title: Balloon dilation of the eustachian tube in a cadaver model: technical considerations, learning curve, and potential barriers.
abstract: OBJECTIVE
  The surgical management options for eustachian tube dysfunction have historically been limited. The goal of the current study was to evaluate the technical considerations, learning curve, and potential barriers for balloon dilation of the eustachian tube (BDET) as an alternative treatment modality.
  
  
  METHODS
  Prospective preclinical trial of BDET in a cadaver model.
  
  
  METHODS
  A novel balloon catheter device was used for eustachian tube dilation. Twenty-four BDET procedures were performed by three independent rhinologists with no prior experience with the procedure (eight procedures per surgeon). The duration and number of attempts of the individual steps and overall procedure were recorded. Endoscopic examination of the eustachian tube was performed after each procedure, and the surgeon was asked to rate the subjective difficulty on a five-point scale.
  
  
  RESULTS
  Successful completion of the procedure occurred in each case. The overall mean duration of the procedure was 284 seconds, and a mean number of 1.15 attempts were necessary to perform the individual steps. The mean subjective procedure difficulty was noted as somewhat easy. Statistically shorter duration and subjectively easier procedure were noted in the second compared to the first half of the series, indicating a favorable learning curve. Linear fissuring within the eustachian tube lumen without submucosal disruption (nine procedures, 37%) and with submucosal disruption (five procedures, 21%) were noted. The significance of these physical findings is unclear.
  
  
  CONCLUSIONS
  Preclinical testing of BDET is associated with favorable duration, learning curve, and overall ease of completion. Clinical trials are necessary to evaluate safety and efficacy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Edward D
authors.initials: ED
authors.lastname: McCoul
authors.forename: Ameet
authors.initials: A
authors.lastname: Singh
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Anand
authors.forename: Abtin
authors.initials: A
authors.lastname: Tabaee
mesh_terms: D002102:Cadaver; D002404:Catheterization / Q000379:methods*; D004502:Education, Medical, Continuing / Q000379:methods*; D004724:Endoscopy; D005064:Eustachian Tube / Q000601:surgery*; D006801:Humans; D059032:Learning Curve; D008953:Models, Anatomic; D010033:Otitis Media / Q000601:surgery*; D010036:Otolaryngology / Q000193:education*; D011446:Prospective Studies