Balloon Dilation for Chronic Eustachian Tube Dysfunction Under Local and General Anesthesia: A Systematic Review and...

Area of Science:

• Otolaryngology
• Interventional Pulmonology

Background:

• Increasing publications evaluate balloon dilation of the eustachian tube (BDET) for chronic eustachian tube dysfunction (ETD).
• Eustachian tube dysfunction significantly impacts patient quality of life.
• Need for comprehensive efficacy assessment of BDET, including anesthesia type.

Purpose of the Study:

• To evaluate the overall efficacy of BDET in treating chronic ETD.
• To perform a subgroup analysis comparing BDET under local anesthesia (LA) versus general anesthesia.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials and prospective studies (Jan 2010-Oct 2025) from PubMed, EMBASE, and Cochrane.
• Included studies used validated outcome measures, primarily the ETD Questionnaire (ETDQ-7).
• Analyzed 6 studies for meta-analysis and 7 for LA protocols and complications.

Main Results:

• Meta-analysis of 309 patients showed a significant decrease in ETDQ-7 scores by 2.03 points one year post-BDET (P < .001).
• Studies using local anesthesia (LA) demonstrated no significant difference in otologic outcomes (tympanometry/ETDQ-7).
• BDET under LA reported minimal complications and high patient willingness to undergo the procedure.

Conclusions:

• Balloon dilation of the eustachian tube (BDET) is an effective treatment for chronic ETD.
• BDET performed under local anesthesia (LA) is safe and comparable to procedures under general anesthesia when patient selection and protocols are optimized.
• LA offers a viable alternative for BDET, potentially improving patient experience and accessibility.