ENT - ET Dysfunction Flashcards
Outline ET dysfunction pathophysiology
ET connects middle ear and throat in order to equalise pressure and drain fluid in the middle ear
If the ET is blocked or stops working, pressure cannot equalise and fluid cannot drain
Air pressure between middle ear and outer become unequal, middle ear can fill with fluid
Can be caused by URTI, allergies or smoking
What are common symptoms of Eustachian tube dysfunction?
- Reduced or altered hearing
- Popping noises or sensations in the ear
- Fullness sensation in the ear
- Pain or discomfort
- Tinnitus
Symptoms can worsen when external air pressure changes and middle ear cannot equalise
What can trigger worsening symptoms of Eustachian tube dysfunction?
- Flying
- Climbing a mountain
- Scuba diving
Can prevent middle ear from equalising
What might otoscopy reveal in cases of Eustachian tube dysfunction?
May appear normal, but need to exclude other causes of otitis media
When are investigations needed for Eustachian tube dysfunction?
Investigations are needed in cases of:
* Persistent symptoms
* Problematic symptoms
* Severe symptoms
What investigations are used to establish the diagnosis of Eustachian tube dysfunction?
- Tympanometry
- Audiometry
- Nasopharyngoscopy
- CT scan
What is tympanometry?
- Inserting a device into the external auditory canal
- Creating different air pressures
- Sending sound towards the tympanic membrane
- Measuring sound reflection
- Plotting a tympanogram
Assess how well sound is absorbed by TM
What is admittance?
Amount of sound absorbed by the tympanic membrane and middle ear, not reflected back to the device
Normal occurs when ear canal pressure matches ambient air pressure
What can cause negative ear canal pressures in Eustachian tube dysfunction?
Negative pressures occur when the middle ear air pressure is lower than ambient air pressure due to inability to equalize
Tympanogram shows peak admittance with negative pressures
What are some treatment options for Eustachian tube dysfunction?
- No treatment, wait for resolution
- Valsalva manoeuvre
- Decongestant nasal sprays (short term)
- Antihistamines and steroid nasal spray for allergies
- Surgery for severe cases
What is the purpose of the Otovent device?
Helps inflate the Eustachian tube, clear blockages, and equalize pressure
Patient blows into a balloon with a single nostril
What are the three main surgical options for Eustachian tube dysfunction?
- Adenoidectomy
- Grommets
- Balloon dilatation Eustachian tuboplasty
What is the function of grommets?
Grommets allow air or fluid from the middle ear to drain to the ear canal
Inserted under local, fall out within 18 months
Describe the balloon dilatation Eustachian tuboplasty procedure
- Inserting a deflated balloon into the Eustachian tube
- Inflating it for about 2 minutes
- Deflating and removing the balloon
