Office-Based LA-BET Without Sedation or Nerve Block: Prospective Evaluation of a Simplified Local Anesthesia Protocol

Area of Science:

• Otolaryngology
• Surgical Innovation
• Anesthesiology

Background:

• Obstructive eustachian tube dysfunction (OETD) impacts quality of life.
• Balloon eustachian tuboplasty (BET) is an established treatment.
• Feasibility of BET under local anesthesia (LA) with simplified protocols is understudied.

Purpose of the Study:

• To assess the feasibility of a streamlined LA-BET protocol.
• To evaluate patient comfort and outcomes using minimal analgesia.
• To determine the safety and efficacy of LA-BET for OETD.

Main Methods:

• Fifty patients with OETD underwent BET under LA.
• Protocol included intramuscular ketorolac and topical lidocaine gel.
• No sedation or nerve blocks were administered.

Main Results:

• Significant improvement in Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores (p < 0.001).
• High rates of minimal clinically important difference (90.6%) and normalization (75.0%) in ETDQ-7 scores.
• Improved Valsalva maneuver success (39.1% to 76.6%) and tympanogram types (64.1% to 84.4%).
• Mean pain scores were low (≤3.5) throughout the procedure.
• High patient acceptance (96% would repeat LA-BET).

Conclusions:

• Streamlined LA-BET using ketorolac and lidocaine is safe, tolerable, and effective.
• The protocol achieves significant symptom relief and functional improvement.
• This approach offers a practical, non-sedated outpatient option for OETD management.