Eustachian tube balloon dilation procedure

[Whiskeytrain]

Good evening,

Today I went to a DAN recommended ENT for my left ear discomfort while flying and diving (not being able to equalize) and vertigo when ascending. He stated the Eustachian tube balloon dilation procedure might be a good solution based on my exams and symptoms. I saw some older threads (a couple years ago) about the procedure but wanted to get any first hand knowledge from anyone who had it done recently. Would like to hear how the procedure was as well as the outcome and improvement.
Any info and thoughts appreciated

 

[Scraps]

Ask @doctormike. It’s his line of work and he has been very generous in sharing his expertise.

 

[doctormike]

Yup, I don't do them myself (not really a pediatric thing), but I have a buddy who does them for divers and says that he gets good results in selected cases.

Of course, patient selection is important, and sometimes it's just a question of equalization technique rather than an anatomic problem with the Eustachian tube. I can't tell you much specific without seeing your audiogram and examining you in person, but if you tell me where you are writing from I may be able to give you the name of a local adult ENT who does this. There are some risks, so you want to make sure that it's really necessary first...

 

[Whiskeytrain]

Thank you for the reply. I am in the Fort Lauderdale, fl area.

 

[Angelo Farina]

That procedure was proposed to my wife at beginning of her diving career, as she had bad equalization problems. She was almost convinced to make this procedure, when she did follow a free diving course, where she was taught the Frenzel equalization technique.
Suddenly she became capable of equalizing very quickly, while descending in free diving. After she learned Frenzel, she went back to scuba diving, where of course the mouth is kept open by the regulator, so you cannot use the pure Frenzel method.
But there is the very similar Marcante-Odaglia method, which can be used while breathing from a regulator. And after learning also this method, she had been fine for the following 40 years, without any further barotrauma or the need to carry with herself the aerosol machine, as it was previously...
So I second @doctormike in the suggestion of first looking into some better equalization technique, and only when all known methods have been tested unsuccessfully, then you can think to an invasive medical procedure for solving the problem.

 

[doctormike]

Thank you for the reply. I am in the Fort Lauderdale, fl area.

Sorry, don't know anyone there....

 

[Whiskeytrain]

That procedure was proposed to my wife at beginning of her diving career, as she had bad equalization problems. She was almost convinced to make this procedure, when she did follow a free diving course, where she was taught the Frenzel equalization technique.
Suddenly she became capable of equalizing very quickly, while descending in free diving. After she learned Frenzel, she went back to scuba diving, where of course the mouth is kept open by the regulator, so you cannot use the pure Frenzel method.
But there is the very similar Marcante-Odaglia method, which can be used while breathing from a regulator. And after learning also this method, she had been fine for the following 40 years, without any further barotrauma or the need to carry with herself the aerosol machine, as it was previously...
So I second @doctormike in the suggestion of first looking into some better equalization technique, and only when all known methods have been tested unsuccessfully, then you can think to an invasive medical procedure for solving the problem.

Did your wife previously have any ear problems when flying? When I fly or dive, my left ear will have discomfort during the activity. After diving or flying, my left ear will feel muffled as of it is clogged. I’m going to look up that method. Although I hope to learn the method, I think I have underlying ear issues dating back to when I was young

 

[Angelo Farina]

My wife had a long history of ear infections starting since her childhood, causing her problems when climbing mountains or diving.
When we were young flying was not so common, so she had no experience of what did happen on an aircraft. We did fly for the first time only at the age of 20, when she was already diving for 4 years, and all the equalizing problems had already been solved.
Her left tube was really narrow and always obstructed. But learning how to open it voluntarily, with the proper equalization technique, allowed her to clean up the situation. After one year diving almost every week a couple of times (in sea water, of course), all her problems disappeared. So diving was the cure (after learning how to equalize).
I remember that during her first dives after learning how to equalize, when emerging her mask was always full of liquids of various colour: yellow, green, red, even black. She progressively emptied all her cavities, leaving the tubes clean and easily openable. It did take some months and almost 50 dives before the situation became perfect.

 

[divepsych]

After dealing with ET Dysfunction since I began diving in 1971, I underwent the ET balloon dilation procedure in December 2022. The next year (2023) I was on multiple cross country and international flights and was surprised how easily my right middle ear pressure spontaneously equalized on ascent and descent, as well as on gondolas in the Swiss Alps. There have been no complications or adverse events.

My first post-operative scuba diving was not until September-October 2023 on Bonaire. I was thrilled to be able to easily equalize my right middle ear for the first time since I began diving in 1971. No decongestants or anything else was needed. I have no regrets whatsoever about having the procedure and am writing a paper for a dive publication about my experience.

There are two FDA devices in the USA: the Acclarent AERA® Eustachian Tube Balloon Dilation System. There are a patient education video and doctor search at the company website (https://www.jnjmedtech.com/en-US/treatment/Acclarent-aera-eustachian-tube-balloon-dilation-system) and Stryker’s XprESS ENT dilation system.

 

[doctormike]

Great to hear, @divepsych ... thanks for the review. While I don't do this myself, I have been referring SELECTED cases to colleagues who do it. Just like most procedures, it's not for everyone, but for the people who really need it, for whom it's not just a technique or training issue, it looks like it can be helpful.