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A specialist at BNH brings the Eustachian tube balloon dilating technique to Thailand

Earache, rather like toothache, can be excruciating. Even if the symptoms are not overly painful but more uncomfortable - an echoing sound, for example, or reduced hearing, the first step is to consult your doctor, who will usually refer you to an otolaryngologist - a specialist dealing in ear, nose and throat disease.

Most disorders of the middle ear are caused by problems in the Eustachian tube, resulting in an imbalance in the air pressure and leading to symptoms ranging from too much fluid, tinnitus and otitis.

Treatment can involve anything from medication to insertion of an ear tube through the eardrum to drain the fluid,

In very serious cases, that tube needs to remain in the ear for as long as 18 months. While the risks are low, patients are advised to avoid swimming to prevent water entering the middle ear.

Now there's an easier way and thanks to otolaryngologist Dr Pasakorn Thavornant of the BNH Hospital, the balloon dilating technique of the Eustachian tube is available in Thailand.

The technique is adapted from heart balloon procedure -the non-surgical procedure that relieves narrowing and obstruction of the arteries to the muscle of the heart.

Dr Pasakorn was trained in the balloon technique for sinusitis a few years back ago in the US. The technique, known as balloon sinuplasty, relieves sinus pain and sinus pressure associated with chronic sinusitis and recurring sinus infections and involves a tiny balloon being placed into the nose to reach the blocked sinuses and then inflated to restructure the sinus opening.

"Last year, the treatment was used for middle ear disorders in America, and it showed a 90 per cent success rate with just a 10 per cent rate recurrence, so I decided to use the treatment for my patients a few months ago," he says.

This method not only gets to the root cause of the problem without needing surgery, but also shortens recovery time.

The doctor will use a nasal endoscopy to insert a flexible tube with a small balloon into the Eustachian tube through the nose. The balloon is left in the place for around one minute, with the aim of widening the constricted area, then the same procedure is repeated two or three times before the balloon is taken out. Each balloon is used for one patient only (for one or both two ears) and then disposed off according to proper hygienic procedures.

The balloon dilating process requires a local anaesthetic and the doctor will spend around 10-15 minutes for an ear and 30 minutes for both ears. The patient can return home immediately after the procedure. The cost is around Bt80,000.

"It helps to restore hearing ability without disturbing the natural structure of the ear or resorting to invasive surgery, making the use of any special equipment unnecessary," says Dr Pasakorn.

Standard treatment of ear problems looks at the symptoms before locating the problem area. If the area of concern is the middle ear, medicine will usually be given first. If there's no improvement, then the balloon dilating will be discussed with patients.

To date, Dr Pasakorn has treated three patients, one of them French and the other two Japanese,

The French patient complained of a wheezing and echoing sound when living in Thailand but said he felt relief when returned to France and went skiing in low air pressure area of the Alps.

"There was no other dysfunctional symptom other than the sound but the procedure cured the problem and the patient can live normally in Thailand," Dr Pasakorn says.

Both Japanese patients presented with chronic middle ear disorders with build-up of fluid. Dr Pasakorn first had to drill the eardrum and insert the tube to release the fluid out in order to maintain the optimal level of internal pressure inside the ears.

He has yet to do the balloon dilating treatment with Thai patients who, he says, often don't realise they have ear problems until these become very serious.

The disorder in the middle ear area can start from a common allergic problem leading to nasal cavity inflammation and causing the Eustachian tube to become swollen and blocked. Some people have pain when there's a sudden change in air pressure, such as during take off and landing of a plane.

The procedure will be a boon to patients suffering from nasopharyngeal cancer and receiving radiation that affect the function of the tube.

"It will help to heal pain and hearing problems without any more surgery," he says.


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