What is the treatment for Eustachian tube dysfunction?
The treatment depends on how badly you are affected by the condition. Often, no treatment is needed.
In many cases, the muffled hearing and popping is mild and does not last longer than a few days or a week or so. This is common after a cold. No particular treatment is needed and the symptoms often soon go.
Try to get air to flow into the Eustachian tube:
- Air is more likely to flow in and out of the Eustachian tube if you swallow, yawn or chew.
- Also, try doing the following: take a breath in. Then breathe out gently with your mouth closed and pinching your nose (the Valsalva manoeuvre). In this way you are gently pushing air into the Eustachian tube. If you do this you may feel your ears go 'pop' as air is forced into the middle ear. This sometimes eases the problem. This is a particularly good thing to try if you develop ear pain when descending to land in a plane. But make sure to do it gently; otherwise, you could accidentally burst a hole in your eardrum.
Decongestant nasal sprays or drops
A decongestant may be advised by your doctor if you have a cold or other cause of nasal congestion. You can buy these from pharmacies. They may briefly relieve a blocked nose. However, you should not use a decongestant spray or drops for more than 5-7 days at a time. If they are used for longer than this, they may cause a worse rebound congestion in the nose and can damage the lining of your nose.
Antihistamine tablets or nasal sprays
Antihistamines may be advised by your doctor if you have an allergy such as hay fever. In this situation they will help to ease nasal congestion and inflammation.
Steroid nasal spray
A steroid nasal spray may be advised if an allergy or other cause of persistent inflammation in the nose is suspected. It works by reducing inflammation in the nose. It takes several days for a steroid spray to build up to its full effect. Therefore, you will not have an immediate relief of symptoms when you first start it. However, if any inflammation is reduced in the back of the nose then the Eustachian tube is able to work better.
Steroid nose drops
These have the same ingredient as the steroid nasal sprays, but because they are drops they can run deep into the back of the nose. You put them in lying flat on your back, with your head hanging off the end of your bed. They can only be prescribed.
Referral to a specialist
- If symptoms continue or the cause of the Eustachian tube dysfunction is not clear, you may be referred to an ear specialist for assessment.
- Treatment options depend on any underlying cause that may be found.
- A small plastic tube (a grommet) can be inserted through the eardrum, under an anaesthetic. This usually helps the problem but carries its own risks such as infection.
- A treatment recently developed is called balloon dilatation. This involves inserting a tiny tube with a small balloon on the end into the Eustachian tube through the nose. The balloon is filled with salt water and left in place for a few minutes in order to stretch the Eustachian tube. Currently the treatment is only being used as part of research but may be authorised for general use if trials are favourable.
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- 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 Feb 39(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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