{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T12:48:12Z","timestamp":1789649292978,"version":"4.0.0"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There has been a recent increase in the publication of articles evaluating outcomes of balloon dilation of the eustachian tube (BDET) as a treatment for chronic eustachian tube dysfunction (ETD). Our objective was to evaluate the overall efficacy of BDET for treating ETD, with a subgroup analysis of BDET performed under local anesthesia (LA) versus general anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PUBMED, EMBASE, and Cochrane databases were searched for English articles from January 2010 to October 2025. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Only randomized controlled trials and prospective studies evaluating BDET for ETD were included. All articles evaluating BDET performed under LA were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our search identified a total of 23 articles after screening (365 articles). Only studies using homogeneous and validated outcome measures were included. A total of 6 studies met criteria for meta-analysis of preoperative and postoperative outcomes of BDET as assessed by the ETD Questionnaire (ETDQ-7). Other reported parameters include LA protocols and surgical complications. Seven studies used LA protocols. A meta-analysis using the random effects model demonstrated a decrease in mean ETDQ-7 scores by 2.03 up to a year following BDET (309 patients, CI \u22122.59 to \u22121.47,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Descriptive statistics were used to analyze studies where BDET was performed under LA due to outcome heterogeneity. The results demonstrate no significant differences in otologic post-BDET outcomes (tympanometry\/ETDQ-7 scores), minimal complications, and high patient-reported willingness to choose LA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BDET is effective for treating chronic ETD. BDET performed under LA with careful patient selection and an established LA protocol is safe and comparable to BDET in the operating room.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251407935","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:06:05Z","timestamp":1773227165000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Balloon Dilation for Chronic Eustachian Tube Dysfunction Under Local and General Anesthesia: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3627-8277","authenticated-orcid":false,"given":"Usman","family":"Khan","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2014Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1736-6618","authenticated-orcid":false,"given":"You Sung (Jon)","family":"Nam","sequence":"additional","affiliation":[{"name":"Dalhousie Medical School, Dalhousie University, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5079-1862","authenticated-orcid":false,"given":"Colin","family":"MacKay","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nael","family":"Shoman","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2014Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819848423"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820924322"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26827"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818821938"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26800"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2003.02748.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-02848-1"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002648"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215117000974"},{"key":"e_1_3_2_11_2","article-title":"Local versus general anesthesia for balloon dilation of the eustachian tube: a single-center retrospective study in a Chinese population","volume":"2020","author":"Chen X","year":"2020","unstructured":"Chen X, Xie L, Zeng H, Xu Y, Xiong H. Local versus general anesthesia for balloon dilation of the eustachian tube: a single-center retrospective study in a Chinese population. Ear Nose Throat J. 2020;2020:145561320923172.","journal-title":"Ear Nose Throat J"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001853"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002396"},{"key":"e_1_3_2_14_2","article-title":"Effect of balloon eustachian tuboplasty in adults that only have symptoms of chronic eustachian tube dysfunction, with a 1-year follow-up: prospective clinical trial","volume":"2020","author":"Form\u00e1nek M","year":"2020","unstructured":"Form\u00e1nek M, Form\u00e1nkov\u00e1 D, \u0160koloud\u00edk L, Zelen\u00edk K, Chrobok V, Kom\u00ednek P. Effect of balloon eustachian tuboplasty in adults that only have symptoms of chronic eustachian tube dysfunction, with a 1-year follow-up: prospective clinical trial. Ear Nose Throat J. 2020;2020:145561320980199.","journal-title":"Ear Nose Throat J"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12812"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.842"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-022-07578-2"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26488"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13236"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wjorl.2019.08.001"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21007"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.652"},{"issue":"6","key":"e_1_3_2_23_2","first-page":"501","article-title":"Balloon dilation of the eustachian tube: a randomized controlled trial with 6 months follow-up","volume":"18","author":"Krogshede SK","year":"2022","unstructured":"Krogshede SK, Kirchmann M, Peter A, Glad H. Balloon dilation of the eustachian tube: a randomized controlled trial with 6 months follow-up. Clin Otolaryngol. 2022;18(6):501-506.","journal-title":"Clin Otolaryngol"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31092"},{"issue":"1","key":"e_1_3_2_25_2","article-title":"Prospective evaluation of the efficacy of isolated balloon eustachian tuboplasty: short- and medium-term follow-up results based on tubomanometry, ETDQ-7, tympanometry, and valsalva maneuver","volume":"28","author":"Azevedo C","year":"2024","unstructured":"Azevedo C, Moreira F, Lima AF, Mar FM, Vilarinho S, Dias L. Prospective evaluation of the efficacy of isolated balloon eustachian tuboplasty: short- and medium-term follow-up results based on tubomanometry, ETDQ-7, tympanometry, and valsalva maneuver. 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