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April 25, 2011

Balloon Dilation For Treatment of Eustachian Tube Dysfunction

Eustachian tube dysfunction is a phenomenon whereby a person is unable to pop their ears to relieve symptoms of ear pressure, clogging, or fullness. It is much akin to the ear pressure a person experiences when flying, but at ground level. Traditionally, treatment of this condition involved medications like steroid nasal sprays and prednisone along with active valsalva. Once medical treatment has failed, ear tube placement has been the step of last resort.

However, a promising new treatment called eustachian tube balloon dilation has been described in March 2011 to address eustachian tube dysfunction at the source surgically rather than indirectly with tube placement across the eardrum. In essence, a balloon is inserted into the eustachian tube and than inflated thereby opening it up (the balloon is "popping" the ear for you). The balloon is than deflated and removed.

Dr. Dennis Poe in Boston, MA is the researcher who first described this technique in March 2011 and at this time, is not offered in many centers. Why? Mainly because of the cost of the balloon itself which is not covered by insurance. The material cost of the balloon is around $2000 or more. Compare this to the cost of a tube which is around $30 or less.

Read more about why this technique is offered in so few places and why it is slow to catch on with ENTs in general.


Reference:
Balloon Dilation of the Cartilaginous Eustachian Tube. Otolaryngol Head Neck Surg April 2011 vol. 144 no. 4 563-569

Balloon catheter dilatation of eustachian tube: a preliminary study. Otol Neurotol. 2012 Dec;33(9):1549-52. doi: 10.1097/MAO.0b013e31826a50c3.

Balloon Dilation of the Cartilaginous Portion of the Eustachian Tube. Otolaryngol Head Neck Surg. 2014 Apr 4;151(1):125-130. [Epub ahead of print]





Here are some devices that have helped some people to pop their ears:

   
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

26 comments:

  1. Some insurance will pay for this, mine did and it worked. Please check into it. Dr Poe in the east, Dr Brian Weeks in the west.

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    Replies
    1. Hi Diana,

      I am looking into this procedure...you mentioned you had it done...can you discuss it with me...when did you have it done? Did you have to have tests done prior? Did you go out of town for this surgery? Which Doctor proformed it? How was it afterwards? Are you still ok? Biggest question...what were your sympthoms that made you look into this procedure? I am not sure my insurance with pay for this and not sure if I should check now or how to...any suggestions? I hope you receive this email...I did speak with Dr. Weeks office and they referred me to Dr. Poe...look forward to hearing back from you...Rosemarie

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  2. Rosemarie, my husband had this procedure done the day after you posted your question. He's had hearing loss most of his life and recently noticed he was unable to pop his right ear when changing elevations and it would always feel plugged. Past treatments and investigations (nasal spray, MRI, CT scan) led to this procedure and insurance paid for all but our 10% which turned out to be a little over a grand for us. He went under general anesthesia for the first time in his life, and they did the balloon dilation for both ears. Recovering from the anesthesia (grogginess/headache/vomiting) was the most difficult, but now his hearing is about the same as before. They say it could take 4-6 weeks to notice any improvement due to inflammation/swelling. The doctor was Ian Alexander. Good luck! ~fawN

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    Replies
    1. Hi fawN, I was wondering how your husband is doing now...is he better since this procedure? Where did he have it done? Did he have motion sickness feeling, dizziness or balance problems, or vertigo problems prior to procedure? Thank you so much for responding to me...any information is greatly appreciated...you are a good person, with all you had going on to take the time to respond to me...hope all is better for your husband! Rosemarie

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    2. Hi Rosemarie,

      My name is Shannon and I am considering this procedure. I was just wondering if you had it done and if you had any advice for me?

      Thanks in advance for any advice you can pass on!
      Shannon

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  3. Hi everyone,

    I would love to learn more about this procedure as I have been suffering from eustachian tube dysfunction for about 2 years now and just recently figured out what it was. It is very uncomfortable and I am dying to get it fixed as it drives me crazy on a daily basis. I would love to hear from others that have had their eustachian tube fixed through either this balloon dialation or by getting a tube put in.

    I appreciate any advice or information! Thank you so much in advance.

    Shannon (you can also email me at: shannon_hillery@hotmail.com).

    ReplyDelete
    Replies
    1. Hi Shannon
      I too have this condition. It seems like most doctors have no answers and just try to treat with nasal sprays and prednisone. Nothing has helped for me and i suffer every day. I dont feel like myself anymore. i feel like im trapped in a bubble in my own head due to the fullness and pressure..its so frustrating not having treatment or a cure...

      Delete
    2. The balloon dilation will work for most people. Dr. Brian Weeks in San Diego is a great doctor.

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  4. I am very interested in getting this treatment done,I have been suffering from eustachian tube dysfunction for nearly 9 years now. I am so tired of suffering this way and I want help!

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  5. I am 63 years old and have suffered ear infections, pain, sinus infections, etc. for a lifetime. My current ENT has diagnosed me with a dysfunctional eustachian tube. this surgery would benefit me, I am sure, very much. Is there anyone in the southern U.S. trained to perform this procedure?

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  6. Dr. Marc Dean in Ft Worth Texas does this procedure. He is a great Dr.

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  7. Dr Dean is doing this for me next Wed. :-)

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  8. I have a history of my eustachian tube getting plugged. I'm from Canada and can't get my family doctor to refer me to an ear,nose and throat specialist until I go through 4 to 6 weeks of pain while I use a nasal spray. I know this won't work for me because I have had a tube placed in my ear before which is the only thing that worked in the past. I'm told I have a narrow eustachian tube from birth and prone to getting a clogged ear when diving, going on an airplane or just changing elevation while driving. I'm wondering if I can get this procedure in the US?

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  9. I saw dr brain weeks in July of 2014, the man is amazing, truely knowledgeable and his staff/partner, Janene is great. I'm a candidate for Eustachian tube plasty, I will post after the operation and inform of my results. Lugo.

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  10. I've had the balloon dilation done twice now and neither time did it help me at all. Very frustrating as I've had this problem for 9 years now. I made an appointment to see Dr. Poe as he is only 2-3 hours from me but the waiting list is over a year...

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  11. How did it go with Dr Brian Weeks? My ENT said that he will refer me to Dr. Dennis Poe if I am interested. I had tubes put in both ears 2 weeks ago, and the results are not what I was hoping for. I am an audio engineer and musician, and the loss of bass in my hearing from putting in the tubes has basically put me out of work until I can get this resolved.

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  12. I had my eustachian tube opened via balloon by Dr. Jordan Pritikin of Chicago in April 2014.

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    Replies
    1. Please do tell me if this procedure worked on you because my daughter is suffering terribly and this might be an only option left....

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  13. Has anyone had long term success with this procedure. I've had tubes inserted in both ears four times in the last five years because of drainage problems in my eustachian tubes. My doctor is considering balloon plasty once insurance covers the procedure next year. I'd like to hear from others who have had it done before going ahead with this. Wonder what the long term success is. Is the balloon then deflated and removed immediately after insertion? Any advise, tips would be welcome.

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  14. Hi Rosemarie. How is your hubby doing now? Please tell me where Dr Ian Alexander is. Thanks

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    Replies
    1. What happened to all the rest of the comments that used to be on here? :(

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    2. Hi Louise, I haven't been on here for a while, I'm e mailing w some of these people. Are some posts missing? I don't get an alert when someone posts so I get out of the loop sometimes. I had this balloon dilation surgery about 4 yrs ago and my ears are still clear. Hope that helps, diana

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  15. I have had 14 T tubes inserted in my right ear since j was 19. I'm 47 now. I have had an eardrum replacement surgery where they used cartelidge from my skull because I still needed a tube. I am a court reporter and was getting close to having to retire early (in about five years) because my hearing is deteriorating with each new tube.
    Kaiser here in Northern California just approved this procedure and I'll be the 4th patient to have it done. I see it as a miracle. I have, in one day, gone from almost certain early retirement and yearly to twice yearly ear tube surgery to quite possible one last surgery and retiring whenever I feel is right!!! I cannot wait and I will post my results.

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  16. nice post iam also suffering from this disease i cant focus on my work
    nice post make me want to cry good job

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  17. HI, Im a 45 year old female that was born with a cleft palate, Ive always had ear trouble, but out grew a lot of it until I turned 40. Since that time I've had tonsillectomy with partial adenoidectomy and tubes placed. I get ear infections at least 2-3 times a month, and my tubes are not draining the thick drainage, Im in pain, constant hearing loss. My ENT want to do the balloon but my insurance denied it as investigational. Any suggestion on how to get this approved?

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  18. Hi Tina, sorry you are suffering. I had this procedure 6 yrs ago. It took two tries, but my ears have been clear ever since. I believe this surgery just got FDA approved, but, some ins companies are still fighting the codes. I would keep trying with them. Have your dr send them a letter explaining why you need it. Good luck! Diana

    ReplyDelete

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