Eustachian tube dysfunction

ear anatomy showing eustachian tubeThe eustachian tube is a structure that functions like a pathway between the middle ear and nose. It functions to equalize pressure in the middle ear and the surrounding environment.  It is also involved in protecting the middle ear as well as removing secretions from the middle ear space.  When eustachian tube dysfunction occurs, you may experience symptoms of:

  • pain in the ears
  • ear fullness
  • “crackling” or “popping” noises in the ears
  • muffled hearing and/or tinnitus (ringing in the ears)
  • dizziness or the sensation of being “off balance”
  • feeling of pressure in the ears

man on airplane with ear pressure from eustachian tube dysfunctionChanges in altitude can make this worse. This may occur while traveling to a mountainous area, flying in an airplane, or even going up in an elevator. If the eustachian tube dysfunction continues it may lead to fluid accumulating in the middle ear space.  As a result, this can worsen the symptoms described above.

causes of eustachian tube dysfunction

When there is increased inflammation either within the tube itself or at the opening of the tube into the nose, the eustachian tube may not function properly.  Developing  a cold or sinus infection is an example of this. Frequently, patients who suffer from allergies also describe symptoms of eustachian tube dysfunction.  Sometimes, nasal polyps or other types of growths towards the back of the nose may compromise the function of the eustachian tube. In addition, some people are predisposed to this condition because of the size or caliber of the eustachian tube related to individual anatomy.

treatment of eustachian tube dysfunction

First, conservative medical treatment for eustachian tube dysfunction should be sought. This typically involves the use of prescription and over-the-counter medications.

These medications can reduce any inflammation within the tube or adjacent to that in an effort to “open” the tube and promote its normal function.  For example:

  • intranasal steroids such as fluticasone nasal spray (Flonase)
  • decongestants (Sudafed)
  • antihistamines (allergy pills)
  • over-the-counter anti-inflammatory medicines such as ibuprofen or naproxen
  • oral steriods (prednisone)

Another option is to make a small incision in the eardrum to suction out middle ear fluid or insert a ventilation tube in the eardrum to help keep it open.

In cases where medical treatment is insufficient to resolve eustachian tube dysfunction and it presents a chronic problem, a procedure known as eustachian tube balloon dilation may be helpful.