Eustachian Tube Dysfunction: Causes, Symptoms, and Treatments

Q: Eustachian Tube Dysfunction: Causes, Symptoms, and Treatments

Hello： Based on the description, it may be an issue related to the Eustachian tube. <br>As you have already consulted several physicians who have provided various treatment options, it is advisable to discuss in detail with a clinical physician before deciding on further manageme

Eustachian tube obstruction

About four years ago, I accidentally got water in my left ear while showering, which led to a feeling of fullness in that ear.
Shortly after, I visited an ENT clinic where ear drops were prescribed, but they were ineffective.
I then consulted several other clinics; one doctor used a tool to spray my nose, which provided some temporary relief, but the fullness sensation persisted.
As time passed without improvement, I felt the need to go to a larger hospital for further examination.
At Shuanghe Hospital, it was found that there was no fluid accumulation in my ear, and it had already dried up.
Two years later, I noticed that sometimes I misheard people speaking, so I went for a hearing test, which showed no abnormalities.
The audiologist suggested that it might be due to a lack of concentration, but I found it hard to believe that so many people could mishear.
I later consulted Dr.
Chao Wei-Jie at Chang Gung Memorial Hospital, who conducted multiple tests and confirmed that my hearing was normal.
I speculated that perhaps the testing equipment was too close to my ear, causing the sound waves to not vary enough to be perceived correctly.
After several tests and medication, Dr.
Chao used a soft tube to enter my nasopharynx to test whether the fullness sensation would disappear.
During the test, the sensation did indeed diminish, but Dr.
Chao noted that my left nasal cavity was too small and suggested that some tissue might need to be removed.
Due to personal reasons, I did not continue with the treatment at that time.
Last month, I visited another ENT clinic recommended online, where the doctor punctured my left eardrum with a needle.
The condition improved significantly immediately after the procedure, but it recurred after a few days.
I then went to Tzu Chi Hospital in Taipei, where they confirmed that my Eustachian tube function was poor, along with a deviated septum and chronic rhinitis.
They indicated that the nasal issues were causing the fullness in my ear, and that treating the nasal problems was necessary for a permanent solution.
However, the doctors found it strange that my septum was deviated to the right while my left ear was more blocked.
They advised me to start medication, and if there was no improvement, to consider surgery.
Today, I visited Tzu Chi again, where they assured me that surgery on my nose would definitely resolve the issue, and there was a reasonable chance it would help the Eustachian tube as well, though it was not guaranteed.
I am currently considering having the nasal surgery at Tzu Chi followed by Eustachian tube balloon dilation at Chang Gung, but I am concerned about the possibility of the surgery being performed incorrectly and exacerbating the problem.
I would appreciate any advice on how to proceed for relief.
Thank you.

Krad, 20~29 year old female. Ask Date: 2018/03/10

Dr. Zheng Jueyi reply Otolaryngology

Hello: Based on the description, it may be an issue related to the Eustachian tube.
As you have already consulted several physicians who have provided various treatment options, it is advisable to discuss in detail with a clinical physician before deciding on further management.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2018/03/10

More Info

Eustachian Tube Dysfunction (ETD) is a common condition that can lead to a variety of symptoms, including a feeling of fullness or pressure in the ear, difficulty hearing, and even discomfort or pain. The Eustachian tube connects the middle ear to the back of the throat and helps to equalize ear pressure and drain fluid. When this tube becomes blocked or does not function properly, it can result in the symptoms you have described.

Causes of Eustachian Tube Dysfunction
1. Allergies and Inflammation: Conditions such as allergic rhinitis or sinusitis can cause inflammation and swelling of the Eustachian tube, leading to blockage.

2. Anatomical Issues: Structural problems, such as a deviated septum or enlarged adenoids, can impede the normal function of the Eustachian tube.

3. Infections: Upper respiratory infections can lead to swelling and mucus production, which can block the Eustachian tube.

4. Barometric Pressure Changes: Rapid changes in altitude, such as during flying or diving, can cause pressure imbalances that the Eustachian tube cannot equalize effectively.

Symptoms of Eustachian Tube Dysfunction
- A feeling of fullness or pressure in the ear
- Hearing difficulties, such as muffled sounds or a sensation of "popping"
- Ear pain or discomfort
- Tinnitus (ringing in the ears)
- Balance issues in some cases

Treatment Options
1. Medications: Over-the-counter antihistamines or decongestants can help reduce swelling and promote drainage. Nasal corticosteroids may also be prescribed to reduce inflammation.

2. Nasal Saline Irrigation: This can help clear mucus and allergens from the nasal passages, potentially improving Eustachian tube function.

3. Eustachian Tube Balloon Dilation: This is a minimally invasive procedure where a small balloon is inserted into the Eustachian tube and inflated to widen the passage. This can help restore normal function and alleviate symptoms.

4. Surgery: In cases where anatomical issues are present, surgical interventions such as septoplasty (to correct a deviated septum) or adenoidectomy (removal of enlarged adenoids) may be necessary.

5. Autoinflation Techniques: Techniques such as the Valsalva maneuver (gently blowing while pinching the nose) can help equalize pressure in the ears.

Prognosis and Considerations
The prognosis for Eustachian Tube Dysfunction is generally good, especially when the underlying causes are addressed. Many patients experience significant relief from symptoms with appropriate treatment. However, if left untreated, chronic ETD can lead to complications such as recurrent ear infections or hearing loss.

Risks and Long-term Management
While procedures like balloon dilation are generally safe, there are risks associated with any surgical intervention, including infection, bleeding, or damage to surrounding structures. It is essential to discuss these risks with your healthcare provider.

Long-term management may involve ongoing treatment for underlying conditions, such as allergies or chronic sinusitis. Regular follow-up with an ENT specialist can help monitor your condition and adjust treatment as necessary.

In your case, it seems that addressing the nasal issues may be crucial for alleviating your ear symptoms. If surgery is recommended, ensure that you have a thorough discussion with your ENT specialist about the expected outcomes and any potential risks involved. It may also be beneficial to seek a second opinion if you have concerns about the proposed treatment plan.

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