Balloon Dilation Is Among the New Frontier of Eustachian Tube Care

by Renée Bacher •

“It’s something to definitely consider and counsel patients about,” she said.

Renée Bacher is a freelance medical writer based in Louisiana.

 

BDET Best Practices

According to Dennis Poe, MD, PHD, a professor of otolaryngology at Harvard Medical School and Boston Children’s Hospital, the following are best practices when considering balloon dilation Eustachian tuboplasty.

  • Accurate diagnosis of obstructive Eustachian tube dysfunction. One of the main symptoms is aural fullness, but there are several other conditions that can cause this symptom, and it isn’t always easy to make sure this is true obstructive Eustachian tube dysfunction.
  • Optimal medical management. Be sure the underlying medical condition (for instance, allergic disease) has been adequately treated and controlled.
  • Appropriate patient selection. Be sure you’re picking patients who will be good candidates for this procedure. Someone with a chronic disease that isn’t in remission (e.g., aspirin-exacerbated respiratory disease) has a mucosal disease that the balloon won’t help.
  • Don’t overtreat. Be sure the balloon treatment is commensurate with the severity of the pathology.
  • Understand complication risks. Think ahead to avoid complications, and be aware of adjacent neurovascular structures—for example, make sure the balloon doesn’t get into the bony part of the Eustachian tube near the carotid artery, and insert the balloon slowly so you don’t get a false passage.
  • Justify the expense. This is an expensive treatment, and insurance companies are all over the place on coverage. You may need to explain why the patient is not a good candidate for tympanostomy tubes. The perfect case is someone who has already had tubes that have fallen out.