- definition: Failed pressure equalization via the eustachian tube, typically at its valve-like opening in the nasopharynx
- Drum often pushed in, tense, dysfunctional
- Causes – anything that irritates mucus lining
- URTI
- Allergic rhinitis
- Enlarged adenoids
- Environmental irritants (e.g. Tobacco smoke)
- Gastroesophageal Reflux
- Pregnancy (esp. third trimester)
- Conditions affecting ciliary function (e.g. primary ciliary Dyskinesia)
- Mass lesions
- Adenoid hypertrophy
- Nasopharyngeal carcinoma
- Symptoms
- Sense of ear fullness or plugging of the affected ear
- Muffled Hearing
- Valsalva does not clear ear discomfort (and may cause pain)
- Tinnitus or crackling Sensation in the affected ear
- Vertigo or sense of Dysequilibrium
- occasionally pain
- popping noises
- Treatment
- Usually nothing
- Watchful waiting for spontaneous resolution over time is consistently effective
- Clear snuffling nose – steam inhalations
- Auto insufflation with Valsalva
- Patient may gently clear eustachian tubes as done by scuba divers
- Hold nose and blow against a closed mouth
- Systemic decongestants
- pseudoephedrine or phenylephrine may be helpful for congestive symptoms
- Systemic or topical decongestants are not effective in cases of otitis media with effusion
- Topical nasal decongestant sprays or drops may be used on a limited basis (generally three days or less) for symptomatic relief of nasal congestion or rhinitis, with or without ear blockage symptoms
- Topical decongestants
- may also be helpful for difficulty clearing the ears during flights and scuba diving. Patients should be counselled not to exceed three days of nasal decongestant treatment, in order to avoid nasal mucosal dependency and rhinitis medicamentosa.
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