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Objective  Documentation of middle ear pressure at different stages of balloon Eustachian tuboplasty and assessing risk of barotrauma with this procedure.    Main outcome measures  Middle ear pressure measurements in patients undergoing balloon Eustachian tuboplasty at the time of pre‐insertion, catheter insertion, inflation, one minute post inflation, deflation, and catheter withdrawal, as well as documentation of pressure change in the middle ear between different stages.    Results  A total of 24 patients and 45 Eustachian tubes, 11 females and 13 males, with an average age of 55.6 years were included in this study. Middle ear pressure values during the active stages of the procedure varied from −356 to +159 daPa. The overall greatest negative pressure change measured was −515 daPa from catheter insertion to immediately post balloon inflation. The overall greatest positive pressure change measured was +418 daPa from immediate catheter inflation to one minute post inflation.    Conclusions  There was no consistent pattern of middle ear pressure change noted during the different stages of balloon Eustachian tuboplasty as both positive and negative middle ear pressure changes were noted at the time of balloon dilation. Dangerous levels of middle ear pressure raising concern for barotrauma were not identified during the procedure.    Level of evidence  Level IV.

In vivo study measuring middle ear pressure during various stages of Eustachian tube balloon dilation