What is eustachian tube dysfunction (EDT)?
The Eustachian tube is a narrow tube that connects the back of the nose to the middle ear. Eustachian tube dysfunction (ETD) occurs when the mucosal lining of this tube becomes swollen or the tube does not open or close properly.
What causes eustachian tube dysfunction?
The Eustachian tube is normally closed but opens when we swallow, yawn, or chew, and its functions include:
- Protecting the middle ear from infection
- Ventilating the middle ear and keeping air pressure equal on both sides of the eardrum, allowing it to work and vibrate properly
- Draining secretions from the middle ear cleft
Eustachian tube dysfunction (ETD) is the inability of the eustachian tube to adequately perform these functions; however, the underlying causes of dysfunction are complex and not fully understood, but may include infectious or inflammatory conditions such as:
- Allergic rhinitis
- Rhinosinusitis
- Upper respiratory tract infections
Other conditions that have been associated with ETD include:
- Cleft palate
- Inflammation or enlargement of the adenoids
- Nasal polyps
- Nasal septal deviation
- Trauma
- Tumors
The risk of ETD is higher in those who smoke, with gastroesophageal reflux disease (GERD), or with a history of radiation exposure.
What are the symptoms of eustachian tube dysfunction?
Symptoms of eustachian tube dysfunction (ETD) may vary depending on the cause and severity but may include:
- A feeling of fullness in the ear
- Difficulties in pressure equalization
- Muffled or reduced hearing
- Pain
- Problems with balance
- Tinnitus
Long term, untreated ETD may cause damage to the middle ear and the eardrum and include otitis media with effusion (glue ear), retraction of the eardrum, and chronic otitis media.
How is eustachian tube dysfunction diagnosed?
If you have symptoms suggestive of eustachian tube dysfunction (ETD), see your doctor. The diagnosis is usually based on your symptoms, a physical examination, and other tests ordered by your doctor to confirm the diagnosis and identify potential underlying causes.
Symptoms that suggest ETD include:
- An inability to “clear” or “pop” the ear during changes in barometric pressure
- Feeling of fullness
- Muffled hearing
How is eustachian tube dysfunction treated?
Most cases of eustachian tube dysfunction (ETD) resolve in a few days and simple measures such as yawning, swallowing, chewing, or forced exhalation against a closed mouth (known as the Valsalva maneuver) are enough to equalize pressure in the middle ear and resolve symptoms.
Treatments for persistent ETD include:
- Blowing up a balloon with each nostril
- Nasal douching with saline
- Decongestants
- Antihistamines
- Nasal or oral corticosteroids
- Antibiotics
- Surgery
