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.

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

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.

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.

Hereditary haemorrhagic telangiectasia (HHT) is characterised by recurrent, severe epistaxis. While nasal closure is a relatively well-established treatment for HHT patients with intractable epistaxis, recent studies highlight the efficacy of bevacizumab in this subgroup. We aim to evaluate the effectiveness of nasal closure for patients with contraindications to bevacizumab.

A case series of five patients with HHT and severe refractory transfusion-dependent epistaxis who were treated with nasal closure.

All patients had subjective improvement in epistaxis. Haemoglobin concentrations increased in all patients, with none requiring transfusion for epistaxis post-operatively. Four patients experienced complete cessation in epistaxis. Four returned positive Glasgow Benefit Inventory scores.

Nasal closure appears to be a safe and effective option for the management of epistaxis in patients with severe, refractory HHT-related epistaxis. Treatment improved quality of life, reduced severity of epistaxis and increased haemoglobin concentrations. Nasal closure should be considered for HHT patients with severe, refractory epistaxis, particularly in cases where bevacizumab is contraindicated.