How is Eustachian tube dysfunction diagnosed?
Short-term Eustachian tube dysfunction
- There are no particular tests to diagnose Eustachian tube dysfunction. It is usually diagnosed on the basis of the story: a bad cold, with a blocked, runny nose and muffled hearing in one or both ears.
- This usually clears up in a few weeks and no further tests or checks with the doctor are necessary.
Long-term Eustachian tube dysfunction
- If the symptoms have gone on for longer than six weeks, you may have long-term (chronic) Eustachian tube dysfunction. It is important to check there are no underlying problems.
- This is particularly important if the hearing is getting worse, particularly on one side; or if you have persistent pain in one ear.
- If that is the case then a GP will usually refer you to an ENT specialist.
- It may be that a hearing test (called an audiogram) will be done to get an accurate idea of your hearing.
- They will also perform a tympanogram, which is a way of testing the pressure behind your eardrum.
- An ENT specialist will probably put a small flexible camera into your nose to look at the back of your nose (the nasopharynx) and to see the openings of the Eustachian tube directly.
- An ENT specialist will be able to advise you, but it may be necessary to have a scan of your ear and the side of your brain. This would probably be a CT scan (termed a 'CAT' scan in the USA).
- This will check there is nothing blocking the middle ear behind your eardrum, or that there is nothing at the back of your nose blocking the other end of the Eustachian tube.
Further reading and references
Norman G, Llewellyn A, Harden M, et al; Systematic review of the limited evidence base for treatments of Eustachian tube dysfunction: a health technology assessment. Clin Otolaryngol. 2014 Feb39(1):6-21. doi: 10.1111/coa.12220.
Balloon dilatation of the Eustachian tube; NICE Interventional Procedure Guideline, November 2011
McDonald MH, Hoffman MR, Gentry LR, et al; New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images. Eur Arch Otorhinolaryngol. 2011 Nov 27.
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