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The Eustachian tube is the passage which extends from the cavity behind the eardrum (middle ear) to the nasopharynx and measures approximately 1.5 inches.  Its main function is to equalize middle ear pressure with that of the atmosphere.  Usually, it is closed with its wall collapsed, but opens during swallowing, yawning, or chewing, allowing air to pass through.

If the external atmospheric pressure alters without a compensatory pressure change in the middle ear cavity, a feeling of blockage develops in the ear; followed by temporary hearing loss and even discomfort.

This may occur while riding in a fast elevator, swimming in deep water, driving up and down steep hills, or when flying.  Normally, these symptoms are relieved by yawning, swallowing or chewing.

However, when these actions do not relieve the symptoms experienced during external atmospheric pressure changes, the result is Eustachian Tube Dysfunction.  Difficulty equalizing the middle ear pressure is worsened by nasal congestion due to cold or allergy.  Some individuals experience this same difficulty due to a narrow Eustachian tube and not nasal congestion. It may also be caused by an infection.

Diagnosis is based on the history or symptoms and visual inspection of the tympanic membrane (eardrum) for fluid, inflammation and retraction.  Other diagnostic procedures may be indicated.

A Tympanogram, a sensitive electric test, documents the ability of the eardrum to transmit vibrations which may reflect Eustachian Tube Dysfunction.  An audiogram (hearing test) may also be warranted.  Otoendoscopy is a procedure that allows direct visualization of the Eustachian tube, giving the definitive diagnosis.

Treating this problem is done by addressing the underlying cause.  This involves the use of topical nasal steroids to reduce the thickening of the lining of the Eustachian tube.  Treatment is carried on for 3 months before complete resolution is appreciated.  In addition, scuba diving, swimming, and flying are not recommended until medical clearance has been received.

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