title: Balloon dilation of the cartilaginous eustachian tube.
abstract: OBJECTIVE
  (1) To translate techniques developed in a previous cadaver study of balloon dilation of the cartilaginous eustachian tube (ET) into clinical treatment for refractory dilatory dysfunction and (2) to study the safety/efficacy of the technique in a pilot clinical trial.
  
  
  METHODS
  Prospective with subjects as their own historical controls since June 2009.
  
  
  METHODS
  Regional academic center.
  
  
  METHODS
  Eleven consecutive adult patients with longstanding otitis media with effusion (OME) who were unable to autoinsufflate their ET by Valsalva, swallow, or yawn and who had previous tympanostomies (average, 4.7). At the time of intervention, 5 of 11 had a tube; 2 of 11 had a tympanic membrane (TM) perforation. Four of 11 had intact TMs, 2 with OME and tympanogram type B and 2 with TM retraction and tympanogram types B and C. Balloon dilation of the cartilaginous ET was performed with sinus dilation instruments via transnasal endoscopic approach under general anesthesia in a day surgery setting. Inflation was to a maximum of 12 atm for 1 minute.
  
  
  METHODS
  ability to Valsalva, rating of ET mucosal inflammation, tympanogram, and otomicroscopy findings.
  
  
  RESULTS
  All cases successfully dilated. Eleven of 11 could self-insufflate by Valsalva (P < .001); tympanograms were A (4/11), C (1/11), or open (6/11). All atelectases resolved. Procedures were well tolerated, without pain or complications related to dilation.
  
  
  CONCLUSIONS
  Dilation of the cartilaginous ET appeared to be beneficial and without significant adverse effects in the treatment of ET dilatory dysfunction. Larger controlled trials with long-term results are now justified and needed.
authors.affiliation: Department of Otolaryngology, University of Tampere Medical School, Tampere, Finland. dennis.poe@childrens.harvard.edu
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Poe
authors.forename: Juha
authors.initials: J
authors.lastname: Silvola
authors.forename: Ilmari
authors.initials: I
authors.lastname: Pyykkö
mesh_terms: D000328:Adult; D000368:Aged; D002356:Cartilage / Q000473:pathology; D002404:Catheterization; D005064:Eustachian Tube / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000150:complications* / Q000473:pathology