Eustachian Tube Dysfunction

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The Eustachian Tubes (or pharyngotympanic tubes) are narrow passages that connect the middle ear to the back of the nose. Their primary function is to regulate air pressure within the ear, ensuring that the eardrum vibrates properly for clear hearing. They also help drain mucus from the middle ear, preventing fluid buildup.

When these tubes fail to open or become blocked, a condition known as obstructive Eustachian Tube Dysfunction (ETD) occurs. This can lead to an uncomfortable sensation of pressure or fullness in the ears. It can also dull and muffle hearing, some patients describe it as a popping or crackling sound in the ear. 

I am internationally recognised for my expertise in treating ETD and advanced treatments, I am frequently referred patients with this condition by Ear specialist (otologists), other nose surgeons and GPs, as well as patients self-referring to me.  I have pioneered techniques such as balloon tuboplasty under local anaesthesia in a clinic setting, which has helped countless patients regain normal ear function and regain clarity in their hearing. My approach combines cutting-edge techniques with tailored treatment plans.

Diagnosis

To determine the underlying cause of ETD, a thorough evaluation is essential:

  • Medical History: Patients may report popping sounds, ear pain or pressure. Understanding the type, duration and severity of these symptoms is vital 
  • Physical Examination and Endoscopy: In my clinic, I use an endoscope to examine the back of the nose (postnasal space) and the eustachian tube orifices (holes) which are located here. This allows me to assess the Eustachian tubes as they enter the back of the nose and identify any blockages or inflammation.  It also helps me determine whether you would be a good candidate for a procedure
  • Hearing Test: A pure-tone audiometry test helps evaluate hearing function and detect abnormalities
  • CT scan: In some cases, a CT scan may be recommended to assess structural concerns.

Treatment Options

Once we identify the cause, tailored treatment options can be explored. Some common causes of persistent issues are abscesses, lumps, tonsils, enlarged adenoids or digestive issues. Each patient receives a tailored care plan, designed to address their individual needs. While treatment varies, the overall approach typically includes:

  • Nasal Sprays: Depending on the cause, I may recommend steroid nasal sprays to reduce inflammation in the nose and postnasal space or a very short-term use of decongestant sprays to improve Eustachian tube function. As a nose specialist I would treat any underlying sinus concerns.
  • Lifestyle: Managing allergies, allergic or non-allergic rhinitis and avoiding smoking. 
  • Balloon Tuboplasty Surgery: For ETD that does not respond to conventional treatment, a balloon tuboplasty procedure can be performed, usually under local anaesthesia in a clinic setting. This minimally invasive technique gently expands the Eustachian tube, restoring normal function. I will always make sure a patient has tried nasal steroids for at least 6 weeks (or preferably 3 months) before I book them in for Tubooplasty
  • Referral for Additional Care: If symptoms suggest the problem is not related to ETD (but is caused by a different ear issue) I will perform diagnostic tests and refer you onto a trusted ear specialist (otologist) for diagnostics and treatment

My goal is to provide patients with clear answers and effective solutions, ensuring they can return to daily life without ongoing ear discomfort and clear hearing. Click here to make an enquiry.