Highlights & Basics
- 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
Diagnostics Tests
Treatment Options
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
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]
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]
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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]
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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]
