Eustachian Tube Dysfunction: Seeking Help for Ear Issues

Seeking assistance from a physician to determine whether the issue is related to the Eustachian tube or the auditory canal?

Hello, doctor! I have been suffering from an ear condition for over a year and still don't know how to resolve it.
In 2015, I had my first episode of otitis media, where I felt pressure and fullness in my ear and couldn't hear well.
Although it improved after four months, I sometimes experienced tinnitus, pain, and occasional dizziness.
While it wasn't daily, it felt unusual.

In early 2016, after catching a cold, I started noticing sounds in my ear when swallowing or during any swallowing motion, accompanied by a feeling of fullness.
When I pinched my nose and closed my mouth, I could quickly hear a popping sound.
After visiting a clinic, I was told I had Eustachian tube dysfunction.
However, despite taking medication, there was no improvement.

A few months later, I went to the hospital for various tests, including hearing assessments, and was informed that there were no significant issues.
They mentioned slight Eustachian tube blockage, but it wasn't severe.
Initially, it was only on the left side, where I would hear sounds when swallowing, but later, the right side also started to exhibit similar symptoms.

At one point, I experienced a severe episode of vertigo due to what was described as canalithiasis (ear stone displacement) and had to go to the hospital, but I recovered within a few days.
Currently, I am not taking any medication, but I still hear sounds in both ears when swallowing.
I try not to intentionally create sounds, but the issue persists on both sides.

I would like to seek your advice, doctor.
Is my problem related to Eustachian tube dysfunction, or is it Eustachian tube obstruction, or could it be Eustachian tube patency disorder? Thank you for your assistance.

Mr. Chen, 30~39 year old female. Ask Date: 2017/02/15

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you have already been examined and no significant hearing abnormalities were found, and you are not experiencing persistent ear fullness or continuous echoing while speaking, this may be a normal finding.
The Eustachian tube connects to the back of the nasal cavity, and it is normal to hear a sound when swallowing saliva.
It is recommended to continue monitoring your condition.
If you have concerns, you may schedule regular follow-up appointments for further evaluation.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/02/15

More Info

Eustachian tube dysfunction (ETD) is a common condition that can lead to various ear-related symptoms, including a feeling of fullness or pressure in the ears, hearing changes, and even pain. Your description of symptoms over the past year, including ear fullness, tinnitus (ringing in the ears), and the sensation of sounds when swallowing, suggests that you may indeed be experiencing issues related to the Eustachian tube.

The Eustachian tube connects the middle ear to the back of the throat and helps to equalize pressure in the ear. When it becomes blocked or fails to open properly, it can lead to a buildup of pressure and fluid in the middle ear, resulting in discomfort and hearing problems. This dysfunction can be caused by various factors, including allergies, respiratory infections, or anatomical issues.

From your account, it seems that your symptoms began after an episode of otitis media (middle ear infection) in 2015, which is a common precursor to Eustachian tube dysfunction. The fact that you have experienced a sensation of fullness, sounds when swallowing, and occasional tinnitus indicates that your Eustachian tube may not be functioning optimally. The mention of "耳咽管阻塞" (Eustachian tube blockage) aligns with this condition.

In terms of treatment, there are several approaches you can consider:
1. Nasal Decongestants and Steroids: If your symptoms are related to allergies or nasal congestion, using decongestants or nasal steroid sprays can help reduce inflammation and open the Eustachian tube.

2. Valsalva Maneuver: This technique involves closing your mouth, pinching your nose shut, and gently blowing to equalize pressure in the ears. However, you mentioned that this has not been effective for you.

3. Eustachian Tube Balloon Dilation: In cases where conservative treatments fail, a procedure called balloon dilation of the Eustachian tube may be considered. This involves inserting a small balloon into the Eustachian tube and inflating it to help open the passage.

4. Avoiding Irritants: If allergies are a contributing factor, avoiding known allergens and irritants can help reduce symptoms.

5. Regular Follow-ups: Since your symptoms have persisted for over a year, it is crucial to continue seeking medical advice. An ENT specialist can perform further evaluations, such as tympanometry or audiometry, to assess the function of your Eustachian tube and middle ear.

6. Hearing Tests: Given your concerns about hearing changes, regular hearing assessments can help monitor any potential impacts on your auditory function.

7. Physical Therapy: Some patients find relief through physical therapy techniques that focus on the neck and jaw, which can sometimes help alleviate pressure in the ears.

It is essential to communicate openly with your healthcare provider about your symptoms and any treatments you have tried. If your current physician is not providing satisfactory answers or solutions, seeking a second opinion from an ENT specialist with experience in Eustachian tube dysfunction may be beneficial.

In summary, your symptoms are consistent with Eustachian tube dysfunction, and while it can be frustrating to deal with persistent issues, there are various treatment options available. Continued follow-up with healthcare professionals and exploring different therapeutic avenues will be key to finding relief.

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