In this episode, host Dr. Ashley Agan discusses eustachian tube (ET) dilation with Dr. Dennis Poe, neurotologist and Professor of Otolaryngology at Harvard Medical School.

First, the surgeons describe clinically meaningful differences between adult and pediatric ETs. Then, Dr. Poe reviews workup of pediatric ET disorders. Since inflammation accounts for most ET dysfunction, controlling comorbid allergies and/or performing adenoidectomy provides relief to some patients. For patients with continued symptoms, balloon dilation – now approved for children as young as eight years of age– directly counteracts obstructive inflammation in the tube lumen. To conclude, Dr. Poe describes how to select patients for, perform, and avoid complications of balloon dilation.

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SHOW NOTES

00:00 - Introduction
04:03 - Understanding Eustachian Tube Anatomy
07:22 - Causes of Eustachian Tube Dysfunction in Children
12:53 - Examination and Diagnosis of Eustachian Tube Dysfunction
19:10 - Treatment Options for Eustachian Tube Dysfunction
27:05 - Avoiding Unpredictable Injury and Scarring During Balloon Dilation
31:51 - Contraindications and Precautions for Balloon Dilation
37:49 - Understanding Risks & Complications of Balloon Dilation
48:34 - Closing Remarks & Future Prospects

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RESOURCES

Dr. Dennis Poe’s Harvard Profile:
https://oto.hms.harvard.edu/people/dennis-poe

BackTable ENT Ep. 40 – “Diagnosis & Management of Eustachian Tube Disorders with Dr. Dennis Poe:”
https://www.backtable.com/shows/ent/podcasts/40/diagnosis-management-of-eustachian-tube-disorders

American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guideline: Otitis Media with Effusion (Update):
https://www.entnet.org/quality-practice/quality-products/clinical-practice-guidelines/ome/

“Complications of Eustachian Tube Balloon Dilation: Manufacturer and User Facility Device Experience (MAUDE) Database Analysis and Literature Review,” Chisolm, P.F. et al: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731503/