Eustachian Tube Dysfunction

Eustachian tube dysfunction (ETD) is the failure of the Eustachian tube to open and/or close properly. When the Eustachian tube (the passage that leads to your middle ear) doesn’t open and/or close properly, it is usually due to the Eustachian tube being narrowed or clogged.

Functions of the Eustachian Tube

Anatomy of Human ear

The Eustachian tube is a narrow tube that links the back of the nose to the middle ear. It is normally closed but opens when we swallow, yawn, or chew. Its three main functions are to:

- Protect the middle ear from pathogens.
- Regulate ear pressure to enable the eardrum to work and vibrate properly.
- Help drain secretions from the middle ear.

Causes of Eustachian Tube Dysfunction

Because the canals in the tubes are so tiny, blockages can happen for many reasons, including

- Sinus infections causing inflammation around the Eustachian tubes
- Seasonal allergies (cause increased mucus and congestion)
- Illnesses that create inflammation, such as the flu or cold
- Simple changes in altitude or air pressure
- Laryngopharyngeal reflux (LPR), e.g., silent reflux

All of these conditions can trigger ETD.

Risk Factors for Eustachian Tube Dysfunction

You may be more prone to Eustachian tube dysfunction if

- You smoke.
- You are obese.
- You have allergies.
- You hike, rock climb, ski at a high altitude, or scuba dive.

Children may be more at risk for Eustachian tube dysfunction because they have much smaller Eustachian tubes and may have more frequent colds and sinus infections.

Symptoms of Eustachian Tube Dysfunction

The signs and symptoms of Eustachian tube dysfunction include:

- Chronic pressure in the ears
- Pain in the ears
- Clogged or underwater feeling
- Loud hearing of your voice (autophony)
- Crackling or popping sounds in the ears
- Ringing in the ears
- Muffled hearing

When To See a Doctor

You should see a doctor for evaluation for Eustachian tube dysfunction if you have had symptoms for more than 2 weeks. Children with suspected Eustachian tube dysfunction should see a doctor sooner, as the symptoms are similar to an ear infection.

Diagnosing Eustachian Tube Dysfunction

During your consultation, your ENT doctor will ask you questions about your hearing changes, pain in the ears, feelings of pressure, or any other underlying illness that may be causing your symptoms. Your ENT doctor will also use an otoscope to look inside the ear to check for any signs of infection or blockages.

If an underlying illness or disorder is causing your symptoms, such as allergies, you will receive treatment for the underlying illness to resolve your symptoms.

Treatment Options for Eustachian Tube Dysfunction

Symptoms of Eustachian tube dysfunction usually resolve on their own and don’t require any treatment. However, if symptoms are bothersome, you can try some home remedies to help open and close the Eustachian tube to relieve the pressure. For example, if symptoms are due to a change in altitude or air pressure, chew gum, force a yawn, swallow, drink water or have a snack. For infants, give them a bottle or pacifier to relieve symptoms.

If these home remedies don’t work, you can try self-inflation of the ears. Pinch your nose closed, hold your breath, and blow through your nose to “pop” your ears. This helps to force air through the Eustachian tube into the middle ear. (Don’t do this if you have a cold or nasal discharge because it may drive infected mucous into the middle ear and cause an ear infection.)

For more moderate symptoms, you may want to use a saline nasal spray or irrigation system to clear passageways. If allergies are causing your Eustachian tube dysfunction symptoms, an antihistamine, such as Zyrtec, Benadryl, or Claritin, may provide the desired relief.

Treatment for Persistent Eustachian Tube Dysfunction

If you suffer from persistent Eustachian tube dysfunction, you may be a candidate for a minimally invasive treatment that uses a balloon dilation system that is safe and effective.

During the procedure, the device dilates (opens up) your narrowed and clogged Eustachian tube using a small balloon.

- The balloon is guided through your nose and into your Eustachian tube.
- Once in place, it is inflated to open up or widen your Eustachian tube to relieve any pressure imbalance or blockage that could be causing your discomfort.
- After your Eustachian tube has been widened, the balloon is deflated and removed.

This procedure is recommended for adults ages 18 and older with persistent ETD.

Benefits of ETD Treatment With Balloon Dilation

Because the procedure is minimally invasive and is done on an outpatient basis (usually in the office), you can expect a short recovery time. Since there are no cuts or incisions involved, you preserve your natural anatomy.

Also, the procedure does not require any placement of ear tubes or devices. It is a non-surgical approach to treat persistent ETD.