Eustachian tube dysfunction is a chronic condition that typically develops in childhood.

Childhood anatomy, by default, increases the risk of eustachian tube dysfunction. In children, the eustachian tube is more horizontal which limits the function and improves into adulthood as the eustachian tube becomes more vertical.

A dysfunctional eustachian tube creates negative pressure in the middle ear space. This negative pressure creates an environment of the middle ear which increases the risk of fluid collection and infection. In children, the treatment is very often the placement of a pressure equalization tube. Chronically eustachian tube dysfunction can not only cause recurrent ear infections but further complications such as tympanic membrane retraction, cholesteatoma and hearing loss. Sometimes surgical intervention is required to correct the developed complications of eustachian tube dysfunction. Once significant damage has occurred a patient will often undergo tympanoplasty with or without mastoidectomy.

Treatment for eustachian tube dysfunction is managed medically as well. Patients are encouraged to avoid environmental toxins such as cigarette smoke and control environmental allergies.

Patients may also consider dilation of the eustachian tube by using a minimally invasive balloon. Eustachian tube balloon dilation is used to help prevent complications of eustachian tube dysfunction and may also be used to prevent postsurgical recurrence of disease.

Eustachian tube balloon dilation is a procedure that may be done under general anesthesia at the hospital or under local anesthesia in the office.

When done in the office, the inside of a patient’s nose is topically anesthetized, and patients will often take a small amount of pain medication and a medication to reduce any anxiety. Patients are fully awake during the procedure and typically do not feel any pain, only mild pressure. Once the patient is comfortable, an endoscope along with the device is inserted into the nasal cavity. The endoscope is advanced and the eustachian tube orifice is identified in the back of the nose. The balloon is then inserted into the eustachian tube and inflated to an elevated pressure for two minutes. The balloon is then deflated and removed from eustachian tube and the procedure is often repeated on the opposite side. Patients can return to work the following day. After the procedure, patients may experience mild nasal congestion and/or nasal crusting. If this occurs patients, may use over-the-counter allergy medications, nasal saline rinse and decongestant nasal spray (only 3 days). The patient may resume normal activity and is encouraged to auto insufflate (pinch nose and close mouth while exhaling).

Benefits of a procedure include reduced ear infections, tolerance to scuba diving and airplane travel and reduced pressure associated with season change.