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Aural fullness is a common complaint that we often come across in many of our otology patients. Management of this condition can be quite challenging. Common differentials include eustachian tube dysfunction, patulous eustachian tube dysfunction, otitic barotrauma, superior canal dehiscence and TMJ dysfunction. I read this article with interest. The senior author provides a very nice algorithm for management of aural fullness which is very clear, systematic and practical. I also like his tips on performing the eustachian tube dilation procedure under local anaesthesia, especially the detailed careful preoperative workup, his attention to detail on placement of local anaesthetic agents in the nasal cavity and in the ear at the appropriate key areas to gain maximum anaesthesia. Furthermore, he shares tips on choice of endoscope to perform the procedure accurately and smoothly. The author seems experienced in his technique and shares useful tips. Overall, I would recommend my colleagues read this nice practical paper.

In-Office Balloon Dilation of the Eustachian Tube under Local Anesthesia.
Dean M, Pynnonen MA.
OTOLARYNGOL CLIN NORTH AM
2019;52(3)509–20.
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CONTRIBUTOR
Sangeeta Maini

FRCS ORL-HNS, Aberdeen Royal Infirmary, Forresterhill, Aberdeen, AB25 2ZN.

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CONTRIBUTOR
Bhaskar Ram

Ain-Shams Faculty of Medicine, Cairo, Egypt.

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