I give an explanation of Eustachian tube dysfunction almost every day as
it is common during allergy season. Here goes:
The Eustachian tube opens in the upper pharynx at the level of the back
part of your nasal passages. In front of the opening is an adenoid, a
lymph node, similar to the tonsils. The tube travels up to the middle
ear chamber which is the part behind the ear drum and in which lies the
bones that conduct sound to the inner ear. Air must move up and down
the tube to equalize pressure in the middle ear with breathing,
swallowing, sneezing or moving into different atmosperic pressures.
Otherwise the ear drum would be pushed in or out depending on the
pressures on each side and could rupture.
When the tube is not opening due to mucus, infection, inflammation or
enlargement of the adenoids, the middle ear becomes a closed chamber;
oxygen is absorbed from the chamber creating a vacuum. If pressure does
not equalize, the ear drum is pulled inward and does not vibrate
properly, causing muffling of the sound. The bones (ossicles) may also
be displaced causing the stapes bone to pull on its attachment to the
cochlea or hearing organ. This reduces pressure in the cochlea and the
receptors get stimulated causing tinnitus or "ringing" in the ears. Air
can percolate up the eustachian tube causing a sensation akin to the
feeling of liquid in the ear.
Treatment is directed to the cause. Often, an inhaled nasal steroid
will reduce swelling of the adenoidal tissue and surrounding orifice of
the eustachian tube and treat any allergy effects locally. This can
help. Decongestants do not help usually. There is no effect on the
vocal folds from nasal steroid.
Inhaled steam often helps either in the shower or a mist device or
boiling water.
If there is no infection in the nasal passages, blowing up balloons can
sometimes gently force air up the tube to equalize pressure temporarily.
Swallowing with the tongue placed on the roof of the mouth forces the
muscles that open the tube with swallowing to pull even more forcefully.
Repeating this exercise plus steam can also help.
Unfortunately, there is no sure fire, 100% effective treatment in most
cases. If the adenoids are enlarged, removal is useful. If it is
persistent beyond 3-4 months, increasingly painful or in a smoker, a
tumor at the eustachian orifice should be ruled out by
nasopharyngoscopy.
John
John Messmer, M.D.
Assistant Professor, Family and Community Medicine
Penn State Hershey Medical Center
...an ENT...suspects that I'm suffering from
eustacian tube disfunction and that it is the root of my ear pressure
problems and tinnitus...
1) Can someone give me a layman's explanation of what eustacian tube
disfunction is?...
2) What will Nasonex do to my vocal cords?
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