Eustachian Tube Dysfunction

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What is Eustachian Tube Dysfunction?

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The Eustachian tube is a small canal that connects the middle ear (behind the eardrum) to the back of the nose and upper throat. Its purpose is to equalize the air pressure in the middle ear with the outside environment.

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Eustachian tube dysfunction (ETD) occurs when the tube fails to open during swallowing or yawning, which results in a difference between the air pressure inside and outside the middle ear. It causes discomfort in the ear, hearing problems and will usually result in fluid accumulation behind the

eardrum.

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Causes

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If the pressure in the environment changes without a change in middle ear pressure, the ear may feel blocked and the eardrum cannot vibrate normally. This can cause hearing problems and discomfort in the ear.  It will also create a vacuum in the middle ear which will begin drawing fluid from the surrounding tissue – accumulating behind the ear drum – further hindering the ability of the eardrum to vibrate normally.  This can lead to a condition called Middle Ear Effusion (Also called Otitis Media with Effusion, Serous Otitis Media or Glue Ear).

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It often occurs when you experience altitude changes from events like flying in an airplane, driving on steep hills, riding in a fast moving elevator, or scuba diving. The symptoms can usually be relieved by swallowing, yawning, or chewing. ETD occurs if the tube is blocked or swollen, trapping air and fluids in the middle ear. This causes symptoms to continue beyond a few hours and can sometimes lead to ear damage.

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ETD is usually caused by nasal congestion from an allergy, cold, or other upper respiratory infection and sometimes by ear or sinus infections. Some people develop ETD because they have a narrow Eustachian tube. Sometimes the Eustachian tube can be mechanically blocked by adenoid tissue in young children or by tumors in adults.

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Risk Factors

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A risk factor is something that increases your chance of getting a disease or condition.

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The following factors increase your chances of developing ETD:

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• Activities with large, rapid altitude changes, such as flying in an airplane or scuba diving

• Allergy, cold, or other upper respiratory infection

• Ear or sinus infection

• Narrow Eustachian tube

• Adults with an underdeveloped ET

• Presence of obstructing tumors in the nasopharynx

• Children with large adenoids

• Children have a higher chance of developing ETD because their Eustachian tube is narrower than that of adults.

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Symptoms

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Symptoms of ETD can include:

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• Feeling of fullness or clogging in the ear

• Discomfort or pain in the ear

• Hearing loss

• Ringing in the ear ( tinnitus)

• Dizziness

• Symptoms cannot be relieved by swallowing, yawning, or chewing

• Pain if the blockage results in an infection

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Diagnosis

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Your doctor will ask about your symptoms and medical history, and perform a physical exam. A lighted instrument called an otoscope is used to look inside your ear. The doctor will check for a slight bulge outward or inward of the eardrum, as well as fluid and inflammation. If your case is severe, your doctor may refer you to a specialist in ear disorders (otolaryngologist).

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Other possible tests include:

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• Tympanogram – to measure pressure in the ear canal and movement of the eardrum

• Audiogram – to measure hearing

• Examination of the nose and the back of the nose with a telescope

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Treatment

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To deal with ear clogging, discomfort, or pain the typical treatment has been Nasal or oral decongestants, oral antihistamines, or nasal steroids.  These medications have been used to try and relieve nasal congestion and enable the Eustachian tube to open. If pain relief is needed, you can use medications such as acetaminophen or ibuprofen.

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In some cases, if the Eustachian tube does not open with other treatments, a myringotomy may be necessary. The doctor makes an incision in the eardrum to allow the pressure to equalize and the fluid to drain.

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The EarPopper device is the latest treatment for opening the Eustachian Tube without any medication or myringotomy surgery.  The EarPopper opens the Eustachian tube naturally with air.

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The air is delivered through the nose and diverted up the Eustachian tube while the person swallows.  The entire treatment only takes a few seconds – and it only occurs when you swallow while the air is blowing.

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This treatment is known by Otolaryngologists as the Politzer Maneuver and is more commonly called Transnasal Eustachian Tube Inflation.  First discovered in 1860 by world famous Otologist Adam Politzer, he discovered that the Eustachian Tube could be opened safely and effectively with the right amount of air pressure and air flow.

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The EarPopper is a modified Politzer Device that is simple to use by anyone suffering from ETD.

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