Volume 44, Issue 4, July–August 2023, 103896Author links open overlay panel, , , AbstractBackground

Eustachian tube dysfunction (ETD) is common in children. Over the past decade, eustachian tube balloon dilation (ETBD) has become a more widespread treatment for this condition. Data has been encouraging in the adult population, but data among the pediatric population has been sparser. This comprehensive review aims to assess current evidence for ETBD in pediatric patients.

Review

Studies relevant to ETBD in the pediatric population were identified by utilizing the PubMed MEDLINE database. While multiple retrospective studies were found, this search yielded two systematic reviews focused on the pediatric population as the highest level of evidence assessing ETBD in children. There was overlap of included studies, but each review contained a unique set of studies. These reviews found that ETBD was safe in children.

Best practice summary

Overall, ETBD appears safe and efficacious in children with refractory ETD. Future prospective trials confirming this conclusion are warranted. At this time, there appears to be a role for ETBD with or without ventilation tube placement in children with refractory ETD.

Section snippetsBackground

Eustachian tube dysfunction (ETD) remains a common problem, particularly in the pediatric population, with an estimated prevalence ranging between 4 and 20 % [1]. As outlined in a clinical consensus statement published in 2015 by Schilder et al., the Eustachian tube serves three main functions within the middle ear: pressure equalization, drainage of secretions, and protection against nasopharyngeal pathogens [2]. ETD occurs when these inherent mechanisms fail and can manifest in multiple forms

Review

Studies relevant to ETBD in the pediatric population were identified by utilizing the PubMed MEDLINE database. Only studies assessing the pediatric population were included in this analysis. This search yielded two systematic reviews as the highest level of evidence assessing ETBD in children (Table 1).

Aboueisha et al. included 7 studies in a systematic review of 408 pediatric patients who underwent ETBD [3]. 6 of the 7 included studies utilized ETBD as treatment for ETD refractory to

Best practice summary

Current literature regarding ETBD in children is dominated by retrospective case series with one retrospective matched cohort study. Two groups completed a systematic review of available data with one group offering meta-analysis. Overall, ETBD appears safe and efficacious in children with refractory ETD. Future prospective trials confirming this conclusion are warranted. At this time, there appears to be a role for ETBD with or without ventilation tube placement in children with refractory ETD.

Level of evidence

These recommendations are based on one systematic review and one systematic review with meta-analysis based on retrospective case series and a retrospective cohort study indicating level 3 evidence.

Funding

This work was unfunded.

Credit authorship contribution statement

Tyler Merrill – data curation, writing: original draft.

Vijay Patel – conceptualization, methodology, supervision, writing: review and edit.

John Dornhoffer – supervision, writing: review and edit.

Robert A. Saadi – conceptualization, methodology, supervision, writing: review and edit.

Declaration of competing interest

None.

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