Eustachian tube dysfunction

The Eustachian tubes are tubes that connect the middle ear to the back of the nose and throat. Their function is to equalize pressure by allowing air to circulate during sneezing, yawning, and swallowing. It is most common in children under the age of 5, although it can occur at any age. 

The dysfunction is usually caused by inflammation or a buildup of mucus in the tubes. Other contributing factors: smoking, sleeping on the stomach and, in children, prolonged use of a bottle. 

It presents with a feeling of pressure or blockage in the ears. Hearing is reduced, as if muffled. It may be accompanied by tinnitus, pain (in one or both ears) and impaired balance. 

It is diagnosed clinically by specific questioning and examination of the ears. 

Eustachian tube dysfunction may improve spontaneously. Chewing gum or yawning may help open the tubes. If the cause is allergic inflammation, antihistamines, decongestants, or corticosteroids may be used. 

There are very thin devices that can be inserted through the nose to the Eustachian tube and used to dilate it by inflating a balloon. Pressurized air can then be blown through the tubes to relieve the air pressure in the ears. 

Finally, a myringotomy may be performed, in which a hole is made in the eardrum to relieve pressure and drain any fluid that may be present. In children with frequent ear infections, a small tube may be implanted in the eardrum to promote continuous drainage of fluid; these fall out spontaneously a few months after implantation.