Balloon dilatation of the Eustachian tube

At Charlottenlund, we offer balloon dilation of the Eustachian tube

Many people experience pain in the ears in connection with flights, where the pressure changes in the cabin (especially during landing) cause pain in the ears. Most adults can equalize the pressure by simply swallowing a little water or yawning, while others have to hold their nose and breathe with their mouth closed - a so-called "Valsalva manoeuvre". Others cannot equalize the pressure at all and must simply bite the pain or wait for the eardrum to burst. In these patients, the pain can persist for several days after the flight and lead to accumulation of fluid in the middle ear and hearing loss in the following weeks. Often it concerns patients who in their childhood have been so-called "ear children"

In many cases, the problem can be remedied by performing a balloon dilation of the Eustachian tube. This is done with a small balloon, which is introduced through the nose and inflated to a very high pressure. If you want to read more about this, you can read the story about Felicia, who was treated by specialist Jacob Fisker at Charlottenlund Private Hospital and subsequently wrote the following:

"Earlier this year, I had an operation with you, after narrow eustatic tubes had prevented me from boarding a plane for 7 years due to severe discomfort and problems with pressure equalization. Today I had my ears tested on a flight. The operation made a much bigger difference than I dared to hope for and now I don't have to feel discomfort in my body when I think about traveling around the world. So a heartfelt thank you to you 🌺 it will have a big positive meaning for my life."

Dbh Felicia

Read Felicia's story in the magazine "Sportsdykkeren" here!

At Charlottenlund Private Hospital, specialist doctor and owner Jacob Fisker performs all balloon dilations of the eustachian tube and has many years of experience with this type of treatment. Jacob Fisker is himself an active diver and has also completed the defense training in diving and aviation medicine and has over the years treated countless patients who often travel by plane, divers, pilots and flight attendants - and has thereby accumulated a great deal of experience and knowledge in the field.

You are always welcome to contact us if you have any questions or wish to book an appointment for a preliminary examination.

What is the Eustachian tube?

The Eustachian tube connects the ear and the throat, and its primary function is to equalize pressure in the ear. The Eustachian tube is normally closed, but it opens briefly when talking, swallowing or yawning. When the tube opens, air is simultaneously transported from the pharynx to the middle ear. In addition to equalizing pressure in the ear, the Eustachian tube also ensures that mucus can move from the middle ear to the throat.

If there is no free passage for the air to move through the Eustachian tube, you will experience it as a blocked sensation in the ear, just as fluid and hearing loss can build up in the ear over time. Many mistakenly believe that it is an ear canal that is closed by earwax, as the sensation is the same. If you cannot equalize the pressure, it may be a sign that the Eustachian tube is not working as intended.

Reduced function of the Eustachian tube

The Eustachian tube is more important to our well-being than one might think. A closed Eustachian tube is immediately felt as a pressure or a plug in the ear, which causes hearing loss that makes it difficult to hear what other people are saying, while one's own voice is distorted. However, an open eustachian tube (so-called tuba aperta) can also give the sensation of having a plug or ringing in the ear, while one's own breathing and voice resonate in the head. This can make it difficult to concentrate and be terribly annoying.

Some are born with a reduced function of the eustachian tube, but the problem can also arise later in life for many different reasons - eg allergies. The condition means that the pipe is constantly blocked or that the problem returns repeatedly. The condition creates negative pressure in the ear, and with long-term blockage, fluid occurs in the middle ear, which can, for example, cause chronic otitis media.

How do we make the diagnosis?

During a preliminary examination with the specialist, a thorough review of the medical history is carried out from childhood to adulthood. Have there always been problems with the ears, or is the problem new? This - and much else - gives the specialist important information about the options for treatment. A thorough hearing test is carried out as well as a so-called tympanometry, where the middle ear pressure is measured with an advanced measuring device and the movement of the eardrum is assessed. A video recording is also made of the movement of the tympanic membrane while the patient is sitting up, where it is ascertained whether the patient can equalize the pressure or not.

If you experience symptoms of blockage of the eustachian tube, we recommend Charlottenlund Privathospital that you have this investigated in terms of whether anything can be done to improve the condition. During the initial examination, our leading ENT doctors can quickly and accurately help identify whether the Eustachian tube is impaired, or whether it is open, and whether a balloon dilatation is necessary. The doctor examines the ears thoroughly and then assesses what treatment is needed to remedy the problem.

However, it can also be a case of another disorder, e.g. chronic otitis media. See what different treatments and operations in the ear we offer at Charlottenlund Private Hospital.

Treatment of reduced function of the eustachian tube

If, on the basis of the investigation, the specialist assesses that the symptoms can be alleviated with the help of a balloon expansion of the Eustachian tube, you will be scheduled for surgery. The operation is called in technical language a "tubal dilatation" and this is an effective treatment that in most patients provides a long-term improvement in the function of the Eustachian tube. This intervention will in some cases be covered by your health insurance, but unfortunately is no longer covered by the extended free choice of hospital for citizens in Region H. For citizens in all other regions, it is still possible to be treated at Charlottenlund Private Hospital - completely free of charge - through the extended free choice of hospital. If you do not live in the Capital Region and are referred to a public hospital where there is a waiting period, you will in many cases be able to undergo surgery with us. Talk to your patient advisor at your home hospital about the options.

How does a balloon dilation of the Eustachian tube take place?

The operation lasts approx. 30 minutes and is done under full anesthesia. It takes place through the nostrils using a scope and probe. A balloon is introduced up through the nasopharynx and into the Eustachian tube, which is inflated and held still for 2 minutes. Approximately 75% of all patients experience an effect after the operation. This means that, after the operation, you can most likely equalize the pressure in the ear again, and that the air can freely pass from the middle ear to the throat. It will thus be possible to travel by plane without getting pain in the ears, and maybe take the diving certificate that you have always dreamed of, but never got because of pain in the ears.

Before the operation

Before the operation, you should have used a prescription nasal spray with adrenocortical hormone for 2 weeks. We also recommend that you buy over-the-counter medication such as Panodil before the operation, as some patients have slight pain after the operation.

After the operation

Some patients experience slight pain in the ears or pressure in the ears after the operation, which is usually only a good sign that the intervention has had the desired effect. After the operation, you must be treated preventively with antibiotics for a week in the form of broad-spectrum penicillin as tablets and two different nasal sprays in each one week (Zymelin/Otrivin) and two months (adrenocortical hormone nasal spray). The day after the operation, you must begin to equalize the pressure several times an hour, which must continue until the check-up two months after the operation, so that you train the function of the Eustachian tube.

Approx. two months after the operation, you will be called in for an outpatient check-up, where you will have your ears checked, and we will assess the effect of the intervention. At the same time, we decide at this stage whether there is a need for further control - but this is often not necessary.

Complications

The risks of the operation are very small. After the procedure, there may be soreness in the ears and nose and a little bleeding from the nose. An effect in the form of healing can be expected for approx. 75% of treated patients. There is a small risk of otitis media.

Make an appointment for balloon dilation of the Eustachian tube

At Charlottenlund Private Hospital, we have many years of experience in treating patients with reduced function of the eustachian tube, and our experienced ENT doctors are ready to help you.