Our Summary

This research paper is about a procedure known as balloon dilation of the eustachian tube (BDET), which is a treatment for a condition where the eustachian tubes in the ear become blocked (obstructive eustachian tube dysfunction or OETD). The researchers brought together a group of specialist ear, nose and throat doctors to establish some agreed advice on the use of BDET. They focused on adults aged 18 or over who had been suffering from OETD for at least three months, to the extent that it significantly affected their quality of life or overall health.

The team used a method designed to generate consensus from a panel of experts and, after three rounds of discussion, they reached agreement on 28 statements about the use of BDET, while another 28 statements did not get full agreement. The statements they agreed on were grouped into three categories: patient criteria (who should receive the treatment), considerations to bear in mind before, during and after the operation, and the expected outcomes of the procedure.

The researchers concluded that the agreed statements help clarify the process of diagnosing OETD and how to manage it around the time of the BDET operation. The lack of agreement on some other statements probably shows that there are still some unanswered questions about the role of BDET in treating OETD. This consensus from a panel of experts can provide useful information for doctors considering BDET as a treatment option for patients with OETD.

FAQs

  1. What is balloon dilation of the eustachian tube (BDET)?
  2. Who are the ideal candidates for BDET?
  3. What are the key considerations during the perioperative phase of BDET?

Doctor’s Tip

A helpful tip a doctor might tell a patient about ear tube surgery is to follow all pre-operative instructions provided by your healthcare team, including fasting before the procedure and avoiding certain medications. This will help ensure a successful surgery and smooth recovery process. Additionally, make sure to communicate any concerns or questions with your healthcare provider before the surgery to address any potential issues.

Suitable For

Patients who are typically recommended ear tube surgery, also known as balloon dilation of the eustachian tube (BDET), are adults 18 years or older who have obstructive eustachian tube dysfunction (OETD) in one or both ears for 3 months or longer. These patients must also experience symptoms that significantly affect their quality of life or functional health status. Candidates for BDET may have symptoms such as chronic ear infections, hearing loss, ear fullness, or pressure changes in the ear. It is important for patients to be properly evaluated and diagnosed by an otolaryngologist before being recommended for ear tube surgery.

Timeline

Before ear tube surgery:

  1. Patient experiences symptoms of obstructive eustachian tube dysfunction (OETD) in one or both ears for 3 months or longer.
  2. Symptoms significantly affect quality of life or functional health status.
  3. Patient is evaluated by an otolaryngologist to determine candidacy for balloon dilation of the eustachian tube (BDET).
  4. Patient undergoes diagnostic tests such as nasal endoscopy, otoscopy, and tympanometry to assess the severity of OETD.
  5. Patient and otolaryngologist discuss the risks and benefits of BDET and make a decision to proceed with surgery.

After ear tube surgery:

  1. Patient undergoes BDET procedure to dilate the eustachian tube and improve ventilation in the middle ear.
  2. Patient may experience mild discomfort or ear pressure immediately following the procedure.
  3. Patient is typically able to return to normal activities within a day or two after surgery.
  4. Patient follows post-operative instructions provided by the otolaryngologist, which may include avoiding water in the ears and using ear drops as prescribed.
  5. Patient attends follow-up appointments to monitor healing and assess improvement in OETD symptoms.
  6. Patient experiences improved quality of life and functional health status as a result of successful BDET surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about ear tube surgery include:

  1. What are the potential benefits of balloon dilation of the eustachian tube (BDET) for my condition?
  2. What are the potential risks and complications associated with BDET?
  3. How long does the procedure typically take and what is the recovery process like?
  4. Will I need to follow any specific postoperative care instructions?
  5. How long do the effects of BDET typically last?
  6. Are there any alternative treatments for obstructive eustachian tube dysfunction (OETD) that I should consider?
  7. How many BDET procedures have you performed, and what is your success rate?
  8. Will I need to undergo any additional tests or evaluations before the procedure?
  9. What can I expect in terms of pain or discomfort during and after the procedure?
  10. What are the expected outcomes of BDET for my specific case?

Reference

Authors: Tucci DL, McCoul ED, Rosenfeld RM, Tunkel DE, Batra PS, Chandrasekhar SS, Cordes SR, Eshraghi AA, Kaylie D, Lal D, Lee J, Setzen M, Sindwani R, Syms CA 3rd, Bishop C, Poe DS, Corrigan M, Lambie E. Journal: Otolaryngol Head Neck Surg. 2019 Jul;161(1):6-17. doi: 10.1177/0194599819848423. Epub 2019 Jun 4. PMID: 31161864