What is Eustachian Tube Dilation: Overview, Benefits, and Expected Results

Definition & Overview

Eustachian tube dilation is a recently developed technique used for the management of Eustachian tube dysfunction. The condition, which affects less than 1% of the population, can lead to cholesteatoma formation and conductive hearing loss, resulting in a compromised quality of life. In the past, there were few options in the treatment of the said condition, making the introduction of Eustachian tube dilation quite a breakthrough.

Who Should Undergo and Expected Results

The procedure is recommended for those who suffer from Eustachian tube dysfunction, also known as ETD.

The Eustachian tube refers to the narrow passage that runs from the pharynx to the middle ear cavity. It begins at the rear of the nose (near the soft palate) and goes upwards, all the way up to the middle ear. It is around 3 mm in diameter and 35 mm long in adults, with the first two-thirds made up of cartilage and the rest with bone. It is lined with tissue that is similar to that found in the nasal cavity.

The Eustachian tube is responsible for the proper ventilation of the middle ear region in order to maintain normal air pressure in the ears. Without it, the middle ear space would simply be a closed air pocket and very vulnerable to air pressure changes. It is also responsible for draining out any accumulated secretions or debris from the middle ear. The tube’s function, which requires it to open when necessary, is regulated by a number of small muscles located at the back of the throat.

However, some medical issues may cause the tube to remain open, in which case it can become blocked or obstructed. When this happens, the patient is at a higher risk of developing chronic middle ear infections and the tube will lose its ability to effectively regulate the air pressure within the ear, leading to several symptoms such as:

• Ear fullness
• Popping sensation inside the ear
• Moderate to severe ear pain
• Intense pain when experiencing sudden air pressure changes
• Muffled sounds
• Tinnitus or ringing in the ears
• Poor balance

Eustachian tube blockages are commonly caused by:

• Colds or other upper respiratory infections
• Sinus infections* Allergic reactions that can cause the tube’s tissue lining to become swollen
• Enlarged adenoids
• Mass or tumour at the base of the skull or nasopharynx

Blockages are particularly common among young children, whose tubes are narrower and in a more horizontal orientation than adults’. However, some children, such as those born with Down syndrome, may have excessively narrow tubes and are thus at high risk of Eustachian tube dysfunction.

As a blocked Eustachian tube does not function properly, it is likely that the air pressure in the ear will fall below normal levels, causing a vacuum to form inside leading to the fluid to be drawn inwards. This condition is identified as otitis media, a major risk factor for the common middle ear infection called suppurative otitis media.

According to studies, Eustachian tube dilation is effective in up to 70% of adults who suffer from long-term ETD.

How is the Procedure Performed?

In this procedure, an ENT specialist passes a tiny tube through the patient’s nose or mouth and guides it slowly into the Eustachian tube. Once there, the doctor inflates a 2 cm balloon located at the end of the catheter for about 2 minutes to dilate the tube and resolve any blockage issues.

Although not painful, the procedure is performed under general anaesthesia to make sure the patient is completely still throughout. For this reason, patients are placed in a recovery room after the procedure and are discharged a few hours after they wake up. They are not allowed to drive following the procedure and are thus advised to arrange for a ride home.

Patients may still have plugged ears immediately after the procedure, with their ears gradually clearing over a period of two weeks. During this recovery period, the patient is advised to perform Eustachian tube exercises, such as popping the ear.

Possible Risks and Complications

The procedure’s minor side effects include minor nosebleeds, an ear infection within the first two weeks following the procedure, and the temporary development of air particularly in the soft tissues located in the neck. The latter, however, occurs in only 2 to 3 cases out of 17,000 dilations.

There is a very small chance that the tip of the catheter used during the procedure will puncture the carotid artery. This may cause serious bleeding, arterial wall dissection, aneurysm, stroke, or even death. This is prevented by a small bone that separates the Eustachian tube from the carotid artery, but the risk of serious complications is higher in patients who do not have this bone in place.

References:

• Williams B., Taylor B., Clifton N., Bance M. “Balloon dilation of the Eustachian tube: a tympanometric outcomes analysis.” Journal of Otolaryngology – Head & Neck Surgery. 2016. https://journalotohns.biomedcentral.com/articles/10.1186/s40463-016-0126-6

• Llewellyn A., Norman G., Harden M. et al. ‘”Interventions for adult Eustachian tube dysfunction: a systematic review.” Health Technology Assessment. NIHR Journals Library. 2014 Jul. http://www.ncbi.nlm.nih.gov/books/NBK262265/

• Diaz R.C. “Patulous Eustachian tube and Eustachian tube dysfunction.” N Engl J Med 2009; 360:e27. http://www.nejm.org/doi/full/10.1056/NEJMicm073137#t=article

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**What is Eustachian Tube Dilation?**



The⁣ Eustachian tube is a small passageway that connects the middle ear to the back of the throat. When the tube​ is open, it allows air to pass through and equalize pressure in the middle ear. However, when the tube becomes blocked, it‌ can cause pain, hearing loss, ‌and dizziness.



Eustachian tube dilation is a procedure that helps‍ to open up the Eustachian tube. This can⁤ be done with a balloon, a catheter, ⁢or a stent.



**Benefits of Eustachian Tube Dilation**



Eustachian tube dilation can provide a number of benefits, including:



* Relief from pain

* Improved hearing

* Reduced risk of dizziness

* ⁢Improved balance



**Expected Results of Eustachian Tube ⁢Dilation**



The results of Eustachian tube dilation can vary from person to person. However, most⁢ people experience significant improvement in their symptoms. The benefits of the⁢ procedure can last for several months or even years.



**Risks of Eustachian ​Tube ⁤Dilation**



Eustachian tube dilation is a relatively safe procedure. However, there are some risks associated with the procedure, including:



* Bleeding

* Infection

* Perforation of⁣ the eardrum

* Damage to⁢ the middle ⁤ear

* Tinnitus



**Who is a Good Candidate for Eustachian Tube Dilation?**



Eustachian tube dilation⁤ is a good option for people who have tried other ‍treatments for their symptoms without success. These treatments may include:



* Nasal ‌decongestants

* Antihistamines

* Steroid nasal sprays

* Oral steroids



**How to Prepare for Eustachian Tube Dilation**



Before your Eustachian tube dilation procedure, you will need to:



* Avoid eating or drinking⁤ anything for 8 hours prior to the procedure.

* Tell your doctor about any medications⁣ you are taking.

* Bring a list of your medications and allergies to the surgery center.



**What to Expect During Eustachian Tube Dilation**



Eustachian tube dilation is usually performed in an outpatient surgery center. The procedure takes about 30 minutes to complete.



During the procedure, you will be given a⁤ local anesthetic to numb⁣ the ⁣area around your ear. The doctor ​will then insert a small ⁤balloon, catheter, or stent into ⁤your Eustachian tube. The balloon or catheter will be inflated to open up the tube. The stent will be left‌ in place to help⁢ keep ⁤the tube ‌open.



**Recovery from Eustachian Tube Dilation**



After your Eustachian tube dilation procedure, ‌you will be able to go home the same day. You may experience‍ some mild discomfort for a few days after the procedure. This discomfort can be relieved with over-the-counter pain medication.



**Follow-Up After​ Eustachian Tube Dilation**



You will need to see your doctor for a follow-up appointment‌ about 1 week ⁢after your procedure. At this appointment, your doctor ⁤will ​check ⁣to⁤ make sure that your Eustachian tube is still open.



**Eustachian Tube Dilation: Conclusion**



Eustachian tube dilation is a safe and effective procedure that can relieve symptoms of Eustachian tube dysfunction. The procedure can be performed in⁣ an outpatient surgery center⁢ and takes about 30 minutes to complete. Most ‍people experience significant​ improvement in ⁤their symptoms after the procedure.