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Balloon Dilation of the Eustachian Tube for Adults With Chronic Obstructive Eustachian Tube Dysfunction: A
Poonam Raj1, Tulasi Kota Karanth2, Dennis Poe3
1Department of Otorhinolaryngology, Armed Forces Medical College, Pune, Maharashtra, India.
Objective:
Studies have shown balloon dilation of the Eustachian tube (BDET) to play a beneficial role in the treatment of obstructive Eustachian tube (ET) dysfunction in adults. This analysis was undertaken to clarify this role.
Data Sources:
Cochrane Central Register of Controlled Trials, PubMed, Embase Ovid, ClinicalTrials.gov, WHO-ICTRP, EU Clinical Trials Register, and Google Scholar.
Review Methods:
This review analyzed randomized controlled trials published through 29 February 2024, updated on 11 January 2025, comparing the effects of BDET with no treatment, medical treatment, or auto-inflation exercises. Outcomes included improvement in tympanogram, decrease in air-bone gap on audiometry, new ability to perform Valsalva, otoscopic confirmation of improvement in tympanic membrane retraction, or new documented mobility of the membrane on pneumatic otoscopy.
Results:
Eleven trials were analyzed, four excluded with reasons and seven included in the analysis. On analysis of 315 participants from three trials who underwent BDET in comparison to control, the relative risk of benefit of post-operatively reaching Type A tympanogram was 4.68 (2.88-7.51) in comparison to control. BDET was also seen to offer significantly more closure in air-bone gap when performed along with tympanoplasty in patients with adhesive otitis media at both 3-month (air-bone gap closure of 3.82 dB [0.47-7.17 dB]) and 6-month (air-bone gap closure of 4.06 dB [1.78-6.34 dB]).
Conclusion:
In adults with chronic ET dysfunction, BDET increased the chance of achieving a Type A tympanogram curve and significantly improved air-bone gap closure when performed along with cartilage tympanoplasty.
Level Of Evidence:
1a.
