Background Balloon catheter dilation of diseased sinus ostia has recently demonstrated efficacy and safety in the treatment of chronic sinus disease with 2 years of follow-up. Similar to sinus surgery, initial studies of partial resection of inflamed mucosa from within the cartilaginous eustachian tube (ET) have demonstrated efficacy and safety in the treatment of medically refractory otitis media with effusion. Therefore, balloon dilation of the cartilaginous \{ET\} was investigated as a possible treatment modality for otitis media. Methods A protocol for sinus balloon catheter dilation was evaluated in each of the cartilaginous \{ETs\} in 8 fresh human cadaver heads. Computed tomographic scans and detailed endoscopic inspections with video or photographic documentation were performed pre- and posttreatment, and gross anatomical dissections were done to analyze the effects of treatment and to look for evidence of undesired injury. Results Catheters successfully dilated all cartilaginous \{ETs\} without any significant injuries. There were no bony or cartilaginous fractures, and 3 specimens showed minor mucosal tears in the anterolateral or inferior walls. Volumetric measurements of the cartilaginous \{ET\} lumens showed a change from an average of 0.16 to 0.49 cm3 (SD, 0.12), representing an average increase of 357% (range, 20–965%). Conclusions Balloon catheter dilation of the nasopharyngeal orifice of the \{ET\} was shown to be feasible and without evidence of untoward injury. A significant increase in volume of the cartilaginous \{ET\} was achieved. A clinical study is now indicated to determine whether balloon dilation will demonstrate lasting benefits and safety in the treatment of otitis media.

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