Balloon tuboplasty in patients with Eustachian tube dysfunction: a prospective study in 39 patients (55 ears).

Eustachian tube dysfunction (ETD) is estimated to affect approximately 1% of the UK population. ETD and subsequent inadequate middle ear ventilation have been implicated in the pathogenesis of otological diseases including otitis media with effusion (OME), retraction pockets, tympanic membrane (TM) perforation and cholesteatoma. Patients may present with vague, non-specific symptoms including aural fullness, tinnitus, discomfort or pain, hearing loss, or sensations of ‘muffled hearing’, ‘crackling and popping’ in the ears, ‘clogged ears’ or ‘feeling under water’. Symptoms may occur as a result of, or be exacerbated by, changes in atmospheric pressure. The cartilaginous portion of the Eustachian tube (ET) is thought to be the primary site of pathology. Mucosal inflammation of this segment and of the nasopharynx can lead to symptoms of ETD and, while management of ETD, should first be directed at associated inflammatory pathologies, and effective treatments are lacking. The application of topical intranasal steroids has been shown to confer no additional benefits when compared to placebo. Tympanostomy tubes may result in persistent otorrhoea, crusting, obstruction, chronic perforation, infection and extrusion leading to recurrent disease and repeat surgery. Balloon eustachian tuboplasty (BET) is aimed at catheterisation and dilatation of the cartilaginous portion of the ET. It is a minimally invasive procedure performed under general anaesthetic whereby the ET is accessed endonasally via the nasopharyngeal Eustachian opening. As the technique was first reported in 2010, it has attracted growing interest from the international ENT community as an effective treatment for ETD. We report the early results from a UK centre.