For many years, tympanostomy tubes were the only available treatment. “Although generally quite safe, this invasive procedure has the potential to produce sequelae, including tympanic membrane perforation, scarring, and hearing loss,” Dr. McCoul said. “Previous generations of otolaryngologists practiced catheterization and irrigation of the Eustachian tube, but this was eventually abandoned due to ineffectiveness.”
But three coinciding advancements have enabled treatment of the relatively large number of patients who suffer from Eustachian tube dysfunction with a procedure that uses a balloon to dilate the Eustachian tube, said Ralph Metson, MD, professor of otology and laryngology at Harvard Medical School and director of the rhinology fellowship program at Massachusetts Eye and Ear Infirmary in Boston. These advancements include a new theory about the pathophysiology of Eustachian tube dysfunction (i.e., that the nasopharyngeal end of the Eustachian tube, not the more proximal bony segment, is the site of obstruction); new endoscopic equipment for better visualization to diagnose the problem; and new tools for enlarging the Eustachian tube opening (initially lasers and microdebriders, now balloons).
In addition, a diagnostic tool that reliably identifies and measures Eustachian tube dysfunction—the Eustachian Tube Dysfunction Questionnaire (ETDQ-7)—is now available (Laryngoscope. 2012;122:1137-1141). “A clinician can use the short, validated symptom score to both identify Eustachian tube dysfunction and assess the response to treatment in adult patients,” said Dr. McCoul, one of the tool’s developers and co-author of a paper about the assessment tool.