The Eustachian tube is the channel that connects the back of the nose to the middle ear space behind the eardrum. It is what opens and closes to equalize the pressure in our middle ear when we fly or dive. It is about 1.5 inches long, part of which is a bony tube through the skull base and part of which is made of cartilage as it exits into the back of the nose. Its function is controlled by muscles of the palate in a fairly complex series of contractions during swallowing. Our 2 Eustachian tubes play an important role in keeping our middle ears healthy and free of infection.
Problems with the Eustachian tube are labeled “Eustachian Tube Dysfunction” and this can occur in one or both ears. There are many different forms of this. The most common form is when the tube(s) do not open properly or adequately. This can result in negative pressure in the middle ear. This can cause discomfort, ear pressure, problems and pain on flights, popping, crackling and decreased hearing. If unrelieved, fluid accumulation in the middle ear (otitis media with effusion), ear infection (acute otitis media) or retraction of the eardrum (atelectasis) can occur. This can lead to chronic ear problems and a skin cyst in the ear, called cholesteatoma. Chronic otitis media with effusion is the most common cause of hearing loss in children. Eustachian tube dysfunction is a major cause of ear infection.
Treatment of Eustachian tube dysfunction is integral to the practice of the otologists at EARS Inc. Treatments are based on the length time with symptoms, hearing levels, health of the eardrum and underlying problems. It usually begins with medical and allergy treatment. After medical treatment is exhausted, surgical treatment is offered if criteria are met. These may include myringotomy with or without insertion of a ventilation tube, adenoid removal, recommendation for sinus surgery and occasionally more extensive ear surgery if the eardrum is damaged or cholesteatoma is present. A new alternative for Eustachian tube dilatory dysfunction has been recently approved by the FDA called “balloon dilatation of the Eustachian tube” or “ balloon Eustachian tuboplasty”.
