The Eustachian tube is a narrow channel linking your throat to your middle ear. Whenever you sneeze, swallow, or yawn, your Eustachian tubes open. This action equalises pressure and allows mucous to drain from your middle ear. Most of us have experienced dysfunction of this tube temporarily when flying on a plane, going up a mountain in the car or scuba diving. These are artificial situation for the human body so this temporary feeling is normal. Occassionally this issue can persist and then it becomes abnormal and is called eustachian tube dysfunction. In such cases, you might experience sounds sounding softer, and your ear could feel congested. Additionally, you could feel discomfort in your ear or even internal body sounds.
The eustachian tube highlighted in green above, is a tube from the back of your nose connecting to the chamber behind your eardrum called the middle ear. You have one on each side for each ear. It is usually closed and only opens for a split second because of throat muscles contracting during swallowing or yawning. It can be forced open with high pressure like when you pinch your nose and blow against it (valsalva manoeuvre).
We don’t know in all cases. Certain groups are more prone such as Children, smokers and those with nasal allergies. It is a common phenomenon after coughs and colds.
This is the most common type. The eustachian tubes fail to open enough to maintain normal ear pressure. This leads to the classic pressure sensation and muffled hearing. Additional symptoms include clogged, underwater feelings, discomfort, popping and crackling. Investigations include hearing tests, pressure tests (tympanometry) and an endoscopic examination of the back of your nose. treatement options include steroid nasal sprays or a procedure called eustachian tuboplasty which I do using a balloon (see procedures for more infomation).
Picture demonstrating where the balloon goes to stretch and dilate the eustachian tube.
This is the opposite problem to obstructive. It is relatively rare but in some patients their eustachian tubes are open all the time instead of just for a split second during swallowing or yawning. These patients complain of hearing internal sounds like chewing, breathing and speaking. It can be painful to blow the nose and patients can experience frequent popping and clicking sounds. Various surgical techniques are described for partially blocking the tube to stop these symptoms.
This is dysfunction triggered by sudden changes in pressure like flying or chaning altitude suddenly. It is treated in the same way as obstuctive cases.
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