Efficacy and long-term outcome of balloon Eustachian tuboplasty (BET) are debated controversially, as high quality prospective controlled studies in this area remain sparse [
1]. In children chronic otitis media with effusion (COME) is a common and often recurrent problem even after first-line treatment involving adenoidectomy (AT) and paracentesis (PC) with or without ventilation tube (VT). Eustachian tube dysfunction (ETD) is considered to be partly causative and retrospective data on BET in children show promising results [
2,
3]. With sham surgery being unethical and a large heterogeneity in disease severity in ETD among patients of all ages, study planning is challenging. Although alternative approaches have been advocated (delayed start design,
see [
4]), the ears provide the possibility of a within-patient control. …