Eustachian tube dysfunction - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Eustachian tube dysfunction (ETD) results in negative pressure in the middle ear cleft.
EDT is closely related to the development of chronic otitis media and is often accompanied by chronic inflammatory disease of the nasal cavity.
Often accompanied by chronic inflammatory disease of the nasal cavity.
Diagnosis may be confirmed by tympanometry and nasal endoscopy.
Treatment involves supportive care and management of contributing disease factors. Some patients may benefit from a trial of intranasal corticosteroids. Decongestants and antihistamines are ineffective in the treatment of ETD.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

A normal left Eustachian tube as seen endoscopically from the posterior nasal cavity.
Normal (type A) tympanogram
Type B tympanogram; flat compliance curve demonstrates no movement of the tympanic membrane
Type C tympanogram, demonstrating a malfunctioning Eustachian tube
A normal left Eustachian tube as seen endoscopically from the posterior nasal cavity.

Citations

Key Articles

Bluestone CD. Eustachian tube: structure, function, role in otitis media. Hamilton, Ontario: BC Decker, Inc.; 2005.
Monsell EM, Harley RE. Eustachian tube dysfunction. Otolaryngol Clin N Am. 1996;29:437-444.[Abstract]
Monsell EM, Harley RE. Eustachian tube dysfunction. Otolaryngol Clin N Am. 1996;29:437-444.[Abstract]
Schilder AG, Bhutta MF, Butler CC, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol. 2015 Oct;40(5):407-11.[Abstract][Full Text]

Referenced Articles

1. Shan A, Ward BK, Goman AM, et al. Prevalence of eustachian tube dysfunction in adults in the United States. JAMA Otolaryngol Head Neck Surg. 2019 Oct 1;145(10):974-5.[Abstract][Full Text]
2. Bluestone CD. Eustachian tube: structure, function, role in otitis media. Hamilton, Ontario: BC Decker, Inc.; 2005.
3. Goldman JL, Martinez SA, Ganzel TM. Eustachian tube dysfunction and its sequelae in patients with cleft palate. South Med J. 1993;86:1236-1237.[Abstract]
4. Monsell EM, Harley RE. Eustachian tube dysfunction. Otolaryngol Clin N Am. 1996;29:437-444.[Abstract]
5. Lazo-Saenz JG, Galvan-Aguilera AA, Martinez-Ordaz VA, et al. Eustachian tube dysfunction in allergic rhinitis. Otolaryngol Head Neck Surg. 2005;132:626-629.[Abstract]
6. Yeo, SG, Park DC, Eun YG, et al. The role of allergic rhinitis in the development of otitis media with effusion: effect on Eustachian tube function. Am J Otolarynogol. 2007;28:148-152.[Abstract]
7. Bernstein JM. Role of allergy in Eustachian tube blockage and otitis media with effusion: a review. Otolaryngol Head Neck Surg. 1996;114:562-568.[Abstract]
8. Stoikes NF, Dutton JM. The effect of endoscopic sinus surgery on symptoms of Eustachian tube dysfunction. Am J Rhinol. 2005;19:199-202.[Abstract]
9. Stammberger H. An endoscopic study of tubal function and the diseased ethmoid sinus. Arch Otorhinolaryngol. 1986;243:254-259.[Abstract]
10. Dubin MG, Pollock HW, Ebert CS, et al. Eustachian tube dysfunction after tobacco smoke exposure. Otolarynogol Head Neck Surg. 2002;126:14-19.[Abstract]
11. White DR, Heavner SB, Hardy SM, et al. Gastroesophageal reflux and Eustachian tube dysfunction in an animal model. Laryngoscope. 2002;112:955-961.[Abstract]
12. Young YH, Sheen TS. Preservation of tubal function in patients with nasopharyngeal carcinoma, post-irradiation. Acta Otolaryngol. 1998;118:280-283.[Abstract]
13. Goldman JL, Martinez SA, Ganzel TM. Eustachian tube dysfunction and its sequelae in patients with cleft palate. South Med J. 1993;86:1236-1237.[Abstract]
14. Fara M, Dvorak J. Abnormal anatomy of the muscles of palatopharyngeal closure in cleft palates: anatomical and surgical considerations based on the autopsies of 18 unoperated cleft palates. Plastic Reconstr Surg. 1970;46:488-497.[Abstract]
15. Yasan H, Dogru H, Tuz M, et al. Otitis media with effusion and histopathologic properties of adenoid tissue. Int J Pediatr Otorhinolarygol. 2003;67:1179-1183.[Abstract]
16. Kubba H, Pearson JP, Birchall JP. The aetiology of otitis media with effusion: a review. Clin Otolaryngol Allied Sci. 2000;25:181-194.[Abstract]
17. Fireman P. Otitis media and nasal disease: a role for allergy. J Allergy Clin Immunol. 1988;82:917-926.[Abstract]
18. Skoner DP. Complications of allergic rhinitis. J Allergy Clin Immunol. 2000;105(6 Suppl):S605-S609.[Abstract][Full Text]
19. Marino MJ, Ling LC, Yao WC, et al. Eustachian tube dysfunction symptoms in patients treated in a tertiary rhinology clinic. Int Forum Allergy Rhinol. 2017 Dec;7(12):1135-9.[Abstract][Full Text]
20. Wu AW, Walgama ES, Higgins TS, et al. Eustachian tube quality of life and severity of disease in patients with chronic rhinosinusitis. Am J Rhinol Allergy. 2020 Jul;34(4):532-6.[Abstract][Full Text]
21. Higgins TS, Cappello ZJ, Wu AW, et al. Predictors of eustachian tube dysfunction improvement and normalization after endoscopic sinus surgery. Laryngoscope. 2020 Dec;130(12):E721-E726.[Abstract][Full Text]
22. Monsell EM, Harley RE. Eustachian tube dysfunction. Otolaryngol Clin N Am. 1996;29:437-444.[Abstract]
23. Lazo-Saenz JG, Galvan-Aguilera AA, Martinez-Ordaz VA, et al. Eustachian tube dysfunction in allergic rhinitis. Otolaryngol Head Neck Surg. 2005;132:626-629.[Abstract]
24. Yeo, SG, Park DC, Eun YG, et al. The role of allergic rhinitis in the development of otitis media with effusion: effect on Eustachian tube function. Am J Otolarynogol. 2007;28:148-152.[Abstract]
25. Dubin MG, Pollock HW, Ebert CS, et al. Eustachian tube dysfunction after tobacco smoke exposure. Otolarynogol Head Neck Surg. 2002;126:14-19.[Abstract]
26. White DR, Heavner SB, Hardy SM, et al. Gastroesophageal reflux and Eustachian tube dysfunction in an animal model. Laryngoscope. 2002;112:955-961.[Abstract]
27. Young YH, Sheen TS. Preservation of tubal function in patients with nasopharyngeal carcinoma, post-irradiation. Acta Otolaryngol. 1998;118:280-283.[Abstract]
28. McCoul ED, Anand VK, Christos PJ. Validating the clinical assessment of Eustachian tube dysfunction: the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope. 2012;122:718-723.[Abstract][Full Text]
29. Schilder AG, Bhutta MF, Butler CC, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol. 2015 Oct;40(5):407-11.[Abstract][Full Text]
30. Tracy JM, Demain JG, Hoffman, KM, et al. Intranasal beclomethasone as an adjunct to treatment of chronic middle ear effusion. Ann Allergy Asthma Immunol. 1998;80:198-206.[Abstract]
31. Karlidag T, Kaygusuz I, Gok U, et al. The efficacy of combining antibiotic treatment with topical intranasal steroid administration in the treatment of chronic otitis media with effusion [in Turkish]. Kulak Burun Bogaz Ihtis Derg. 2002;9:257-262.[Abstract]
32. Gluth MB, McDonald DR, Weaver AL, et al. Management of eustachian tube dysfunction with nasal steroid spray: a prospective, randomized, placebo-controlled trial. Arch Otolaryngol Head Neck Surg. 2011;137:449-455.[Abstract][Full Text]
33. Van Heerbeek N, Ingels KJ, Zielhuis GA. No effect of a nasal decongestant on Eustachian tube function in children with ventilation tubes. Laryngoscope. 2002;122:1115-1118.[Abstract]
34. Luu K, Remillard A, Fandino M, et al. Treatment effectiveness for symptoms of patulous Eustachian tube: a systematic review. Otol Neurotol. 2015;36:1593-1600.[Abstract]
35. Hussein AA, Adams AS, Turner JH. Surgical management of patulous Eustachian tube: a systematic review. Laryngoscope. 2015;125:2193-2198.[Abstract]
36. Poe DS, Grimmer F, Metson R. Laser Eustachian tuboplasty: two-year results. Laryngoscope. 2007;117:231-237.[Abstract]
37. Metson R, Pletcher SD, Poe DS. Microdebrider Eustachian tuboplasty: a preliminary report. Otolaryngol Head Neck Surg. 2007;136:422-427.[Abstract]
38. Karlidag T, Kaygusuz I, Gok U, et al. The efficacy of combining antibiotic treatment with topical intranasal steroid administration in the treatment of chronic otitis media with effusion [in Turkish]. Kulak Burun Bogaz Ihtis Derg. 2002;9:257-262.[Abstract]
39. Catalano PJ, Jonnalagadda S, Yu VM. Balloon catheter dilatation of Eustachian tube: a preliminary study. Otol Neurol. 2012;33:1549-1552.[Abstract]
40. McCoul ED, Anand VK. Eustachian tube balloon dilation surgery. Int Forum Allergy Rhinol. 2012;2:191-198.[Abstract]
41. Huisman JML, Verdam FJ, Stegeman I, et al. Treatment of Eustachian tube dysfunction with balloon dilation: A systematic review. Laryngoscope. 2018 Jan;128(1):237-247.[Abstract]
42. Poe D, Anand V, Dean M, et al. Balloon dilation of the eustachian tube for dilatory dysfunction: A randomized controlled trial. Laryngoscope. 2018 May;128(5):1200-1206.[Abstract]
43. Tucci DL, McCoul ED, Rosenfeld RM, et al. Clinical consensus statement: balloon dilation of the Eustachian tube. Otolaryngol Head Neck Surg. 2019 Jul;161(1):6-17.[Abstract][Full Text]
44. National Institute for Health and Care Excellence. Balloon dilation for chronic Eustachian tube dysfunction. NICE guideline IPG665 interventional procedures guidance. Dec 2019 [internet publication].[Full Text]
45. Rosenfeld RM, Shin JJ, Schwartz SR, et al. American Academy of Otolaryngology-Head and Neck Surgery Foundation; American Academy of Pediatrics; American Academy of Family Physicians clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg. 2016;154(1 Suppl):S1-S41.[Abstract][Full Text]
46. Terris MH. Magit AE. Davidson TM. Otitis media with effusion in infants and children. Primary care concerns addressed from an otolaryngologist's perspective. Postgraduate Med. 1995;97:137-138.[Abstract]
47. Bluestone CD. Management of chronic otitis media with effusion. Acta Otorhinolaryngol Belg. 1983;37:44-56.[Abstract]
48. Fireman P. Otitis media and Eustachian tube dysfunction: connection to allergic rhinitis. J Allergy Clin Immunol. 1997;99:S787-S797.[Abstract]