Balloon Dilation of the Eustachian Tube

Question 1

Anesthesia/Sedation for Eustachian Tube Balloon Dilation

Answer 1

1) 10mg Diazepam 90 minutes prior to procedure
2) 5mg Hydrocodone 30 minutes prior to procedure
3) 4 Sprays of Afrin/Lidocaine Mix into the nostril/s on arrival
4) Staggered Placement of 2 cottonoids soaked in 2% Tetracaine along the nasal floor bilaterally (10 minutes)
4) 5mL Pliagliss Compounded (7% Tetracaine/7% Lidocaine) drops on ET orifice via Weiss needle and replacement of Tetracaine Soaked pledgets (10-15 minutes)

Question 2

Injection Protocol for Balloon Dilation of the Eustachian tube

Answer 2

1) Place 4% Lidocaine-soaked cotton pledgets in the nasal cavity bilaterally for 10 minutes
- Slide the pledgets posteriorly onto the Torus Tubaris after 10 minutes - let this sit for 10 minutes
2) Inject the following areas of the nose with 1% lidocaine using a Reinforced Anesthesia Needle/RAND Needle (from Styker):
- Posterior part of the inferior turbinate
- Posterior nasal septum
- Inject the Torus Tubaris

Question 3

Eustachian Tube Balloon Dilatation

Answer 3

1) Insert the balloon into the Eustachian Tube orifice until the yellow stripe on the balloon is visible
2) Inflate the balloon to 12 Atm
3) Deflate after 2 minutes