Eustachian Tube Dysfunction

Nurse practitioner Rachel Hisim discusses eustachian tube dysfunction, which is characterized by ear pain or pressure in one or both ears and can result in muffled hearing. She reviews the underlying causes, management and treatment options. #EustachianTubeDysfunction #JohnsHopkins

[Northernbreed]

Given the rampant quackery about this on youtube, it’s a real breath of fresh air to find and listen to this. Thanks!

[Elizaaaa]

After dealing with this for almost a year I finally got answers 😞 I felt as if I was the only one dealing with this.

[UbaldoZam]

I’ve had etd for about 5 months now. My left ear had so much pressure, my right ear felt like fluid was filling up. Dr prescribed antibiotics and steroids. I think mine came from inhaling some dust particles at an old job. There’s not a lot of pressure in my right ear, it has gotten better but still bothers me. My right ear has gotten better too, I still feel fluid build up every once in awhile but I just mess with my ear and it drains. I still get pressure in my forehead and nose. I heard red light therapy helps to heal etd, there’s a guy on YouTube who explains how it healed him. Ordered mine yesterday, hopefully it will help to heal it permanently. It’s really messing with my life. Praying for everyone to start healing!!!!

[heywally]

I've had (apparently, according to an ENT who observed some pretty thick mucus up in my nasal cavity) Eustachian tube dysfunction for months now, the worst symptom being my hearing getting screwed up in one ear, intermittently. When the hearing is bad, there is no pop in that ear and more of a feeing of fullness. When the hearing gets better, I've got good popping going on. No fluid was observed in my middle ear but I'm not sure there isn't some mucus in there. Making things worse, my other ear has been fried by Ménière's disease and conversation is permanently distorted over there. So, I need my other "good" ear. I'm 70 soon and so there's a bit of natural hearing loss for me. I have a hearing aid for the good ear but it is not very effective when I have these bad days.

An antihistamine spray was prescribed and that seemed to make it worse so I stopped. A nasal saline rinse was also suggested and that has possibly made a difference. Using the NeilMed system; kind of weird at first but it seems to be clearing my nasal passages and I haven't got any rinse into my middle ear. Check the YouTube videos; do the "ka ka" thing to keep rinse from going into the wrong places.

The other things I'm now doing - 500 mg of magnesium per day (look into that) and I've pretty much totally eliminated dairy as that is a mucus creator. Going good now for 6 days straight

Update: after a few relapses, I’m up to over 2 weeks now with good hearing health in my good ear. So, no dairy, magnesium supplements (500 mg total per day, spread to 1 pill twice per day), lots of water … seems to have made a difference as my hearing is as good now as several years ago. Coinciding with this improvement is a more consistently clear nasal passage. Have not been doing the nasal saline rinse. Also, I’m now wondering if this eustachian dysfunction was the cause of my Ménière’s symptoms. One other thing, I’ve had a history of ear infections, childhood and adult.

[peterdelaney-cntd]

I've been using a steroid nasal spray for 3 weeks but pointing it up my nose. I'm going to try pointing it towards the back of my nose. What an amazing tip I didn't know before.

[lithishaislam]

I'm dealing with this about a week or something, I just thought that it's just my feelings and I'm the problem.I'm soo happy that it does make sense to the Doctors.

[acelson]

Had this for years and can never seem to get the right treatment here in the UK, they diagnosed me with hearing loss however I can regain my hearing when I pinch my nose and blow however this only lasts a couple of mins before my eardrums pull back and I can’t hear we’ll again. It’s horrible!

[kelbee]

Thank you for this clear explanation. Greatly appreciated.

[Ukepa]

Rachel has really explained the problem and solutions in 3 minutes that I couldn't find in longer videos. Thanks a lot!!!

[mash]

I’ve had ears that constantly pop for probably over five years now. I tried many different methods, went to doctors, still have it so I kinda gave up. Honestly I’m just desensitized to it now so I don’t even notice it anymore. I even went as far as pouring water in my ears every day, still didn’t do anything🤷‍♀️

[MysticalMoonBaby]

I hate this disease ive had it since birth it also hurts and makes me think i have an ear infection when I don't...

[carolyngrover]

I think I am suffering from this currently after allergies turned into a nasty sinus infection
I’ve been taking Flonase which provides some relief but now I know the trick is to use it while lying down before bed!!

[davidspomer]

I went to buy some Flonase today and found, as you'd expect, several different Flonase products. Rachel, could you be more specific when you say Flonase? Or show a picture of the bottle. Thanks.

[sequoiaserenity]

Oh my goodness! I have had popping every time I swallow in my ears for 15 years. I have a deviated septum and severe hearing loss but the audiologist told me they weren’t sure why except for genetics and gave me a hearing aid. I think this is it! Chronic sinus infections for my entire 34 years and lack of medical care for various reasons. I have a doc appt in a few weeks and I’m going to bring this up. Are you telling me my hearing loss may just be stuffy ears 😭 I would cry to be able to hear again!!! They do feel like they need to pop 24/7

[nosedoctor]

Not personal assault intended, but you should talk with your supervising physicians regarding the discussion of using nasal steroid sprays off-label for treating ETD. They may have even supported this but there is no evidence that this is effective in adult patients. To summarize the finding from the most recent systematic review of multiple studies on the subject (19 studies were reviewed), typically empirically recommended treatments have not been proven to offer statistically significant benefit. The following statement is the lead of the summarization of the study's conclusion: ..."It is not possible to draw conclusions regarding the effectiveness of any of the interventions for the treatment of adults with an ETD diagnosis, and there is insufficient evidence to recommend a trial of any particular intervention. Further research is needed to address lack of consensus on several issues, including the definition of ETD in adults, its relation to broader middle ear ventilation problems and clear diagnostic criteria."

With regard to the recommendation to use the nasal steroid in the manner you described, while off label use of any drug remains the purvey of the treating physician, there is no clinical trial that has shown that this method of treatment is effective and, in fact, the contrary is true... there have been trials that demonstrate LACK of evidence to support clinical efficacy of this approach. I am not in favor of censorship but I am in favor of full disclosure.

The official position of the AAO-HNS is that there is no proven medicinal treatment that has been shown to be effective in terms of providing statistically significant therapeutic benefit to the adult ETD patient. Advising otherwise is perhaps a harmless exercise but it is not supported by the available data. Treating underlying causes is clearly reasonable, provided such cause can be identified, and there is date to support this, but in many cases there is no obvious cause and observation is warranted without pharmacologic treatment in those cases. Intervention should be pursued in the form of providing ventilation if there is evidence of impending problems related to poor ventilation of the middle ear.

The search for effective management of ETD, particularly in adult patients, is quite telling and sparse. Although sinus surgery was, in at least one study, shown to be statistically beneficial in terms of improving ET function in selected patients with radiographic evidence of significant sinus pathology, other treatment methodologies have not been successful until the arrival of eustachian tube balloon dilation (ETBD). When used in appropriately selected patients, balloon dilation is the first treatment of ETD to receive FDA approval for that stated purpose. The FDA is not what I would consider the ultimate authority on efficacy, but FDA approval did open the door for direct treatment of the eustachian tube (after a roughly 3 year delay following the FDA approval, due to insurance companies stalling the use of this new treatment for the obvious reason they did not want to pay for it). Even so, ETBD has a roughly 35% failure rate. Fortunately there is an extremely low risk profile and, in properly selected patients, very little downside if you exclude the cost of trying the treatment. In the interest of full disclosure, I am a practicing otolaryngology surgeon with > 25 years of experience, and I have no financial interest in any product or treatment.

[WardsWildLifePNW]

Tbh I’m absolutely terrified of having surgery, at almost 30 and not having and I feel like it’s worse. I went can ent, steroids, Flonase and allergy meds. Still feeling it. Been smoking Jane for almost 10 years with absolutely no problems. Then all of a sudden I have vertigo(not sure how) ent I think fixed that, but my ear pain is still here. I don’t smoke cigarettes (did for about a year) stopped smoking Jane about 2 days ago but still bugging me. The amount of panic attacks it’s cause me is so draining. Idk how yall have been doing this for years 😭

[paulwary]

Note the above info seems to be just for obstructive dysfunction. Patulous eustacian tube is basically the reverse problem, and decongestants are not recommended as per Johns Hopkins site. I recently read a paper where plain water nasal rinse was mentioned, and have been using that method with success. I think the mechanism is that it causes a general swelling of the tissue (due to osmotic pressure), allowing the valve to close. The method gives me up to 24 hours relief, but its unpleasant and seems to damage the sense of smell. A saline solution of oestrogen was also mentioned, but I've not tried that. Paper said either method was 'poorly tolerated', which I guess means painful! General practitioners, and even ENT specialists seem to be clueless about the condition, and they do not appreciate you telling them what you've learnt.

[octavio]

I have experienced Eustachian tube dysfunction for the majority of my life. Has anyone looked into permanently inserting a synthetic eustachian tube inside the actual biological eustachian tube? Wouldn't this keep the eustachian tube open permanently and prevent the tube from ever closing again, thereby preventing the infections from occurring to begin with or from reoccurring?

[dthomason]

The problem is getting the medicine to that area. I’ll use her recommendations.

[madisonbain]

I think this is what’s wrong with me. I dance and every rehearsal it happens. I notice it happens more when I’m breathing heavy after strenuous activity. My left goes and then my right follows it. My left is the one that does it the most. I have vertigo too and everything on top of each other really impacts my dance performance negativity :/ this has been happening almost 3 years. Ent told me nothings wrong