Eustachian Tube Dysfunction

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Because the ears, nose, and throat are all connected, it's not uncommon for problems in one area to spill over into another. One example is Eustachian tube dysfunction (ETD).

Eustachian tubes are narrow passageways that connect the inside of the ears to the back of the nose in an area known as the nasopharynx (refer back to Figure 2.2). These tubes equalize the pressure between your ears and the outside atmosphere. When you feel your ears popping in an elevator or on an airplane, that's your Eustachian tubes opening and closing.

ETD occurs when the Eustachian tubes become blocked and don't open properly. It can cause a buildup of pressure in the ears, leading to a sense of blockage, decreased hearing, and pain. This condition is likely to occur when you're flying while you have a cold and the plane begins to descend. However, anything that ,163

causes the inside of your nose to swell, including allergies and sinusitis, can also cause the Eustachian tubes to swell shut, leading to ETD.

With sinusitis, the increased mucus produced during an infection typically drains over the Eustachian tubes as it flows from the nose into the throat. This bacteria-laden drainage causes membranes that surround the Eustachian tubes to become inflamed, which prevents the tubes from opening. If fluid builds up in the ear, you can develop an ear infection on top of the sinus infection. The same antibiotics prescribed to treat sinus infections usually take care of ear infections as well.

In severe cases of ETD, a surgeon can insert tiny ventilation tubes made of plastic or metal through the eardrums to drain fluid and equalize pressure inside the ear. This procedure is commonly done in children with recurrent ear infections. A new surgery called Eustachian tuboplasty, in which the opening to the Eusta-chian tubes in the back of the nose is enlarged with a laser or microdebrider, is now being evaluated for the treatment of ETD.

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