EUSTACHIAN TUBE DYSFUNCTION
What is
Eustachian Tube Dysfunction?
Eustachian tube dysfunction (ETD) is one of the most common diagnoses in the Ear Nose and Throat office. ETD can be easily misdiagnosed and misunderstood, and often patients face overwhelming costs, undergo numerous exams, and fail treatments without much improvement of their ETD.
How do I know if I have ETD?
ETD is often misdiagnosed due to subtleties in exam findings. Many general ENT physicians do not perform the appropriate testing required to identify this disorder. A thorough history and physical exam by an otologist is required to diagnose Eustachian tube dysfunction. A hearing test is often necessary to differentiate Eustachian tube dysfunction (ETD) from other similar problems.
What should I expect during my visit for ETD consultation?
Your otologist should spend a significant amount of time reviewing your history, symptoms, and medical issues. If the likelihood of ETD is high, several other exams may be necessary to properly diagnose the type of ETD you are suffering from:
- Audiogram and Tympanogram
- Nasal Endoscopy
- CT scan of the sinuses and temporal bone
- Allergy testing
What can happen if I don’t treat my ETD?
We believe that chronic ETD is the root cause for most diseases of the ear. Failure to appropriately treat ETD in a timely fashion can result in:
- Recurrent and chronic ear infections
- Worsened Hearing loss
- Cholesteatoma (requiring more advanced surgery)
- Eardrum retraction
- Eardrum perforation
- Damage to nerves of the face, taste, hearing, and balance
- Vertigo
Medical Therapy for ETD
Once diagnosis has been established, and more serious problems have been ruled out, medical therapy can be instituted. This may include nasal steroid sprays, anti-histamines, nasal irrigations, corticosteroids, and other decongestants, depending on your individual findings. Your otologist may also want to perform additional testing to determine if there are other treatmetn options that will help you decrease the symptoms of ETD.
Medical treatment
Some treatment options include:
- Nasal steroid spray (Flonase, Nasonex),
- Anti-histamines (Claritin, loratadine),
- Leukotriene Inhibitors (Singulair),
- Corticosteroids (Medrol dose pack, prednisone),
- Afrin (for short-term relief only),
- Sudafed (for short-term relief only),
- Anti-reflux medications (Prevacid, Zantac, omeprazole).
Each patient is different and should be treated on an individual basis.
Lifestyle modifications
Smoking is a very potent irritant that can exacerbate Eustachian tube dysfunction. An easy way to improve Eustachian tube dysfunction dramatically is to quit smoking cigarettes and any other inhaled smoke or vapor.
There are also maneuvers that patients can utilize, called auto-insufflation, which is the process of blowing air through your nose into your ears. This can help relieve built up pressure in the ears, especially when changing altitudes.
Allergy Testing and Immunotherapy
Sometimes, an allergy test may reveal an avoidable allergen such as a certain food or animal. By avoiding certain allergens, inflammation and swelling in the Eustachian tube can improve and thus restore function.
If it is detected that you are allergic to certain unavoidable allergens such as pollen, dust, trees, or weeds, your doctor may offer immunotherapy. Immunotherapy is a customized process wherein the body develops a higher tolerance for allergens.
How is ETD diagnosed?
A thorough history and physical exam by an otologist is required to diagnosis Eustachian tube dysfunction. A hearing test are often necessary to differentiate Eustachian tube dysfunction (ETD) from other similar problems. ETD is often misdiagnosed due to subtleties in exam findings. Many general ENT physicians do not do the appropriate testing required to identify this disorder.
There is no consensus on indications for treatment, or on the optimal timing of the interventions. Surgical interventions are generally (though not exclusively) used where ETD is resistant to other interventions. A step-up approach is usually adopted, from primary to secondary and tertiary care settings. Treatment choice is based on aetiology, severity, and persistence of symptoms, as well as the degree of invasiveness of the treatment and surgical preference.
Still have questions regarding the condition?
While the information in this website may be helpful, it will never fully relate ear treatment to you. If you are facing any ear problem, please call our office and one of our representatives will talk to you.
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