Eustachian Tube Dilation

Eustachian tube dilation is a procedure using a small camera and balloon catheter through the nose to relieve recurrent ear infections or persistent ear fluid.


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What is Eustachian Tube Dilation?

Eustachian tube dilation is a novel procedure used to open the canal that connects the ear to the nose for a condition called Eustachian tube dysfunction (ETD). The procedure uses a balloon to dilate the tubular opening from the back of the nose. The Eustachian tube connects the ear to the nose to allow air pressure in the middle ear to be equal to the outside air pressure. This pressure equalization prevents fluid from accumulating in the middle ear, a condition called otitis media.

When is Eustachian tube dilation necessary?

Eustachian tube dilation is a minimally invasive procedure to treat Eustachian tube dysfunction (ETD) for people with persistent middle ear fluid, recurrent ear infections, and ear drum retraction. Other causes of ETD should be evaluated, including chronic rhinitis, nasal septal deviation, inferior turbinate hypertrophy, chronic sinusitis, nasopharyngeal masses, and adenoid hypertrophy, to establish an effective treatment plan. 


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How is Eustachian tube dilation performed?

Using an endoscope for visualization, a small FDA-approved balloon catheter (FDA approved in 2016) is guided through the nose and inserted into the Eustachian tube opening in the nasopharynx (back of the nose). This area is next to the location of the adenoids. Currently, the procedure is performed with brief general anesthesia and the patient can go home the same day.

Recovery is usually quick with minimal pain.

The FDA requires that every physician undergo specialized training in this procedure prior to performing it on patients.


Dr. Thomas Higgins was the first physician in Kentucky trained to use the Eustachian tube dilation device. He now provides training to other physicians across the country in effort to help make this procedure widely available for patients.

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Are there alternatives to ear tube surgery?

For a common condition that causes fluid to build up in the middle ear, a tube can be inserted into the eardrum to let air in and out. This procedure is called a myringotomy with tympanostomy tube insertion (or ear tube placement), which can be performed in the office or under general anesthesia. Eustachian tube dilation is an alternative to ear tubes that avoids a cut into the ear drum. This procedure may also help patients who have had many sets of ear tubes in the past. Doctors insert a thin tube through the nose and down to the back of the throat, where it is inflated with a small balloon. The balloon opens up the Eustachian tube and allows fluids to drain from the middle ear.


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Man with ear pain for ear infections | Eustachian tube dilation procedure | Dr. Thomas Higgins, Expert in Louisville, Kentucky

What are the risks of Eustachian tube dilation?

Any surgery has risks and making sure the benefits outweigh the risks is important discussion to have with your surgeon.


Some of the potential risks of Eustachian tube surgery include:



  • Nosebleeds
  • Risks of anesthesia
  • Infection
  • Scarring
  • Hearing loss
  • Tinnitus
  • Ear pain
  • Patulous Eustachian tube
  • Numbness
  • Carotid artery injury (exceedingly rare)


All surgeries have risks, but it is possible to minimize the risks by taking certain precautions and make sure that you are under the care of a qualified and experienced surgeon.


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Frequently Asked Questions

  • Who should I see for Eustachian tube dilation?

    We recommend you see an otolaryngologist or ENT who has expertise in managing ear, nose, and sinus conditions. Dr. Thomas Higgins is a fellowship-trained rhinologist (sinus specialist) and advanced sinus surgeon in Louisville, Kentucky who is dedicated to relieving people's sinus issues. Contact us today to begin your journey back to health.

  • Is Eustachian tube dilation safe?

    Eustachian tube dilation is safe using FDA-approved devices. The most common risks are trauma to the lining, scarring, and infection. The surgeon should be aware that carotid artery injury is possible but exceedingly rare. 

  • Does health insurance pay for Eustachian tube dilation?

    Health insurance may cover Eustachian tube dilation. Eustachian tube dilation has two CPT codes:

    • 69705: Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral
    • 69706: Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral

    Our dedicated staff reviews the medical necessity with your insurance company on your behalf and, occasionally, Dr. Higgins will even get on the phone with the health insurance doctor representative to aid in the approval process. Breathe easier with Dr. Thomas Higgins, a John Hopkins-trained sinus surgeon. (*Please note that insurance may require a portion of your individual contribution in the form of such items as deductibles, out-of-pocket expenses, and co-pays.)

  • Is Eustachian tube dilation painful?

    Eustachian tube dilation is performed with anesthesia, whether local or general, to reduce any pain associated with the procedure. After the procedure, people usually report minimal to no pain. 

  • How long does it take to recover from Eustachian tube dilation?

    Recovery from Eustachian tube dilation is very quick. People usually return to normal activities the very same day and pain after this procedure is minimal.

  • How long does it take to see results from Eustachian tube dilation?

    After Eustachian tube dilation, some people report ear pressure relief right away. As the area of the procedure heals, patients note significant improvement in symptoms up to 8 weeks after the procedure.  

  • What is the success rate of Eustachian tube dilation

    Studies have found that Eustachian tube dilation has a success rate between 63% and 92% in patients being followed for 3 to 12 months. Eustachian tube dilation has been shown to successfully improve or resolve ear symptoms, such as ear pain, ear pressure, or hearing loss.  The procedure also treats persistent ear fluid.