Transtympanic balloon dilatation of eustachian tube: a human cadaver pilot study

Objective: To determine the feasibility and safety of transtympanic balloon dilatation of the eustachian tube. Methods: Transtympanic eustachian tube dilatation was performed on six cadaver heads using balloon catheters. Catheters were placed in each eustachian tube and the head scanned by computed tomography. Randomised, blinded dilatation of one balloon in each head was performed, followed again by a second computed tomography scan. The scans were reviewed by a neurotologist and neuroradiologist who were blinded to previous treatment, and measurable dilatation and incidental damage noted. Results: There was adequate placement of the balloon catheter beyond the bony isthmus in 6 of 10 eustachian tubes. There was one insufficient catheter placement and three adverse placements (one into the petrous carotid canal and two into the vidian canal). Only one dilated tube showed a measurable increase in diameter. Conclusion: This experiment revealed serious safety issues with transtympanic eustachian tube dilatation. Therefore, this approach should not be considered feasible at this time.