Eustachian Tube Dysfunction

Definition, symptoms and treatment

The auditory tube, also known as the Eustachian tube, is a 3-4 centimetre long ear canal that connects the eardrum with the nasopharynx (nose) and therefore with the outside. Its main function is to ventilate the eardrum and keep the pressure of the middle ear equal to the external pressure. This activity is accomplished through the normal tubal opening and closing movements that occur during swallowing, yawning and other movements that stimulate the tube muscles.

Eustachian tube blockage: symptoms

The clinical condition known as chronical eustachian tube dysfunction indicates an abnormal and chronic alteration of the physiological mechanism of the eustachian tube opening and closing with a condition of persistent opened tube.

The patulous eustachian tube is a rarely recognized condition that, due to the feeling of pressure in the ear, it is often confused with blocked sinuses or ear infection. It mainly concerns women, affects one ear only and it is characterized by a sensation of blocked ear, autophony and intermittent hearing loss. Other symptoms can include a ringing or buzzing sound in the ears or the feeling of pressure changes in the ear when breathing in and out.

What causes a patulous eustachian tube?

This hearing condition doesn't always have an obvious cause; it usually represents the outcome of various pathological situations, almost always determined by:

  • Muscle and adipose tissue diseases (in case of excessive and rapid weight loss).
  • Diuretic drugs, with consequent alteration of the interstitial tissue
  • Radiotherapeutic action on the tubal mucus.
  • Chronic inflammatory processes of the nose, throat and tube.
  • Predisposition to develop nervous and vascular dysfunctions.

How to unblock the eustachain tube

It can be diffucult to diagnose eustachian tube dysfunction because there is no specific test for the condition and it shares symptoms with earache and tinnitus. With an otoscopy no changes in the tympanic membrane are detected, while with a otomicroscopy small movements of the tympanic membrane synchronized with respiratory movements can be highlighted. The hearing test may highlight a small hearing deficit limited to low frequencies. The tympanogram is usually normal and is characterized by an increase in compliance (high peak) and, sometimes, by a series of spikes that are the graphic representation of the breaths.

As for remedies and blocked eustachian tube treatment, the approach can include:

  • A visit to your ENT doctor, able to eliminate the cause (chronic ear infections, weight loss, etc.).
  • Surgery, to remove inflammatory foci (adenoids, tonsils, etc.).
  • Rehabilitation, carried out with appropriate stimulation exercises of the tube, palate and tongue,

A holistic approach includes also the Eustachian Tube Massage (ETM), that helps reduce pressure and promotes the release of fluid from the tube. It can alleviate congestion and discomfort. A patulous eustachian tube can be a temporary problem but, if symptoms affect daily life, seeing a doctor is advised. 

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