Managing eustachian tube dysfunction with balloon catheterization: A local experience report

Objective: Eustachian tube dysfunction (ETD) is not commonly acknowledged until it leads to sequelae within the middle ear. Thus, treatments are focusing on treating active middle ear diseases repetitively rather than identifying possible fundamental causes. This study aims to report a preliminary local experience in treating ETD using balloon dilatation. Methods: This prospective, randomized controlled study was conducted in a tertiary academic center. Sixteen patients who were identified with symptoms of ETD were recruited. Six who had failed initial medical therapy underwent balloon dilatation of Eustachian tube (BDET); meanwhile, ten subjects were recruited into the medical treatment group. The primary efficacy endpoint was the comparison of reduction from baseline in overall 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score. Added endpoints were normalization of tympanogram and improvement of tympanic membrane appearance at 2 weeks, 6 weeks, and 3 months after intervention. Results: The median in reduction of overall ETDQ-7 score for the interventional group was 2.93 (2.14, 3.14) versus 0.43 (0, 0.86) for the control group. Reduction in overall ETDQ-7 score showed a significant improvement at 6 weeks which was persistent at 3 months post balloon dilatation (P < 0.05). Similarly, the BDET group demonstrated changes in tympanogram at 6 weeks and 3 months post balloon dilatation (P < 0.05). Tympanic membrane appearances were similar at the end of the study in both the groups. Conclusion: BDET is a promising precise treatment for patients who present with symptoms of ETD. The improvement of symptoms it provides may increase the readiness for it to be introduced as a standard practice in local settings and beyond.