Eustachian tube dysfunction

Question 1

What is Eustachian tube dysfunction

Answer 1

Becomes blocked so can’t equalise air pressure or drain fluid from middle ear freely

Question 2

Eustachian tube dysfunction causes

Answer 2

May be related to upper resp. tract infection, allergies e.g. hayfever or smoking

Question 3

Eustachian tube dysfunction presentation

Answer 3

Reduced or altered hearing, popping noises or sensations in ear, fullness of ear, pain/discomfort, tinnitus. Symptoms tend to get worse when external air pressure changes and middle ear can’t equalise e.g. flying, climbing, scuba diving…
Otoscopy normal

Question 4

Eustachian tube dysfunction investigations

Answer 4

Only in severe cases

Nasopharyngoscopy (camera through nose), CT scan, Tympanometry

Question 5

Eustachian tube dysfunction differentials

Answer 5

Meniere’s disease, Otitis media with effusion, acute otitis media

Question 6

Eustachian tube dysfunction management

Answer 6

Wait to resolve spontaneously. Valsalva manoeuvre. Decongestion spray short term. Antihistamines for allergies.
Otovent - patient blows into balloon using single nostril.
Surgery - grommets, balloon dilation eustachian tuboplasty