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Eustachian Tube Dysfunction

 

The Eustachian tube is a narrow tube that connects the middle ear with the back of the nose. Eustachian tube dysfunction (ETD) means that the Eustachian tube is blocked or does not open properly. Therefore, the air pressure on the outer side of the eardrum becomes greater than the air pressure in the middle ear. This pushes the eardrum inward. The eardrum becomes tense, and does not vibrate so well when hit by sound waves.

Causes

  • Blocked Eustachian tube
  • Swollen lining of the tube
  • Inability of the tube to open
  • Colds and other nose, sinus, ear or throat infections
  • Glue ear (a condition where the middle ear fills with glue-like fluid instead of air).
  • Allergies
  • Rarely, ETD can be a symptom of rare tumors that sometimes develop at the back of the nose

Symptoms

  • Muffled or dull hearing
  • Ear pain
  • Feeling of fullness in the ear
  • Tinnitus (ringing or buzzing in the ear)
  • Dizziness

Symptoms can last from a few hours to several weeks or more depending on the cause.

Treatment

  • Try to get air to flow into the Eustachian tube: Air is more likely to flow in and out of the Eustachian tube if you swallow, yawn or chew. Also, try doing the following. Take a breath in. Then, try to breathe out gently with your mouth closed and pinching your nose (the Valsalva manoeuvre). In this way, no air is blown out but you are gently pushing air into the Eustachian tube. If you do this you may feel your ears go 'pop' as air is forced into the middle ear. This sometimes eases the problem. This is a particularly good thing to try if you get ear pain when descending to land in a plane.
  • Decongestant nasal sprays or drops: These may be advised by your doctor if you have a cold or other cause of nasal congestion. You can buy these from pharmacies. They may briefly relieve a blocked nose. However, you should not use a decongestant spray or drops for more than 5-7 days at a time. If they are used longer than this, they may cause worse 'rebound' congestion in the nose.
  • Antihistamine tablets or nasal sprays: These may be advised by your doctor if you have an allergy such as hay fever. In this situation they will help to ease nasal congestion and inflammation.
  • Steroid nasal spray: A steroid nasal spray may be prescribed by your doctor if an allergy or other cause of persistent inflammation in the nose is suspected. It works by reducing inflammation in the nose. It takes several days for a steroid spray to build up to its full effect. Therefore, you will not have an immediate relief of symptoms when you first start it. However, if any inflammation is reduced in the back of the nose, then the Eustachian tube may be able to work better.

Prevention

  • Avoid pressure changes
  • Avoid second-hand smoke
  • Avoid respiratory infections
  • Avoid allergies