Diagnostic Algorithm for Eustachian Tube Dysfunction and Indications for Balloon Dilation of the Eustachian Tube.

This review outlines a standardized diagnostic algorithm for balloon dilation of the Eustachian tube (BDET) in obstructive ETD. The algorithm prioritizes excluding differential diagnoses including patulous ETD, temporomandibular joint disorders, and superior canal dehiscence syndrome. Objective tests and patient-reported outcomes help when facing equivocal clinical findings. BDET is indicated for barochallenge-induced ETD, chronic otitis media with effusion, and tympanic membrane retraction pockets after failed medical management, and may adjunct tympanoplasty in adhesive otitis media. Contraindications include patulous ETD and significant Eustachian tube anatomical distortion. Rigorous patient selection remains essential for safe and effective outcomes.