Eustachian Tube Dysfunction

What Is Eustachian Tube Dysfunction?

The Eustachian tube connects the nose and throat to the ear. It controls traffic between these structures. It allows the ears to clear into the nose and throat. The lining of the ear, nose, throat, and lungs is contiguous. The Eustachian tube shares this same lining or mucosa. Eustachian tube dysfunction means failure of the Eustachian tube to ventilate the middle ear, or space behind the eardrum. The severity of this dysfunction varies from mild to severe.

What Causes Eustachian Tube Dysfunction?

Most commonly, ETD is due to local inflammation. This includes sinus infections, allergies, smoking, and acid reflex.

Less commonly, ETD is due to structural abnormalities. Examples of this would be cleft palate, Down syndrome, and other syndromes that cause stunted growth of the head and face.

Rarely, ETD occurs with obstruction due to local neoplasia. Growths/tumors of the sinuses or lymphoma are examples.

In children, ETD is common due to their small size and frequently colds. This will usually resolve as they grwo

What Are the Symptoms of Eustachian Tube Dysfunction?

Just as the severity may range from mild to severe, the symptoms also may be mild or severe. Mild symptoms include fullness in the ears when the Eustachian tube is challenged. Upper respiratory infection (common cold) or changes in elevation (air travel) are examples of Eustachian tube challenge.

Severe cases will lead to chronic infection, hearing loss, tympanic membrane perforation (hole in the eardrum), and cholesteatoma (growth behind the eardrum) formation.

How Is Eustachian Tube Dysfunction Diagnosed?

ETD can be diagnosed by discussing your symptoms and examining your ear. A hearing test can be helpful in determining the severity of the Eustachian tube dysfunction. The Eustachian tube can also be examined by a fiberoptic camera inserted through the nose. This is a quick and easy office based procedure.

Can Eustachian Tube Dysfunction Be Treated?

Mild cases of ETD do not require treatment. Treatment of root cause usually will prevent symptoms and progression. Smoking cessation, allergy treatment, treatment of sinus infections will improve mild cases of ETD.

More advanced ETD can be treated by attempt to ventilate the ear. This has traditionally been achieved by placing a pressure equalization tube in the eardrum. A small cut in the eardrum is made and a tiny tube made of plastic or other material is inserted.

Recently, Eustachian tube dilation has been developed. This allows the direct treatment of the malfunctioning Eustachian tube. A deflated balloon is inserted through the nose into the Eustachian tube and then inflated.