Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube

Abstract

Objectives: Studies of Balloon Eustachian tuboplasty (BET) have shown encouraging results with short follow-up in small series. We present long-term results of a prospective study in which subjects act as their own controls. Our pilot study showed patients with prolonged otitis media with effusion (OME) or tendency to atelectatic tympanic membrane (TM) clearly benefit from BET. We chose this patient group for long-term follow-up. Methods: Out of 80 patients with BET, 42 consecutive adult patients were included. Subjects’ inclusion criteria were OME and/or tendency to atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had a 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 major complications. Follow-up was 1-3.5 years. Eighty-one percent (34/42) of patients were able to do a Valsalva maneuver after balloon dilation. Tympanometry Results showed clear improvement even though many patients have permanent damages in their TMs after longstanding ME ventilation problems. The successful patients did not need new tympanostomy tubes. Also, subjective symptoms were relieved. For 19% (8/42) the ET function did not recover. Conclusions: There is accumulating evidence that BET effectively improves ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues for these patients, and we investigate possible reasons for negative results.