The eustachian tubes are hollow canals that connect the middle ear to the back of the throat, helping to regulate pressure and drain fluids from inside the ears. These tubes stay closed to protect the middle and inner ear from bacteria and viruses, but they open during certain functions.

When we chew, swallow, or yawn, the tubes open with a slight popping sensation to help equalize air pressure between the ear and the outside environment. They are located behind the ear drum and extend to the back of the nasal cavity.

What is eustachian tube dysfunction?
Sometimes, the eustachian tubes fail. This causes fluid buildup in the middle ear, which can be painful. There are three types of eustachian tube dysfunction, and diagnosis is determined by how the tubes have failed. Patulous ETD occurs when the tubes remain open, and obstructive ETD occurs when the tubes don’t open properly. Both can be caused by environmental allergens, inflammation, acid reflux, abnormal tissue growth, cancer, and more. Eustachian tube dysfunction may also be associated with chronic ear infections, or otitis media.

Baro-challenge-induced ETD is a unique condition in which the tubes don’t open properly due to atmospheric changes, like when at extreme altitudes like traveling in a plane or scuba diving.

Signs & Symptoms
Depending on the type of dysfunction you’re experiencing, the symptoms can vary. The most common symptoms of eustachian tube dysfunction are fullness in the ear, muffled or distorted hearing, pain, ringing in the ears/tinnitus, clicking or popping sensation, dizziness or vertigo, and other balance issues. For patients with patulous ETD, the tubes may carry sound from the nasal cavity to the ear drum. Muffled hearing can be the most prominent sign for people with obstructive ETD.

For most patients, ETD is temporary and can be relieved with over-the-counter medication. If your symptoms last longer than two weeks, we strongly recommend talking with your primary care physician. Lingering ETD symptoms can affect our hearing, so seeking treatment is important for the best patient outcome. For severe cases, patients may require surgical intervention.

Treatment Options
Over-the-counter medications can help patients with eustachian tube dysfunction caused by allergies or other sinus-related illnesses like the common cold and the flu. Antihistamines, decongestants, nasal sprays, and pain relievers can help to relieve any discomfort, but long-term use is not recommended for patients with chronic conditions. Infections may require antibiotics or corticosteroids to combat inflammation.

For patients with severe or chronic ETD, surgical procedures may be required to prevent ongoing problems. Depending on the severity of your condition, your surgeon may suggest one of several options. A myringotomy is a simple procedure in which a small incision is made on the eardrum to drain fluids from the middle ear. Sometimes, a pressure equalization tube or tympanostomy tube may be inserted to keep the incision open. Eustachian tuboplasty, also known as eustachian tube balloon dilation, is a new treatment option that uses endoscopic tools to reinflate the eustachian tubes.

Post-Surgical Care
Patients who undergo a myringotomy usually make a full recovery in the days after their surgery. Because some of these procedures require anesthesia, patients cannot drive for at least 24 hours and will require transportation after surgery. There should be no visible swelling or bruising, however, some patients may experience mild tenderness, soreness, or temporary congestion. Your doctor may prescribe ear drops or a nasal spray for a few days after your procedure.

Your surgeon will provide you with a full list of preventative measures you can take to ensure proper healing, and any warning signs you should look for during the process. It is important to talk with your surgeon about any questions you have about the procedure, recovery, and your condition before signing consent for surgery. Most patients can return to their regular activities within a day or two after surgery, regardless of the surgical method chosen.

At-Home Symptom Relief
Under normal circumstances, eustachian tube dysfunction will subside on its own without any major repercussions. However, for patients with chronic ETD, long-term fluid buildup and pressure within the ear can cause hearing damage. If you have mild ETD symptoms that are not recurring or persistent, there are a few things you can do to relieve symptoms at home without medication.

For people with mild ETD, there are two at-home remedies that you can try to make yourself more comfortable until the symptoms subside. Eustachian tube massage can release fluid buildup and should be performed about three times per side, three times a day. Starting at the back of the ear lobe, run your fingers down the back of the jaw through to the collar bone with the same pressure. The Valsalva maneuver is a quick way to relieve that clogged feeling by “popping” your ears. Close your nostrils and mouth, then push the air in your lungs outward until you hear a slight “pop”. Do not blow too forcefully, as there is a slight possibility of rupturing your eardrum. People with sinus infections or viruses should not attempt this technique, as exposing the eustachian tubes to bacteria can cause an ear infection. You can also chew gum or yawn to release air pressure from within the ear.

While ETD is not usually a serious condition, it can affect your day-to-day life by making it harder to properly hear. For people with chronic conditions, untreated ETD can cause hearing loss or damage to your middle ear and tympanic membrane. If you’ve experienced ETD symptoms for longer than two weeks, we highly recommend seeking treatment to avoid permanent damage, tinnitus, and other hearing- or balance-related issues. Contact Acadian Ear, Nose, Throat, & Facial Plastics by phone at (337) 237-0605 for more information, or to schedule your initial consultation today!