Feasibility and Safety of Transtympanic Balloon Dilatation of Eustachian Tube

Objective: Assess safety and feasibility of transtympanic dilatation of proximal (tympanic-end) of the cartilaginous segment of the Eustachian tube in patients undergoing surgery for chronic ear disease. Study Design: Case series. Setting: Tertiary care hospital. Subject and Methods: We reviewed the charts of 40 consecutive patients undergoing chronic ear surgery in our practice with manometric evidence of obstruction who underwent attempted transtympanic dilatation of proximal (tympanic-end) segment of the Eustachian tube. A range of outcome measures were reported that included pre and postdilatation opening pressure measurement of the Eustachian tube, closure of perforation, audiometric data, and complications. Results: Dilatation of proximal (tympanic-end) of the cartilaginous segment of the Eustachian tube was technically feasible in 37 of 40 patients (93%). Postdilatation inspection of protympanum showed increased aperture in all dilated tubes. Opening pressure of Eustachian tube declined in 36 of 37 patients (97%). Residual perforation was evident in 5 of 40 patients (12%). No facial nerve or carotid complications were observed. Two patients had severe dizziness (5%) with one patient sustaining severe cochlear loss. Conclusion: Transtympanic dilatation increases the patency of the Eustachian tube immediately after instrumentation. No carotid complications were observed. Continuous endoscopic control is essential to avoid subluxation of stapes. Further study of this technique is warranted to identify its role, if any, in chronic ear surgery.