Eustachian Tube Dysfunction

Blocked pressure equalization tube causing muffled hearing and popping

Overview

The Eustachian tube connects the middle ear to the back of the nose. It normally stays closed and opens briefly during swallowing or yawning to ventilate the middle ear, equalize pressure, and drain secretions. In obstructive Eustachian tube dysfunction it fails to open adequately, often because of colds, allergies, enlarged adenoids, or anatomy, so negative pressure builds in the middle ear and causes fullness, popping, muffled hearing, and sometimes pain. Chronic dysfunction can lead to retraction of the eardrum, middle ear effusion, and in some cases cholesteatoma. Tympanometry often shows a Type C pattern. Treatment depends on the cause and may include nasal steroid sprays for allergic inflammation, ventilation tubes, or balloon dilation of the tube. The opposite problem, a patulous tube that stays open, causes autophony, an unusually loud perception of one own voice and breathing. In children, function usually improves with growth as the tube lengthens and becomes more angled.