The American Academy of Otolaryngology-Head and Neck Surgery considers Eustachian Tube Balloon Dilatation (ETBD) as appropriate treatment for pediatric patients with Obstructive Eustachian Tube Dysfunction (OETD) resulting in chronic otitis media which is refractory to standard surgical interventions (eg – tympanostomy tube placement and adenoidectomy). Multiple studies have demonstrated the efficacy and safety of ETBD in the pediatric population, with evidence showing improvements in hearing, tympanogram, quality of life, and decreased likelihood for additional surgery. The procedure can be completed safely, as a stand-alone procedure or in combination with other procedures. The American Academy of Otolaryngology-Head and Neck Surgery thus considers ETBD as a proven and effective therapeutic option in a select group of pediatric patients. The recommendation for ETBD should be determined by a qualified Otolaryngology-Head and Neck surgeon. A CT scan is not required preoperatively unless determined to be clinically indicated by the performing physicians. Otolaryngologists should use devices that are approved by the Food and Drug Administration (FDA) for these indications, and their use should adhere to the restrictions and guidelines specified by the appropriate governing agency, such as the FDA in the United States.
Approved July 2025
References:
- Aboueisha MA, Attia AS, McCoul ED, Carter J. Efficacy and safety of balloon dilation of eustachian tube in children: Systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2022 Mar;154:111048.
- Ahluwalia J, Babu S, Haupert M, Thottam P. Outcomes of Concurrent Balloon Eustachian Tuboplasty and Tympanostomy Tube Placement in Children. Laryngoscope. 2024 Nov;134(11):4799-4802.
- Ahluwalia J, Babu S, Haupert M, Thottam P. Safety Outcomes of Balloon Dilation Eustachian Tuboplasty in Pediatric Patients: A Follow-Up Study. Otol Neurotol. 2024 Nov 6. Epub ahead of print.
- Gurberg J, Dean M, Kawai K, Toivonen J, Poe D. Long-term efficacy of balloon dilation of the pediatric Eustachian tube: A six-year matched cohort study. Am J Otolaryngol. 2024 May-Jun;45(3):104208.
- Howard A, Babu S, Haupert M, Thottam PJ. Balloon Eustachian Tuboplasty in Pediatric Patients: Is it Safe?. Laryngoscope. 2021;131(7):1657-1662.
- Mukerji S, Rosas Herrera AM, Rochat R, Hosek K, Liu YC. Outcomes and Complications of Pediatric Eustachian Tube Dilation Surgery. Otolaryngol Head Neck Surg. 2024 Nov;171(5):1530-1534.
- Shareef Z, Conway RM, Creaman T, Babu SC. MAUDE database and Eustachian tube balloon dilation: Evaluation of adverse events and sales data. Am J Otolaryngol. 2024 Aug 3;45(6):104481.
- Toivonen J, Kawai K, Gurberg J, Poe D. Balloon Dilation for Obstructive Eustachian Tube Dysfunction in Children. Otol Neurotol. 2021;42(4):566-572.
Important Disclaimer Notice (Updated 7/31/14)
Position statements are approved by the American Academy of Otolaryngology–Head and Neck Surgery or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results. Position statements are not intended to and should not be treated as legal, medical, or business advice.
