The Eustachian tube connects the nasopharynx at the back of the nose to the middle ear and is responsible for equalizing pressures with the external environment. When in an area of changing external atmospheric pressures (such as in an elevator or diving under water), the Eustachian tube may open or remain closed, creating a sensation of ear popping or ear fullness. The Eustachian tube is made of both cartilage and bone, with the cartilaginous component in the nasopharynx and the bony component closer to the middle ear. Eustachian tube balloon dilation is a procedure whereby surgeons place a balloon in the back of the nose and dilate the cartilaginous Eustachian tube to induce a healing response that favors improved functioning of a dysfunctional tube. This is an excellent choice for well-selected patients with Eustachian tube dysfunction and chronic ear fullness or ear infections (chronic otitis media), and is a good alternative to multiple sets of ear tubes for many people. Eustachian tube balloon dilation is safe and effective and can be performed in the office under local anesthesia.