Interventions for Obstructive Eustachian Tube Dysfunction: An Evidence-Based Umbrella Review of Efficacy and Safety

Obstructive eustachian tube dysfunction (ETD) contributes to a spectrum of middle ear disorders, including otitis media with effusion (OME), tympanic membrane retraction, and barochallenge-induced symptoms. This review summarizes evidence-based treatment outcomes, focusing on efficacy derived from systematic reviews and safety from additional sources. Medical management has no proven benefits for obstructive ETD. Tympanostomy tubes and adenoidectomy demonstrate age-specific effectiveness for pediatric OME with accepted risks. Some manifestations of ETD may benefit from balloon dilation of the eustachian tube (BDET), or sinonasal surgery, but much evidence is of low quality; indications, long-term benefits, and safety are not clearly established for BDET.