Tinnitus: Is Eustachian Tube Dysfunction the Cause? - Otolaryngology

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Tinnitus issues and Eustachian tube dysfunction?


Hello Doctor: For the past two months, I have been experiencing tinnitus, initially presenting as high-frequency ringing accompanied by occasional ear fullness and worsening tinnitus (also high-frequency but not as intense).
After consulting several doctors, I was diagnosed last month with gastroesophageal reflux disease (GERD) and Eustachian tube dysfunction.
I also have a long-standing issue with nasal allergies.
After using a nasal spray and medication for my stomach, I have not experienced the "ear fullness and worsening tinnitus" for the past three weeks, but the tinnitus persists and fluctuates, averaging around a level 2 intensity.
Does this indicate that my tinnitus is indeed related to the Eustachian tube issue? Currently, my symptoms include: 1.
When I swallow saliva, I hear a popping sound in my ear, but in the morning right after waking up, the swallowing sound is not very loud, and it gradually becomes louder with subsequent swallows.
2.
Due to the sound, I tried not swallowing for an hour, which resulted in some pain in my ear and a feeling of pressure.
3.
I attempted the method of blowing air into the Eustachian tube, but it seems difficult to open and close properly.
After it opens, I sometimes need to swallow multiple times to close it, and the sensation differs between my left and right ears.
If this is indeed the case, are there any methods to help the Eustachian tube recover more quickly? (I have tried chewing gum, but it doesn't seem to help much.) Thank you, Doctor.

YAO, 20~29 year old female. Ask Date: 2016/06/02

Dr. Zheng Jueyi reply Otolaryngology


Hello, it is likely primarily an issue with the Eustachian tube.
Currently, there are no effective pharmacological treatments.
It is recommended to manage nasal allergies and gastroesophageal reflux properly, and to continue using nasal sprays.
The function of the Eustachian tube will often gradually improve.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/06/02

More Info


Tinnitus, or ringing in the ears, can be a frustrating and often perplexing condition. In your case, it seems that your tinnitus may be related to Eustachian tube dysfunction (ETD), especially given your history of gastroesophageal reflux disease (GERD) and nasal allergies. The Eustachian tube connects the middle ear to the back of the throat and helps equalize pressure in the ear. When this tube is not functioning properly, it can lead to a feeling of fullness in the ear, discomfort, and tinnitus.

Your symptoms, including the popping sounds when swallowing and the pressure sensation in your ears, are indeed indicative of Eustachian tube dysfunction. The fact that you experience these symptoms more prominently in the morning and that they improve with swallowing suggests that your Eustachian tube may be partially obstructed or not opening and closing as it should. This can be exacerbated by conditions such as GERD, which can lead to inflammation in the throat and nasal passages, further affecting Eustachian tube function.

Here are some insights and recommendations based on your situation:
1. Understanding Eustachian Tube Dysfunction: ETD can occur due to various factors, including allergies, infections, and anatomical issues. In your case, the combination of nasal allergies and GERD may be contributing to the dysfunction. The inflammation and mucus production associated with allergies can lead to blockage of the Eustachian tube, while acid reflux can irritate the throat and affect the tube's ability to function properly.

2. Management Strategies: Since you've already started using nasal sprays and medications for GERD, here are additional strategies that may help:
- Nasal Decongestants: If you are experiencing nasal congestion, over-the-counter decongestants may help reduce swelling in the nasal passages and improve Eustachian tube function.

- Allergy Management: Continue to manage your allergies with antihistamines or nasal corticosteroids as recommended by your doctor. Reducing inflammation in the nasal passages can help the Eustachian tube function better.

- Valsalva Maneuver: This technique involves closing your mouth, pinching your nose shut, and gently blowing to equalize ear pressure. However, be cautious with this maneuver, as excessive force can damage the ear.

- Chewing Gum or Swallowing: As you've tried, chewing gum or swallowing frequently can help open the Eustachian tube. If you find that this is not effective, consider trying different types of gum or candies that encourage more swallowing.

- Stay Hydrated: Keeping well-hydrated can thin mucus and may help with Eustachian tube function.

3. When to Seek Further Help: If your tinnitus persists or worsens, or if you experience significant pain or hearing loss, it is important to follow up with an ear, nose, and throat (ENT) specialist. They can perform a thorough examination and may recommend additional treatments, such as allergy testing or even surgical options if necessary.

4. Tinnitus Management: While addressing the underlying cause of your Eustachian tube dysfunction may help alleviate your tinnitus, it is also important to manage the tinnitus itself. Sound therapy, cognitive behavioral therapy, and relaxation techniques can be beneficial in coping with the persistent ringing in your ears.

In summary, your symptoms suggest that Eustachian tube dysfunction may be contributing to your tinnitus. By managing your allergies and GERD, and employing techniques to improve Eustachian tube function, you may find relief. However, ongoing symptoms warrant further evaluation by a specialist to rule out other potential causes and to explore additional treatment options.

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