Balloon Eustachian tuboplasty, or BET, is a minimally invasive endoscopic procedure that addresses Eustachian tube obstruction directly from within the tube itself. Using a thin catheter introduced through the nose and positioned at the Eustachian tube opening in the nasopharynx, a small balloon is inflated within the tube for approximately 2 minutes at low pressure. This dilates the tube's lumen, disrupts the scar tissue or mucosal changes causing obstruction, and improves tube function and pressure equalisation. BET is performed under general or local anaesthesia, typically as a day procedure, and most patients notice improvement in ear pressure, fullness, and hearing within days to weeks. It is considered when: Eustachian tube dysfunction has been confirmed by tympanometry and clinical assessment, conservative management including nasal steroid therapy, allergy treatment where allergy is present, and a trial of the Valsalva manoeuvre has not produced adequate improvement, and the patient's symptoms are significantly impacting quality of life. BET is not a replacement for grommet insertion in all cases - grommets ventilate the middle ear from outside the Eustachian tube and are appropriate for different presentations. The choice between BET and grommets depends on the specific pattern and severity of ET dysfunction in the individual patient.
Written by Dr. Rajendran Dinesh Kumar, MBBS, MS ENT, AASC (Allergy Asthma Specialist Course), FAAP, Consultant ENT Specialist and Allergy, Asthma Specialist, Trustwell Hospitals Pvt. Ltd., JC Road, Vinobha Nagar, Sudhama Nagar, Bengaluru, Karnataka 560002. 16+ years, 20,000+ patients. Phone: 9620928650.
