The Eustachian tube is a tube that connects the middle ear and a cavity behind the nose. It is a hollow, tiny tube located in the middle ear, attached between the pharynx and the middle ear. Its function is to balance the internal and external ear pressure. If both pressure levels are not equalized, this may well result in hearing problems, and if the levels differ greatly, this may cause ear pain.

 

 

 

The Balloon dilatation technique is a major breakthrough in terms of medical technology and was developed for the treatment of a blood vessel blockage in heart disease patients by inserting coils to dilate the clogged blood vessel. This technique is currently being   adapted to treat constriction of the Eustachian tube, or the tube that connects the middle ear and the cavity behind the nose to correct the abnormality using balloon dilatation; a technique developed to replace surgery. In foreign countries, this technique has been used with patients   for about a   year, while BNH first introduced it in Thailand 2 months ago, and is the first hospital to use this kind of technique.

 

 

Diseases that can be cured using the balloon dilatation technique:

1. Chronic inflammation of the middle ear (Chronic Mucoid Otitis Media) or Otitis – caused by long-term inflammation of the middle ear and may give rise to   other complications such as meningitis, inflammation of the inner ear, brain abscess, ear abscess, throat abscess, and facial paralysis.

2. Fluid in the middle ear (Chronic Serous Otitis Media) - It usually happens after having a cold, inflammation of throat, sinusitis, or allergies which make the tube that connects the cavity behind the nose and the middle ear swollen and constricted, and traps fluid in the middle ear that may be pus-like, clear yellow, or clear. Patients who have trapped fluid in the middle ear will have tinnitus and partial loss of hearing.

3. Retraction of Eardrum – caused by ear infection, ear injury, or sudden change of air pressure, resulting in tinnitus, hearing loud noise in the ear, ear pain, and possibility of ear bleeding.

4. Eustachian Tube Disorder – The tube that connects the middle ear and the cavity behind the nose maintain the equilibrium of pressure level of the middle ear and external atmosphere. Dysfunction of this tube will cause tinnitus, ear pain, ringing in the ears, or dizziness. 

5. Nasal cavity inflammation from allergies (Allergic Rhinitis) – caused by irregularity of the body’s immune system where symptoms show up through the nose. Nasal membrane inflammation is triggered by allergens, causing itchiness, a running nose, sneezing, and a stuffy nose. As a result the   Eustachian tube may become swollen, blocked, and can also impair hearing.

6. Post Radiation Eustachian Tube Blockage – caused by   a blockage of   the Eustachian tube, usually occurs after having radiation due to   the treatment administered for Nasopharyngeal cancer resulting in tinnitus, and distorted hearing.

7. Sudden change of air pressure – impairs air pressure regulation of the middle ear (Recurrent Otitic Barotrauma). Frequent inflammation of the connecting tube between the middle ear and respiratory tract may cause blockage.
 

 

 

 

   The way to treat a patient changed radically when a BNH doctor discovered this new innovative technique for the first time ever in Thailand which involves, dilating the tube in the middle ear to treat patients with hearing problems. It helps to restore patients’ hearing ability without disturbing the natural structure of the ear or resorting, to invasive surgery making the use of any special equipment unnecessary. In addition, it also helps to decrease risk of other complications and subsequent wound infection.

 

   Dr. Pasakorn Thavornant, an expert in Otolaryngology at BNH Hospital, said that the symptoms of having mild hearing loss, hearing echo, and intermittent tinnitus are the warning signs of abnormality in the middle ear. When there is an imbalance in the air pressure inside the ear caused by the constricted tube that connects the middle ear and a cavity behind the nose, it limits the ability to regulate the air pressure and release of accumulated mucous, and as a result affects hearing. 

 

   Nowadays, middle ear abnormality can be cured by using the balloon dilatation technique (Balloon Dilatation of the Eustachian Tube), it is the same successful approach used for treating both sinusitis and heart diseases. Doctors have been using this technique for a year in other countries and it has been available for about two months in Thailand.

 

   BNH is the first hospital that has begun using this technique to cure patients having unclear hearing, hearing echo, and tinnitus caused by the constricted tube that connects the middle ear and the cavity behind the nose (Eustachian Tube) or patients born with a dysfunctional Eustachian tube. This method not only gets to the root cause of the problem without needing surgery, but also shortens recovery time.

 

   “This balloon technique to dilate the tube connecting the middle ear and the cavity behind the nose does not require patients to have a tiny tube inserted in their ears as in the past,” says Dr. Pasakorn. He also emphasized that treatment statistics of this technique in foreign countries showed a 90% success rate and the chance of recurrence is only 10%, depending on the severity of the disease in each individual.
“In the past, treatment of Eustachian Tube abnormality required drilling of the eardrum to take the liquid out in order to maintain the optimal level of internal pressure inside the ears. For cases with serious symptoms - the liquid became too condensed, the doctor needed to insert a tiny tube inside the eardrum to drain the confined liquid in the middle ear,” the doctor said.
 

   “This tube would be in the ear about a year and a half and it will come off. However, with this treatment, many patients still did not get any better. Therefore, the drilling of the eardrum is repeated two to three times to improve the symptoms. This can cause loss of elasticity of the membrane as well as accumulation of calcium” explained the doctor. He also added that the patients treated by this method were limited to some activities such as swimming to prevent water to enter the middle ear that could cause inflammation.
Nowadays, the treatment concept has changed to aim at maintaining the body's natural structures as much as possible by avoiding destruction which is the cause of inflammation and implications. This change means that the balloon dilatation technique is an ideal form of alternative treatment, especially for patients treated with 3-4 months with symptoms still persisting.

 

   The doctor also added that the balloon dilatation technique was the treatment of choice to get to the root cause of the condition and if diagnosis and treatment are provided early enough, patients will be able to live their lives normally without having to put up with constantly irritating symptoms.