Pediatria pre prax 4/2021

Balloon Eustachian tuboplasty in children

Eustiachian tube (ET) dysfunction occurs in approximately 40 % of children and is a common cause of otogenic problems in childhood. At present, in addition to conservative and surgical treatment, we may consider endoscopic treatment of chronic dysfunction using ET balloon dilation. As part of the diagnosis, acquisition of a thorough patient´s history, including the completion of the EDTQ-7 (Eustachian tube dysfunction questionnaire) scoring questionnaire for the evaluation of ET dysfunction (1), complete ENT examination including flexible nasopharyngeal endoscopy, tubomanometry and a selected set of audiological examinations (tympanometry, pure tone and speech audiometry) are required (2). As a standard step, CT scan of the skull base and the temporal bones with a focus on the course of ET, is recommended. Balloon Eustachian tuboplasty is a short endoscopic procedure performed under general anesthesia, during which a dilation balloon which is contained in a catheter is introduced via nasal cavity into the cartilaginous part of the ET. The dilator is inflated for 2 minutes at a pressure of 10 bar using saline solution (2, 3). Balloon Eustachian tuboplasty in children is a new and modern curative approach, from which we expect in the indicated group of patients an improvement or normalization of ET function and thus pressure parameters in the middle ear. Amelioration of these parameters is ascertained by monitoring objective parameters before and after the procedure, such as tympanometry as well as according to the respective otoscopic findings.

Keywords: Eustachian tube, dysfunction, childhood, balloon dilation