What happens with eustachitis
The auditory tube is a narrow canal several centimeters long, lined with mucous membrane. It ventilates the middle ear, equalizes pressure and drains mucus into the nasopharynx. In children, the tube is shorter, wider and more horizontal, so infection from the nose can more easily enter the ear. When the pharyngeal mouth of the tube swells, air is sucked in from the tympanic cavity, negative pressure arises, the membrane is retracted and vibrates worse. With prolonged disruption of ventilation, fluid accumulates in the cavity - exudative otitis media develops.
- Acute eustachitis - against the background of ARVI, up to several weeks
- Chronic - more than 3 months
- Obstructive dysfunction - the tube does not open
- Gaping eustachian tube - the tube is constantly open
- Barodisfunction - complaints only with pressure drops
Causes and risk factors
Most often, eustachitis develops during a cold: inflammation from the nasal mucosa spreads to the mouth of the auditory tube. In children, the main cause of protracted forms is enlarged adenoids, which mechanically close the orifice. In adults, persistent unilateral ear congestion must be checked so as not to miss the formation of the nasopharynx. Allergic rhinitis, chronic sinusitis, deviated septum, smoking, and reflux contribute to dysfunction. Sudden changes in pressure during airplane landing and diving provoke barotrauma of the ear.
- ARVI and influenza
- Allergic rhinitis
- Adenoids in children
- Chronic sinusitis and nasal polyps
- Deviated nasal septum
- Smoking and secondhand smoke
- Air travel and diving with a runny nose
Symptoms
The main symptom is a feeling of fullness or pressure in the ear, sometimes in both ears. Hearing decreases, sounds seem muffled, and your own voice sounds loud and booming. When swallowing and yawning, the ear may make a clicking or crackling noise, after which it feels better for a short time. There may be a noticeable noise in the ear and fluid transfusion when tilting the head. Pain is not typical for eustachitis: severe pain and fever often indicate acute otitis media. A small child may not complain, but only ask more often and turn up the TV volume.
- Ear congestion
- Hearing loss
- Sounding your own voice loud
- Clicking and crackling sounds when swallowing
- Feeling of fluid in the ear
- Mild noise in the ear
Diagnostics
The ENT doctor examines the eardrum: with eustachitis, it is retracted, and if fluid accumulates behind it, a level or bubbles are visible. Tympanometry objectively assesses the pressure in the middle ear and the mobility of the membrane, and audiometry shows the degree of hearing loss. Be sure to examine the nasal cavity and nasopharynx using an endoscope to find the cause - edema, adenoids, polyps or formation. If children are suspected of having adenoids, they undergo endoscopy or x-ray of the nasopharynx. According to indications, a CT scan of the sinuses and temporal bones is prescribed.
- Otoscopy
- Tympanometry
- Pure-tone threshold audiometry
- Endoscopy of the nasal cavity and nasopharynx
- X-ray of the nasopharynx in children
- CT scan of the paranasal sinuses - according to indications
Treatment and prevention
Since the cause is almost always in the nose, treatment is aimed at restoring nasal breathing. Nasal rinsing, nasal glucocorticosteroids are used, for allergies - antihistamines, vasoconstrictor drops - in short courses. Gentle exercises to open the tube help: swallowing, yawning, blowing through the nose into a special balloon. An ENT doctor may perform blowing or catheterization of the auditory tubes. In case of persistent dysfunction, balloon dilatation of the tube is performed; in case of prolonged exudative otitis media, eardrum bypass is performed; in children with adenoids, adenotomy is performed.
- Treatment of runny nose, sinusitis and allergies
- Nasal glucocorticosteroids
- Autoinsufflation - blowing with a balloon
- Blowing and catheterization of the auditory tubes by a doctor
- Balloon dilatation of the auditory tube
- Shunting of the eardrum for exudative otitis media
- Do not fly or dive with a stuffy nose
