Clear the path. Relieve the pressure.
A simple, easy way to treat Eustachian tube dysfunction.

Disease State

An illustrated diagram of the anatomy of the human ear

Approximately 4.6% of adults in the United States suffer from Eustachian tube dysfunction (ETD)1. ETD presents in two primary forms: patulous and obstructive. Common symptoms of ETD can include:

  • Plugged feeling in the ears
  • Ears feeling like they are filled with water
  • Tinnitus
  • Muffled hearing
  • Ticking or popping sounds
  • Pain around the ear
  • Tingling sensation
  • Trouble with balance

While some cases of ETD are mild and symptoms can clear up after a few days, other cases of ETD can be categorized as persistent which will require a treatment path. Treatment can be nonsurgical or surgical in nature.

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Diagnosing Obstructive ETD

Leveraging the following tools assists in diagnosing obstructive Eustachian tube dysfunction (ETD)2:

  • Nasal scope
  • Audiogram
  • Tympanogram
  • ETDQ-7 survey

Hear from Dr. Boris Karanfilov on his diagnosis protocol for ETD:

In 2019, a clinical study was published regarding consensus on balloon dilation of the Eustachian tube.3

Some of the consensus statements reached include:

  • A comprehensive history and physical exam, including otoscopy, are essential parts of the diagnostic evaluation of a candidate for BDET.
  • Nasal endoscopy is an essential part of the diagnostic evaluation prior to BDET.
  • Tympanometry is an essential part of the diagnostic evaluation prior to BDET.
  • Establishing a diagnosis of obstructive ETD requires ruling out other causes of aural fullness such as patulous ETD, temporomandibular joint disorders, extrinsic obstruction of the ET, superior semicircular canal dehiscence, and endolymphatic hydrops.
  • Comprehensive audiometry is an essential part of the diagnostic evaluation prior to BDET.
  • Common causes of obstructive ETD that benefit from identification and management are allergic rhinitis, rhinosinusitis, and laryngopharyngeal reflux.

Patient Selection for BDET in Office

As with any ENT office procedure, patient selection for BDET is part of the analysis to ensure positive patient outcomes.

Dr Boris Karanfilov discusses patient selection in this video:

When done in an office setting, BDET is considered a minimally invasive treatment.What type of criteria do you use when selecting a patient for in office procedures? When treating ETD, do you consider patients that also suffer from rhinitis, or chronic rhinosinusitis?

NuVent™ Eustachian Tube Dilation Balloon

Medtronic is pleased to announce they have entered the relief path to treat obstructive ETD with the launch of the NuVentTM Eustachian tube dilation balloon. The device is a manually-controlled balloon catheter that, when inserted into the eustachian tube canal and pressurized, the balloon expands and dilates the Eustachian tube canal. The system consists of two major components, the balloon handpiece and the inflator.

The system is designed specifically to treat persistent, obstructive ETD.5 With an atraumatic tip, a flexible balloon section, and a simple, easy design, the device is designed to be atraumatic during insertion into the Eustachian tube.6 The tip is designed not to pass through the bony isthmus.7

Eustachian tube dilation is considered a safe procedure and is proven effective in treating Eustachian tube dysfunction.8


The following resources are available for your practice:

  • Patient brochure on ETD
  • Ear anatomy poster
  • BDET procedure video
  • Reimbursement guide
Physician and patient

Prevalence of Eustachian Tube Dysfunction in Adults in the United States. Alan Shan, BS1; Bryan K. Ward, MD2; Adele M. Goman, PhD1; Joshua F. Betz, MS1,3; Nicholas S. Reed, AuD1,2; Dennis S. Poe, MD, PhD4; Carrie L. Nieman, MD, MPH1,2 JAMA Otolaryngology Head Neck Surg.2019;145(10):974-975. doi:10.1001/jamaoto.2019.1917.


Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway. Matthew E. Smith1, Yemisi Takwoingi2, Jon Deeks2, Cuneyt Alper3, Manohar L. Bance1, Mahmood F. Bhutta4, Neil Donnelly1, Dennis Poe5, James R. Tysome1*PLOS ONE | November 8, 2018.


Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube. Tucci DL, McCoul ED, Rosenfeld RM, Tunkel DE, et al. Otolaryngol Head Neck Surg. 2019 Jul;161(1):6-17. doi: 10.1177/0194599819848423. Epub 2019 Jun 4. PMID: 31161864.


Balloon Dilatation Eustachian Tuboplasty: A Clinical Study, The Laryngoscope, 2010, Ockermann et al.


Medtronic data on file.


Medtronic data on file.


Medtronic data on file.


A Randomized Controlled Trial of Balloon Dilation as a Treatment for Persistent Eustachian Tube Dysfunction With 1-Year Follow-Up. Otology/Neurotology, 2018, Meyer et al.