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eustachian tube dysfunction

Etiology: - barotrauma - air travel Pathology: - eustachian tube fails to equalize pressure between the middle ear & the atmosphere, resulting in negative middle-ear pressure Clinical manifestations: - otalgia, muffled hearing, tinnitus, aural fullness - may occur in the setting of nasal congestion & cough Special laboratory: - Weber test lateralizes to the side of eustachian tube dysfunction - otoscopy: - tympanic membrane intact, but appears dull & retracted - tympanic membrane does not move with pneumatic otoscopy [3] - tympanic membrane appears thickened with amber hue [3] Complications: - recurrent middle-ear infections requiring myringotomy & tube placement - chronic otitis media with tympanic-membrane retraction & cholesteatoma Management: - observation - pseudoephedrine does not appear to shorten recovery period [3] - eustachian tube balloon dilation system FDA approved to dilate stenotic eustachian tube in adults

Related

eustachian tube; auditory tube; pharyngotympanic tube

General

eustachian tube disorder

References

  1. McCoul ED et al. Validating the clinical assessment of eustachian tube dysfunction: The Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Laryngoscope 2012 Mar 1; 122:1137 PMID: 22374681
  2. Seibert JW and Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am 2006 Nov 14; 39:1221 PMID: 17097443
  3. NEJM Knowledge+ Otolaryngology