Name of the Procedure:

Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral.

Summary

Nasopharyngoscopy with balloon dilation of the eustachian tube is a procedure where a small, flexible tube with a camera (nasopharyngoscope) is inserted through the nose to visualize the nasal passages and eustachian tube. A balloon is then used to dilate (widen) the eustachian tube to improve its function.

Purpose

This procedure addresses eustachian tube dysfunction (ETD), which can cause problems such as chronic ear infections, fluid build-up, and hearing loss. The goal is to improve ventilation of the middle ear, alleviate symptoms, and prevent recurrent ear problems.

Indications

• Chronic ear infections
• Persistent fluid in the middle ear (otitis media with effusion)
• Hearing loss due to ETD
• Ear fullness or pressure
• Eustachian tube dysfunction

Preparation

• Patients may be required to fast for several hours before the procedure.
• Medications may need to be adjusted or temporarily stopped.
• A thorough medical evaluation, including hearing tests and possibly imaging studies, might be required.

Procedure Description

1. The patient is positioned comfortably, and local or general anesthesia is administered.
2. The nasopharyngoscope is gently inserted through the nose to visualize the nasal passages and eustachian tube.
3. A specialized catheter with a balloon at the tip is navigated to the eustachian tube opening.
4. The balloon is inflated to dilate the eustachian tube, held for a few minutes, and then deflated and removed.
5. The scope is withdrawn, and the procedure is completed.

Equipment used includes the nasopharyngoscope, balloon dilation catheter, and possibly imaging equipment for guidance.

Duration

The procedure typically takes about 20-30 minutes.

Setting

This procedure is generally performed in an outpatient clinic, surgical center, or hospital.

Personnel

• ENT surgeon (otolaryngologist)
• Nurses
• Anesthesiologist or anesthesia provider

Risks and Complications

• Bleeding
• Infection
• Pain or discomfort
• Temporary nasal congestion
• Rarely, damage to the nasal passages or eustachian tube

Benefits

• Improved eustachian tube function
• Relief from chronic ear symptoms
• Improved hearing and quality of life
• Benefits can be realized within days to weeks.

Recovery

• Patients can usually go home the same day.
• Instructions may include avoiding strenuous activities and following up with the doctor.
• Pain management typically involves over-the-counter pain relievers.
• Recovery time is generally a few days to a week.

Alternatives

• Medical management with decongestants, nasal steroids, or ear tubes
• Observation for mild symptoms
• Each alternative has its pros and cons; medical management may be less invasive but may not be as effective for severe cases.

Patient Experience

During the procedure, patients under local anesthesia may feel some discomfort or pressure, but it is usually well-tolerated. Post-procedure, there may be minor soreness or nasal congestion, managed with pain relief and comfort measures. Full recovery and return to normal activities are expected within a week.