Year: 2026 | Month: March | Volume: 16 | Issue: 3 | Pages: 246-260
DOI: https://doi.org/10.52403/ijhsr.20260330
Efficacy and Safety of Balloon Dilation of the Eustachian Tube in Adults with Obstructive Eustachian Tube Dysfunction: A Systematic Review
Sattam Muslih Musallam Aljuaid
Consultant Otorhinolaryngology Head and Neck Surgery, Department of ORL Head and Neck Surgery, Taif Medical Center, Taif, Saudi Arabia.
Corresponding Author: Sattam Muslih Musallam Aljuaid
ABSTRACT
Background: Obstructive Eustachian tube dysfunction (OETD) in adults is a common otologic condition associated with aural fullness, hearing impairment, pressure intolerance, and reduced quality of life. Balloon dilation of the Eustachian tube (BDET) has emerged as a minimally invasive intervention intended to improve tubal function and middle-ear ventilation. However, the overall evidence regarding its efficacy and safety in adult patients remains variable.
Objective: This systematic review aimed to evaluate the efficacy and safety of balloon dilation of the Eustachian tube in adults with obstructive Eustachian tube dysfunction.
Methods: A systematic literature review was conducted using major biomedical databases. Studies were eligible if they involved adult patients with obstructive Eustachian tube dysfunction and evaluated balloon dilation as the primary intervention while reporting efficacy and/or safety outcomes. Screening, study selection, data extraction, and quality assessment were performed using predefined criteria. A total of 1,247 records were identified, of which 289 duplicates were removed. After title and abstract screening, 75 full-text articles were assessed for eligibility, and 10 studies were included in the final review.
Results: The included studies comprised randomized controlled trials, prospective studies, retrospective cohort studies, pilot studies, and comparative clinical studies conducted across multiple countries. Overall, the evidence showed that BDET was associated with significant improvement in patient-reported symptoms, particularly Eustachian Tube Dysfunction Questionnaire scores and pressure-related complaints. Several studies also reported improvement in objective outcomes, including tympanometric findings, Valsalva maneuver performance, hearing levels, and middle-ear status. Safety findings were favorable, with serious complications being rare and most studies describing the procedure as feasible and well tolerated. The pooled effect estimates from the included studies suggested a significant overall benefit of the intervention.
Conclusion: Balloon dilation of the Eustachian tube appears to be an effective and generally safe treatment for adults with obstructive Eustachian tube dysfunction. Nevertheless, the evidence is limited by methodological heterogeneity, variable risk of bias, and relatively short follow-up, highlighting the need for larger, high-quality studies with standardized outcome reporting.
Key words: Balloon dilation; Eustachian tube dysfunction; Obstructive Eustachian tube dysfunction; Adult otology; Systematic review.