Eustachian Tube Blockage (ETB) occurs due to the swelling of the eustachian tubes due to inflammation, which may occur due to an allergy or an infection of the throat.
The ear consists of an outer canal (external auditory canal) that ends at a membrane, which is the eardrum, and which is also known as the tympanic membrane. Behind the eardrum, there is a space or a cavity, which is called the middle ear. Eustachian tube is a canal that connects the middle ear to the throat or the pharynx. The eustachian tubes help to maintain normal pressure inside the middle ear by equilibrating it with the pressure in the external environment. It also drains any accumulated secretions or debris from the middle ear to the throat. Movement of throat muscles during swallowing, sucking, chewing or yawning regulates the opening and closing of the eustachian tubes.
In normal people, eustachian tubes open and close several times during the day. When the tubes remain closed for a long time and when they are not able to normalize the pressure inside the middle ear, it is termed as Eustachian Tube Blockage (ETB). It may cause sensations of clicking, popping or tickling in the ear. There may also be a sensation of fullness in the ear or hearing loss.
Chronic (symptoms remain for a long time), Infectious, non-contagious, non-genetic.
There is swelling and blockage of the eustachian tubes, on one or both the sides. There may be mild hearing loss.
Eustachian tube gets blocked due to inflammation and swelling of the cells that line the walls of the tube. A blockage may occur due to:
Cold, Sore Throat: During cold or sore throat, inflammation of the throat or nose occurs. The inflammation may spread to the eustachian tubes resulting in blockage.
Sinus Infections: Sinuses are spaces present in the bones of the face that open into the nose. Infection and inflammation of the sinus (Sinusitis) may spread to the cells lining the eustachian tubes, resulting in blockage.
Allergy: People allergic to some substances in the air such as pollens (from plants or flowers) or dust may develop swelling of the throat, the nose (Allergic Rhinitis) or the eustachian tubes.
Adenoid Enlargement: Adenoid is a structure present in the back part of the throat near the opening of eustachian tubes. It may enlarge due to an infection or due to inflammation of the mouth, tonsils, throat or the sinuses. When enlarged the adenoid blocks the opening of eustachian tube.
Tumor: People with tumors or masses in the throat region or behind the nose may have blockage of the eustachian tubes.
Habit Induced: People who smoke have higher chances of ETB as smoke damages the cells that line the tubes.
Due to Pressure Changes: Blockage of tubes may occur while flying, climbing or descending from mountains, diving deep water or swimming. As we go up, pressure outside our body falls. During deep diving, the pressure outside increases. These pressure changes may result in blockage of the eustachian tubes.
ETB is common in children. This is because tubes are narrower, straighter and open closer to the adenoid in children as compared to adults.
The usual symptom is a feeling of fullness in the ear, usually on both the sides. There may be popping or cracking sensation in the ears and some hearing loss. One may hear ringing or buzzing sounds in the ear, even though there are no such sounds around, which is a condition known as. In some cases, there may be a feeling of head spinning or rotating, which is called Vertigo.
In many people, the symptoms may not be present all the time and appear only while riding elevators, driving through mountains, diving in the sea or flying in airplane.
The doctor may ask about the symptoms and any recent infections of the nose, sinus or throat. Examination of the ears is done to look for any discharge. The doctor may use an Otoscope to view the inside of the ear canal. Otoscope is a lighted handheld device whose one end can be put into the ear canal, while the other end has a small screen on which the doctor to view the inside of the ear.
Further to that, following tests may be done to confirm the diagnosis:
Audiogram: The person sits in a sound proof room and wears a headphone attached to a machine. Different sounds of varying intensity or loudness are given through the headphone and the person is asked to tell whether he hears the sound or not. Each ear is tested separately. An audiogram helps to assess any hearing loss.
Tympanometry: It is used to assess the compliance of the eardrum and the ear bones. A probe is put in the external ear canal and made to fit tightly. The probe delivers a sound and picks up the reflection from the eardrum. It can also change the pressure inside the ear canal from positive to negative. Different kinds of sounds reflections are obtained when the compliance is noted at different pressures, which can confirm ETB.
Nasopharyngoscopy: A tube containing a camera on one end is put in the mouth. The doctor will be able to see the inside of the throat on a screen. Any masses, tumors or enlargement of the adenoids which is blocking the opening of the eustachian tube can be seen.
Computed Tomography (CT) Scan: Multiple images of the affected ear are taken and assembled using a computer to generate a clear image. It helps to diagnose any blockage of the tube and also any damage to the middle ear. Any tumors in the throat or the nose can also be diagnosed.
The aim of treatment is to relieve the symptoms and the blockage of the eustachian tubes.
The person may be advised to quit smoking, if smoking.
One may be advised to open up the Eustachian tube by taking a deep breath and blowing air out while pinching the nostrils and closing the mouth. This may be done a few times to relieve the blockage. Chewing gums or sucking toffees also helps.
A person with an ear infection may find it soothing to apply a warm cloth on the affected ear.
People having eustachian tube problems may be given pills or sprays. These medications are to be taken an hour before taking off on an airplane or before sea diving. These medications reduce the swelling and shrink the membranes that line the nose and the throat, to prevent blockage of the eustachian tubes.
Pain killers such as ibuprofen or acetaminophen may be given to relieve any pain. These medications also reduce inflammation and swelling of the eustachian tubes and help in relieving the blockage.
Anti-allergic medications such as chlorpheniramine may be given to reduce inflammation and swelling to relieve blockage. These medications also relieve any congestion in the nose due to Cold or Sore Throat).
Antibiotics may be given as eardrops or orally to cure any infection of the ear, throat or the sinuses.
Surgery may be needed to remove any tumors in the throat or enlarged adenoids that may be causing the blockage of the eustachian tubes. Surgery may also be needed to remove cholesteatoma from the middle ear, if present.
Blocked tubes may result in accumulation of water inside the middle ear without any infection, which results in conditions such as Otitis Media with effusion, or Glue ear. There may be feeling of fullness in the ear and loss of hearing.
ETB results in negative pressure inside the middle ear. Over long time, the negative pressure sucks in a part of the eardrum toward the middle ear. The sloughed off or dead cells from the outer part of ear drum may accumulate in the sucked in or retracted part. These changes may result in formation of Cholesteatoma.
Maintaining proper hygiene and washing hands after coming from outside helps. It is important that children do the same. This prevents infections of the ear, throat or the sinuses.
People travelling in airplane may benefit by chewing gums, sucking toffees or drinking fluids. Swallowing, chewing or sucking relieves a blockage of the eustachian tubes. Babies travelling in airplane should be given a bottle or pacifier to suck on during the trip.
Early and appropriate treatment of adenoid enlargement, sore throat, nose infections or sinusitis relieves ETB.
People with problems of eustachian tube should avoid a trip by airplane, if they have cold, sore throat, sinusitis or an ear infection. Deep sea diving or scuba diving should also be avoided.
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