 Introduction Dysfunction in the auditory tube Eustachian tube ET is a frequent problem that may cause a series of middle ear conditions. Middle ear atelectasis, retraction of the tympanic membrane, in some cases retraction pocket type-cholesteatoma 5, chronic otitis, perforation of the tympanic membrane and conductive hearing loss due to poor middle ear ventilation are all associated with ET-dysfunction. The ET consists of two parts, the mobile cartilaginous part medially, and the fixated bony part laterally. The bony part is demarcated by thin bony walls and situated in the close proximity of vulnerable anatomical structures, while the cartilaginous part is supported by parapharyngeal soft tissue. Recent years, a new treatment procedure of ET balloon dilation has emerged. Restoration of ET function has offered a new approach for this large group of patients with great reduction of symptoms and secondary middle ear disease. 