Name of the Procedure:

• Common Name: Eustachian Tube Balloon Dilation
• Medical Term: Nasal endoscopy, surgical; balloon dilation of eustachian tube (C9745)

Summary

Eustachian Tube Balloon Dilation is a minimally invasive surgical procedure that uses a small balloon catheter to open up and dilate the Eustachian tube, which connects the middle ear to the back of the nose. This helps improve ventilation and drainage in the ear.

Purpose

• Medical Conditions Addressed: Chronic Eustachian Tube Dysfunction (ETD), persistent ear fullness, discomfort, and hearing difficulties.
• Goals/Expected Outcomes: To restore the normal function of the Eustachian tube, reduce symptoms like ear pressure and pain, improve hearing, and prevent recurring ear infections.

Indications

• Specific Symptoms/Conditions: Chronic ear pressure, pain, fullness, or recurrent ear infections despite medical treatment.
• Patient Criteria/Factors: Adults and children with persistent Eustachian tube dysfunction that has not responded to other treatments such as medications or less invasive procedures.

Preparation

• Pre-Procedure Instructions: Patients may need to fast for several hours before the procedure. Specific instructions will be provided by the medical team.
• Diagnostic Tests: Hearing tests, tympanometry, and possibly an evaluation by an ear, nose, and throat (ENT) specialist to confirm ETD.

Procedure Description

1. Anesthesia: Local anesthesia with or without sedation, depending on the patient's condition and the setting.
2. Steps:
   • A nasal endoscope is inserted through the nostril to visualize the Eustachian tube opening.
   • A balloon catheter is guided into the Eustachian tube.
   • The balloon is inflated to open and dilate the tube.
   • The balloon is then deflated and removed, along with the endoscope.
3. Tools/Equipment: Nasal endoscope, balloon catheter, monitor for visual guidance.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

The procedure is usually performed in an outpatient clinic, surgical center, or hospital.

Personnel

• ENT surgeon or otolaryngologist
• Surgical nurse or assistant
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Common Risks: Mild bleeding, nasal or throat discomfort, temporary ear pain.
• Rare Risks: Infection, injury to adjacent structures, prolonged pain or dysfunction.

Benefits

• Improved Eustachian tube function.
• Reduced symptoms like ear pressure, pain, and hearing loss.
• Enhanced quality of life.
• Benefits can often be realized shortly after the procedure.

Recovery

• Post-Procedure Care: Patients may experience mild discomfort, which can be managed with over-the-counter pain medications.
• Recovery Time: Most patients can return to normal activities within a few days.
• Restrictions/Follow-Up: Follow-up appointments may be needed to ensure the dilation was successful and to monitor healing.

Alternatives

• Other Treatment Options: Medication (decongestants, steroids, antibiotics), Eustachian tube exercises, myringotomy with or without tube insertion.
• Pros/Cons: Medications and exercises are less invasive but might be less effective for chronic cases. Myringotomy might require repeated procedures.

Patient Experience

• During the Procedure: Patients may feel pressure or mild discomfort, especially during balloon inflation.
• After the Procedure: Some soreness or a sensation of pressure is common. Pain should be minimal and manageable.
• Pain Management: Over-the-counter pain relievers and comfort measures like applying a warm compress can help.