failures.

Keywords: Eustachian tube; balloon dilation; secretory otitis media.

MeSH terms

  • Acoustic Impedance Tests
  • Adolescent
  • Adult
  • Cartilage / pathology
  • Catheterization* / methods
  • Dilatation / methods
  • Eustachian Tube* / pathology
  • Female
  • Follow-Up Studies
  • Hospitals, University
  • Humans
  • Male
  • Middle Aged
  • Middle Ear Ventilation
  • Otitis Media with Effusion / diagnosis
  • Otitis Media with Effusion / therapy*
  • Otoscopy / methods
  • Prospective Studies
  • Treatment Outcome
  • Tympanoplasty