Hostname: page-component-cb9f654ff-d5ftd Total loading time: 0 Render date: 2025-08-06T06:09:05.615Z Has data issue: false hasContentIssue false

Local anaesthetic Eustachian tube balloon dilatation: a prospective case-series analysis of 31 patients

Published online by Cambridge University Press:  07 April 2025

Edward Balai*
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
Elizabeth Bullock
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
Talisa Ross
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
Mark Ferguson
Affiliation:
Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
*
Corresponding author: Edward Balai; Email: Edward.balai@nhs.net

Abstract

Objectives

Eustachian tube balloon dilatation performed for obstructive Eustachian tube dysfunction can lead to improvements in symptoms and a reduction in Eustachian Tube Dysfunction Questionnaire-7 scores. While historically performed under general anaesthetic, studies have demonstrated that Eustachian tube balloon dilatation can be performed under local anaesthetic with equivalent efficacy. We describe our local anaesthetic protocol used to perform Eustachian tube balloon dilatation in the out-patient setting and report outcomes from our case series.

Methods

Prospective analysis of all patients undergoing Eustachian tube balloon dilatation between October 2019 and July 2024.

Results

Thirty-one patients underwent 40 dilatations under local anaesthetic. All were well tolerated, with no adverse events. There was a statistically significant decrease in the average total Eustachian Tube Dilatation Questionnaire-7 score of -6.75 points (p = 0.0029) at short-term follow-up and of -7.58 points (p = 0.034) at long-term follow-up.

Conclusion

Our study provides further evidence that Eustachian tube balloon dilatation for obstructive Eustachian tube dysfunction can improve Eustachian Tube Dilatation Questionnaire-7 scores, and can be performed successfully under local anaesthetic in the out-patient setting.

Information

Type
Main Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Bluestone, CD. Introduction. In: Bluestone, MB, ed. Eustachian Tube: Structure, Function, Role in Otitis Media. New York: B C Decker, 2005;1-9Google Scholar
Browning, GG, Gatehouse, S. The prevalence of middle ear disease in the adult British population. Clin Otolaryngol 1992;17:317–21Google Scholar
Teixeira, MS, Swarts, JD, Alper, CM. Accuracy of the ETDQ-7 for identifying persons with Eustachian Tube Dysfunction. Otolaryngol Head Neck Surg 2018;158:83–9Google Scholar
McCoul, ED, Anand, VK, Christos, PJ. Validating the clinical assessment of Eustachian tube dysfunction: the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope 2012;122:1137–41Google Scholar
Schilder, AG, Bhutta, MF, Butler, CC, Holy, C, Levine, LH, Kvaerner, KJ, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol 2015;40:407–11Google Scholar
Ockermann, T, Reineke, U, Upile, T, Ebmeyer, J, Sudhoff, HH. Balloon dilatation Eustachian tuboplasty: a clinical study. Laryngoscope 2010;120:1411–6Google Scholar
Catalano, PJ, Jonnalagadda, S, Yu, VM. Balloon catheter dilatation of Eustachian tube: a preliminary study. Otol Neurotol 2012;33:1549–52Google Scholar
Froehlich, MH, Le, PT, Nguyen, SA, McRackan, TR, Rizk, HG, Meyer, TA. Eustachian tube balloon dilatation: a systematic review and,eta-analysis of treatment outcomes. Otolaryngol Head Neck Surg 2020;163:870–82Google Scholar
Meyer, TA, O’Malley, EM, Schlosser, RJ, Soler, ZM, Cai, J, Hoy, MJ, et al. A randomized controlled trial of balloon dilatation as a treatment for persistent Eustachian tube dysfunction with 1-year follow-up. Otol Neurotol 2018;39:894902Google Scholar
Toivonen, J, Dean, M, Kawai, K, Poe, D. Comparison of outcomes for balloon dilatation of the Eustachian tube under local vs general anesthesia. Laryngoscope Investig Otolaryngol 2022;7:1120–8Google Scholar
Luukkainen, V, Kivekäs, I, Hammarén-Malmi, S, Rautiainen, M, Pöyhönen, L, Aarnisalo, A, et al. Balloon Eustachian tuboplasty under local anesthesia: is it feasible? Laryngoscope 2017;127:1021–5Google Scholar
Chen, X, Xie, L, Zeng, H, Xu, Y, Xiong, H. Local versus general anesthesia for balloon dilatation of the Eustachian tube: a single-center retrospective study in a Chinese population. Ear Nose Throat J 2020:145561320923172Google Scholar
Tucci, DL, McCoul, ED, Rosenfeld, RM, Tunkel, DE, Batra, PS, Chandrasekhar, SS, et al. Clinical consensus statement: balloon dilatation of the Eustachian tube. Otolaryngol Head Neck Surg 2019;161:617Google Scholar
Stryker XprESS ENT dilatation system. https://www.stryker.com/gb/en/ent/products/xpress.html [17 March 2024]Google Scholar
Froehlich, MH, Le, PT, Nguyen, SA, McRackan, TR, Rizk, HG, Meyer, TA. Eustachian tube balloon dilatation: a systematic review and meta-analysis of treatment outcomes. Otolaryngol Head Neck Surg 2020;163:870–82Google Scholar
Ungar, OJ, Demir Bajin, MD, Dahm, V, Lin, VYW, Chen, JM, Le, TN. Balloon dilation of the Eustachian tube using endovascular balloon under local anesthesia-a case series and systematic literature review. Front Surg 2024;11:1271248Google Scholar
Sheppard, SC, Beckmann, S, Caversaccio, M, Anschuetz, L. In-office Eustachian tube balloon dilation under local anesthesia as a response to operating room restrictions associated with the COVID-19 pandemic. Front Surg 2023;10:1033010.Google Scholar
Keschner, D, Garg, R, Loch, R, Luk, LJ. Repeat Eustachian tube balloon dilatation outcomes in adults with chronic Eustachian tube dysfunction. Otolaryngol Head Neck Surg 2022;166:951–6Google Scholar
Møller, MN, Berthelsen, D, Svahn, M. In-office Eustachian tube dilation reduces symptoms among patients with barometric challenges. Laryngoscope 2025;135:361–5Google Scholar
Raymond, MJ, Shih, MC, Elvis, PR, Nguyen, SA, Brennan, E, Meyer, TA, et al. A systematic review of Eustachian tube procedures for baro-challenge Eustachian tube dysfunction. Laryngoscope 2022;132:2473–83Google Scholar
Dean, M. In-office balloon dilatation of the Eustachian tube under local anesthesia: a retrospective review. World J Otorhinolaryngol Head Neck Surg 2019;5:143–7Google Scholar
Toivonen, J, Dean, M, Kawai, K, Poe, D. Comparison of outcomes for balloon dilatation of the Eustachian tube under local vs general anesthesia. Laryngoscope Investig Otolaryngol 2022;7:1120–8Google Scholar
Ramakrishnan, N, D’Souza, R, Kadambi, P. A systematic literature review of the safety and efficacy of Eustachian balloon tuboplasty in patients with chronic Eustachian tube dysfunction. Indian J Otolaryngol Head Neck Surg 2019;71:406–12Google Scholar