Eustachian Tube Dysfunction: Symptoms and When to Seek Help

Q: Eustachian Tube Dysfunction: Symptoms and When to Seek Help

Hello Annie, <br>The issues you mentioned could be due to： 1) Eustachian tube dysfunction： This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over. <br>2) Sudden sensorineural hearing loss

Eustachian tube dysfunction (ETD)

Hello Doctor, about a year ago, I experienced persistent tinnitus (mainly in my right ear) and dizziness, so I went to a major hospital's ENT department to have my Eustachian tubes checked.
At that time, the doctor informed me that my left Eustachian tube was dysfunctional.
I later used nasal medication, which slightly improved the Eustachian tube issue.
However, I recently noticed that the Eustachian tube problem has recurred, and I feel a sensation of Eustachian tube dysfunction in my right ear.
Previously, this sensation would occur after yawning, but recently it happens in the middle of conversations, leading to feelings of emptiness and tinnitus.
In the past two days, it has even affected my sense of balance (whenever I feel emptiness in my ear, I experience a sense of imbalance).
Should I seek further evaluation?

Annie, 20~29 year old female. Ask Date: 2017/05/10

Dr. Ji Zhaoyun reply Otolaryngology

Hello Annie,
The issues you mentioned could be due to: 1) Eustachian tube dysfunction: This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over.
2) Sudden sensorineural hearing loss or degeneration of the auditory nerve.
3) Otitis media: a) Acute otitis media: Often occurs alongside upper respiratory infections (like colds) and sinusitis, and in severe cases, may lead to ear discharge.
b) Chronic otitis media with acute exacerbation: This typically occurs when there is a pre-existing perforation in the eardrum, which can become inflamed due to contaminated water or improper ear cleaning.

All of the above conditions can be appropriately managed with medication after consulting a healthcare provider.
If you have already undergone a pure tone audiometry test (which requires headphones in a soundproof room where you press a button in response to sounds, rather than just using a tuning fork), and it has confirmed that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not had a pure tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
The golden period for treating sudden hearing loss is within two weeks, and early treatment yields better outcomes.

Wishing you health and safety,
Dr.
Chi Chao-Yun,
Director of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2017/05/10

More Info

Eustachian tube dysfunction (ETD) can be a frustrating and uncomfortable condition, often leading to symptoms such as ear fullness, tinnitus (ringing in the ears), and balance issues. The Eustachian tube connects the middle ear to the back of the nose and throat, helping to equalize pressure and drain fluid. When this tube does not function properly, it can lead to a variety of symptoms that can significantly affect your quality of life.

Based on your description, it seems that you have been experiencing recurrent issues with your Eustachian tube, particularly on the right side, which has been accompanied by tinnitus and balance problems. These symptoms can be indicative of ETD, which can be caused by various factors, including allergies, sinus infections, colds, or anatomical variations. The fact that your symptoms have returned after a period of improvement suggests that there may be an underlying issue that needs to be addressed.

The sensation of "fullness" or "vacuum" in the ear, especially when talking or yawning, is a common symptom of Eustachian tube dysfunction. This can occur when the tube fails to open properly, leading to a pressure imbalance in the middle ear. The associated tinnitus and balance issues you are experiencing could be related to the pressure changes affecting the inner ear, which plays a crucial role in hearing and balance.

Given that your symptoms have worsened and are now affecting your balance, it is advisable to seek further evaluation from an ear, nose, and throat (ENT) specialist. They may recommend additional tests, such as tympanometry, which measures the movement of the eardrum in response to changes in air pressure, or a hearing test to assess any impact on your auditory function. In some cases, imaging studies like a CT scan may be warranted to rule out any anatomical abnormalities or other underlying conditions.

In the meantime, there are several management strategies you can consider. Over-the-counter decongestants or nasal corticosteroids can help reduce inflammation and improve Eustachian tube function. Additionally, practicing techniques such as the Valsalva maneuver (gently blowing with your mouth closed and nose pinched) can help equalize pressure in the ears. However, these should be done with caution and ideally under the guidance of a healthcare professional.

In summary, your symptoms of recurrent ear fullness, tinnitus, and balance issues warrant further investigation. It is essential to consult with an ENT specialist who can provide a comprehensive evaluation and recommend appropriate treatment options. Early intervention can help prevent complications and improve your overall quality of life.

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