Obstructive Eustachian tube dysfunction is the inability of the Eustachian tube to sufficiently open in order to ventilate the middle ear and can result in acute otitis media, or even chronic otitis media with or without cholesteatoma. Treatment of obstructive Eustachian tube dysfunction has traditionally been targeted at the tympanic membrane or the adenoid. Balloon dilation of the Eustachian tube has been shown to be safe and effective. However, the procedure has mostly been performed in adults and under general anesthesia.

In this study, we first studied the efficacy of balloon dilation of the Eustachian tube in pediatric patients. Next, we studied performing balloon dilation under local anesthesia in adults with a comprehensive anesthesia protocol. We examined the possibility of recanalization to restore normal function in patients with total obliteration of the Eustachian tube. Finally, in a multicenter study, we studied the risk of patulous dysfunction after dilation and determined risk factors for developing symptoms of patulous dysfunction.

We found that balloon dilation was a safe procedure in pediatric patients. The need for additional procedures was significantly lower in children treated with balloon dilation than with tympanostomy tube placement. In adults, the procedure was feasible under local anesthesia with significant improvement in middle ear ventilation. A procedure to recanalize a totally obliterated Eustachian tube was shown to be effective. After balloon dilation, the rate of patulous dysfunction symptoms was 7%. Pediatric patients, patients undergoing repeat dilation and patients with severe Eustachian tube mucosal inflammation were at a greater risk for patulous dysfunction after balloon dilation.

Balloon dilation of the Eustachian tube is safe and effective in pediatric patients and feasible under local anesthesia in adults. Total obstruction of the Eustachian tube can be surgically opened. There is a small risk for developing patulous dysfunction symptoms after the dilation procedure.