Balloon Dilation of the Cartilaginous Eustachian Tube

Abstract

Dilation of the cartilaginous ET appeared to be beneficial and without significant adverse effects in the treatment of ET dilatory dysfunction. Larger controlled trials with long-term results are now justified and needed.

Balloon dilation for eustachian tube dysfunction: systematic review

“…Nine prospective studies, 4,6,[8][9][10][11][12][13][14] describing 713 eustachian tube balloon dilations in 474 patients (aged 18-86 years), were identified. Follow-up duration ranged from 1.5 to 18 months.…”

“…As a potential solution for this, eustachian tube balloon dilation (proposed as a treatment for chronic eustachian tube dysfunction) aims to ventilate and drain the middle ear by improving the physiological function of the eustachian tube. 6,10 The initial papers by Ockermann et al in 2010 5,6 and Poe et al in 2011 10,17 focused on establishing the safety of eustachian tube balloon dilation by performing both cadaveric and clinical studies. The cadaveric studies revealed no evidence of fractures to the cartilaginous or bony lumen, and no damage to the internal carotid artery.…”

“…These include a 5 × 16 mm balloon inflated to 8 atm for 30 seconds, 4 a 5 × 24 mm or 7 × 24 mm balloon (adjusted for individual patients) inflated to 10 atm for 2 minutes, 9 or a 7 × 16 mm balloon inflated to 12 atm for 1 minute. 10,12 Valsalva The ability to perform a Valsalva or Toynbee's manoeuvre pre-and post-eustachian tube balloon dilation was reported in seven studies. This improved from 20 (8 per cent) to 177 (72 per cent) out of 245 ears following eustachian tube balloon dilation, 6,8,[10][11][12]14 and, where data were reported in terms of patient numbers, from 15 (7 per cent) to 189 (90 per cent) out of 210 patients.…”

“…13 Tympanometry Tympanometry results were reported in six studies. [8][9][10][11][12]14 Tympanograms were classified as type A in 7 out of 141 ears (5 per cent) pre-operatively, and this improved to 86 out of 141 ears (61 per cent) post-operatively. Twelve of these classifications (9 per cent) were because of grommets being removed and/or tympanic membrane perforations healing.…”

“…Poe et al 10 reported 5 cases of minor mucosal lacerations in 11 eustachian tube balloon dilations Pre-op = pre-operative; post-op = post-operative; N/A = not applicable and 1 case of C6-C7 contralateral radiculopathy, the latter of which was thought to be caused by operative positioning.…”