Eustachian Tube Dysfunction

The Eustachian tubes are the openings that connect the middle ear with the cavities in the sinuses. These tubes are responsible for balancing the pressure in your middle ear and for protecting your ears from hearing sounds caused internally in the body. If these tubes can’t open fully, it can cause a build-up of pressure in the ear which can cause pain.

If a eustachian tube opens wider than it should, it can cause the person suffering from the condition to hear unusual sounds; for instance hearing their own voice too loudly or even hearing their own breathing. Eustachian tube disorders are the most commonly occurring cause of ear infections.

Common Eustachian tube disorders include:

• Patulous Eustachian tube dysfunction
• Obstructive Eustachian tube dysfunction
• Baro-challenge-induced Eustachian tube dysfunction (this often occurs on aeroplanes)

What is Eustachian Tube Dysfunction?

Eustachian tube dysfunction (ETD) can be attributed to a chronic blockage in the eustachian tube. The eustachian tube’s function is to keep the pressure in the middle ear at the same level as the environment and it usually only opens when we yawn, chew or swallow.

When the eustachian tube gets blocked, it can cause a build-up of pressure on the ear which can impact on the eardrum and cause pain in the middle ear. Blockages can cause a build-up of fluid in the middle ear and sometimes, if severe, Eustachian Tube Dysfunction can even result in hearing loss.

Symptoms of Eustachian Tube Dysfunction can vary from person to person, but they generally include one or more of the following symptoms:

• Pressure in the ears
• A sense of fullness in the ears
• Pain in the ears (otalgia)
• Changes to a person’s hearing
• Popping sounds
• Odd sensations in the ears such as tingling or tickling
• Tinnitus symptoms such as ringing and whirring in the ears
• Pain or tenderness in one or both ears
• Trouble with balance that can lead to dizziness

Eustachian Tube Dysfunction Causes

There are many causes of Eustachian tube dysfunction include which commonly include environmental allergies as well as sinusitis. Other factors that may cause Eustachian Tube Dysfunction include:

• Acid reflux
• Impaired muscle coordination or muscular deficiency
• Abnormal tissue growth (neoplasms)

Eustachian tube dysfunction can be caused by many factors but usually occurs when the tubes become irritated or inflamed. Illnesses such as mild colds and flus, allergies, smoking and pollution can aggravate and inflame the tubes and can sometimes lead to them becoming blocked. Polyps can be another leading cause of ETD.

How is Eustachian tube dysfunction diagnosed?

There are no comprehensive guidelines for diagnosing ETD. Diagnosis typically relies on a patient’s medical history and a clinical examination. Your ENT doctor will examine your ear canals and eardrums, your nasal passages, and the back of your throat to identify potential underlying causes. Negative pressure and changes in ear structure can indicate obstructive Eustachian tube dysfunction.

Who is at risk of Eustachian tube dysfunction?

While we have all suffered from Eustachian Tube Dysfunction at one point or another (for instance, your eustachian tubes are not functioning correctly when your ears pop due to an increase in pressure), some people are more prone to having more severe and recurring symptoms. The below groups of people are the most at risk of developing ETD.

Children
Children have smaller eustachian tubes than adults and their immunity is not fully developed, so it makes sense that germs are more likely to travel to their middle ear. This makes children more susceptible to ear infections

People with allergies
Allergies cause more mucus in the nasal passages which can cause the eustachian tubes to become inflamed and congested

People who are greatly overweight
Being overweight can cause a build-up of both fatty deposits and mucus around the eustachian tubes which increases the chances of developing ETD.

Complications

• Risk for recurring symptoms- when the underlying condition is not treated
• Chronic otitis media may occur in severe situations
• Otitis media with effusion- fluid build-up in the middle ear which may cause permanent hearing damage
• Eardrum retraction- eardrum is sucked back into the canal

Eustachian Tube Dysfunction Treatment

While oftentimes symptoms of ETD go away on their own, there are plenty of ways in which you can help to treat the condition yourself.

• Swallowing, yawning, chewing gum or sucking on a sweet can open the tubes and relieve symptoms and discomfort. This can be particularly beneficial to combat the build-up of pressure in the ears when planes are taking off or landing.
• ETD symptoms can also be relieved by pinching your nose and blowing hard with your mouth shut.
• Antihistamines and decongestants may offer relief in the event of a sudden onset of ETD. Other medications can be prescribed by your family physician if ETD symptoms become persistent. Sometimes, people may need to undergo surgical procedures to alleviate the condition.
• If your baby is suffering from inflammation of their eustachian tubes, it can be helped by giving them milk or by allowing them to suck on a dummy. The swallow reflex encourages the tubes to open. Always ask for a doctor’s advice if symptoms persist as symptoms can be like those of a more serious ear infection.

Surgery for Eustachian tube dysfunction

If any of the treatments don’t help, your ENT doctor may suggest other options. These can include surgery such as implanting small tubes in the eardrums or using a balloon dilation system. The specific surgical method will be assessed by your doctor.

Implants, fillers, grafts, and fat transfers work by filling out the tissue in the surrounding area, allowing the Eustachian tube to close properly and return to normal function. Occasionally, grafts are also applied to the eardrum If you're concerned about your hearing, book in for a complimentary hearing test. With over 350 clinics situated all across Canada, you're sure to find a clinic near you!

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Our Ear Health Hub has guidance and useful information on the following: Burst Eardrum, Ear Cleaning, Ear Infection, Earwax Removal, Fluid in the Ear, Glue Ear, Itchy Ears, Labyrinthitis, Meniere's Disease, Otosclerosis, Presbycusis, Pulsatile Tinnitus and  Swimmer’s Ear.