Balloon dilation has become established as a novel method for managing chronic ventilatory dysfunction of the Eustachian tube. In the present study the role of this method was assessed in a population of adult patients with ventilatory dysfunction of the Eustachian tube which did not respond to other treatment. The presence of a space-occupying lesion was ruled out. Clinical symptoms improved in 70 % of the patients after balloon dilation and none of the patients reported deterioration of symptoms. Balloon dilation is a rapid, simple and safe method and is currently used in particular for treating patients with ventilatory dysfunction of the Eustachian tube which does not respond to other treatment. Further studies, ideally multicentre studies are required in order to optimize the definition of existing and potential new indications for this treatment approach.