DEAR DR. GOTT:
I have been having a problem with my ears since 2007. I have been to several ear- nose-and-throat doctors but they all tell me I have dysfunctional Eustachian tubes and give me medication.
My complaint is that my ears always feel plugged. I have tried several different medications such as antibiotics, prednisone, nasal sprays, and others. Most don’t work. The one I am currently trying works sometimes but not all the time. My doctors have even gone as far as ordering a CT scan but nothing abnormal was found. Please help me!
DEAR READER:
If you have been diagnosed by several ENT physicians with Eustachian tube dysfunction, then I must assume they are correct. However, that doesn’t mean there is no help for you despite the steps you have taken. For your and my readers benefit, I will first discuss what this disorder is and then go into the various treatment options.
Eustachian tube dysfunction is caused by a chronic blockage of the Eustachian tubes that leads from sinuses to the ear drum and equalizes pressure within the ear. When a blockage occurs it cuts off the space from the outside environment which creates a vacuum that can pull the eardrum backward into the ear leading to pain, pressure and/or hearing loss. A common, temporary cause of this is flying. “Popping” the ears can reduce or resolve the symptoms.
In long-term blockages, fluid can accumulate within the tube causing worsened symptoms and a feeling of the ear being plugged. (If bacteria gets into the fluid, it can lead to a middle ear infection.) Common causes of Eustachian tube dysfunction (ETD) include inflammation or irritation of the nasal lining (due to the flu, colds, etc.), pollution, cigarette smoke, nasal allergies and more. Obesity can lead to fatty deposits near the passageway of the Eustachian tube and rarely, more serious conditions such as nasal polyps, a skull base tumor or a cleft palate can be the cause.
ETD is most common in children because of an anatomical narrowing and flattening of the Eustachian tube. By about age six, this changes into the common down-sloping shape seen in adolescents and adults.
Treatment depends on the cause. Allergies are a leading cause so most physicians attempt to reduce the inflammation and allergic response. Allergy medications, nasal decongestants and steroids such as prednisone, are commonly used. Self-inflation techniques may be advised in order to re-establish equalized pressure. The easiest way to do this is to blow up a balloon. It can even be done several times a day if needed. If these fail to provide results, further investigation is needed to determine the underlying cause.
If the dysfunction persists (as yours has), surgery may be an option. There are several types but which one is done depends on the cause and severity of symptoms. Another important factor is whether or not there is a significant amount of fluid present.
Speak to your physician about whether surgery is an option.
To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
