The eustachian tubes are small tubes that connect the middle ear with the back of the nose.  They help ventilate and drain mucus from the middle ear.  They are normally closed, but open with swallowing, yawning, chewing, and positive pressure.  

Eustachian tube dysfunction (ETD) affects about 1% of adults and occurs when the eustachian tube does not open properly or becomes blocked.  Air pressure on either side of the eardrum becomes uneven and can cause fullness, muffled hearing, pain, ringing, and dizziness.  Common causes include a cold or sinus infection, allergies, or large adenoids.  ETD also occurs if someone cannot equalize the pressure between the middle ear and surrounding atmosphere while flying or diving.  While ETD usually resolves on its own, persistent untreated ETD can lead to problems such as middle ear effusions, infections, and cholesteatomas.

In the past, treatment for ETD was mainly limited to medications (decongestants, nasal sprays, steroids) or placement of ear tubes.  A new treatment option became available in the U.S. in 2016.  The Acclarent AERA Eustachian Tube Dilation System is the first device approved by the FDA for the treatment of ETD.  A catheter is used to insert a small balloon through the nose and into the eustachian tube.  The balloon is inflated to help restore eustachian tube function.  After the eustachian tube is dilated, the balloon is deflated and removed.  Studies have shown a higher rate of success compared to medical treatment.