Balloon Dilation of the Eustachian Tube: Past, Present, and Future.

Balloon dilation of the Eustachian tube has moved from an experimental concept to a mainstream option for selected adults with chronic obstructive Eustachian tube dysfunction that persists despite optimized medical management. Contemporary practice emphasizes careful phenotyping (obstructive vs patulous vs baro-challenge induced disease), correlation of symptoms with objective middle ear findings, and endoscopic evaluation of the nasopharyngeal orifice before intervention. Randomized trials and subsequent long-term follow-up demonstrate meaningful improvements in patient-reported symptoms and selected objective measures for appropriately chosen patients, with low rates of serious adverse events.