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A Discussion of Eustachian Tube and Middle Ear Problems

Understanding problems in the middle ear can be difficult, especially when you don’t know about the mechanisms in the ear that are being affected. Here is everything you need to know.

How We Hear

There are three sections that make up the ear. The first is the outer section, the second is the middle section, and the third is the inner section. Each of these areas plays a unique role in transmitting sound.

It is in the middle ear that contains the eardrum, as well as a number of highly delicate, tiny bones. It is connected to the throat via the eustachian tube. When sound enters through the ear, it sends vibrations to the bones and eardrum. The brain then picks up these signals, identifying them as sounds. The eustachian tube works as a kind of valve, regulating pressure.

Damage to any of these components can lead to interruptions in sound perception, either manifesting as slight or severe hearing impairment. When this damage occurs, it almost always has to be corrected through medication or surgery.

How The Eustachian Tube Works

The eustachian tube is a 1 ½ inch connector that runs from the middle ear to the nasopharynx, the top of the throat located just above the flat palate of the mouth. When you swallow, yawn or “pop” your ears, that is opening the tube to allow air into the middle ear. This keeps the pressure in the middle ear properly balanced, releasing old air, and refilling it with the new.

When there is a problem with this tube, it cannot open and so release pressure the way it is meant to. That leads to problems hearing, and can be a long term problem. It may also cause discomfort or tinnitus (ringing or buzzing in the ear), as the pressure builds unevenly, obstructing the middle ear.

Many people, both with and without regular eustachian tube dysfunction, will experience problems while they are on airplanes. Cabin pressure rises and drops as the plane moves up and down along different altitudes. During takeoff, that pressure decreases. During landing, it increases.

Ideally, you should avoid flying if you have chronic eustachian tube problems, or if you are experiencing an illness like a cold or upper respiratory infection. Allergies can also cause a blockage in the middle ear. If you do fly during these times, nasal sprays or antihistamines may be used to reduce symptoms. Chewing gum may also help you to open up the eustachian tubes, as well as holding your nose closed and swallowing air into the back of the throat.

Serous Otitis Media

The eardrum itself can suck inwards, and fluid can build over time. This is called serous otitis media, commonly found with infections and respiratory illnesses, especially in young children.

For adults, another condition that can develop is patulous eustachian tube. This is when the opening of the tube widens and then refuses to close. This gaping brings air in and out of the middle ear regularly, and amplifies sounds such as breathing, or the sufferer’s own voice. Other sounds are heard just fine, but there will be a blockage sensation similar to serous otitis media.

What You Should Know About Serous Otitis Media

Because serous otitis media is such a common condition, it is important to know all you can about it. This is especially true for parents; this issue is prevalent in children, and often it comes with no uncomfortable symptoms that a child is likely to complain about. Therefore, you may not know for months that they have developed fluid in the ear, which can lead to further problems down the line.

Chronic ear infections may be a precursor to the development of serous otitis media. But it is possible that only slight hearing impairment will be the only symptom, making it hard to notice an issue. Speech and learning delays are another possible result, and so your child’s school may be quicker at catching the problem than checkups.

The sooner serous otitis media is diagnosed, the better. Medical treatment, and in extreme cases surgical intervention, can usually restore hearing function to near total levels. If the condition has been present long enough to cause long term damage, some hearing impairment may remain. Which is why it is so important to have your children checked once a year by an audiologist, or to take part in their school’s annual hearing checks at the beginning of the year.

Three common factors lead to fluid buildup in the middle ear:

Ear Infections – The middle ear is a part of the wider system of the throat, nose and sinuses. Because of that, an infection in any one of those areas can lead to an ear infection, which causes fluid buildup in the middle ear. Inflammation may also block off the eustachian tube, leaving it unable to alleviate pressure and pass air. Infected middle ears can cause a great deal of pain, requiring immediate medical attention.

Undeveloped Eustachian Tube – During childhood, the eustachian tube is small, and shaped differently than it will be later in life. The older a child becomes, the more that tube matures and grows into a larger tube. That is why ear infections can be very common in young children, but they grow out of it as they age.

Allergies – Allergies can cause inflammation in the sinuses and throat, as well a the mucus membranes. When that happens, the eustachian tubes can become impacted, and have trouble opening as they should. The more acute and frequent these reactions, the more common the middle ear dysfunction that can result.

Treating these conditions will often lead to the end of serous otitis media. Antibiotics (oral or topical drops), antihistamines, pain medication, and other medications may all be used. In extreme cases, surgery may be required. For some infections when severe pressure is being placed on the eardrum, a small incision may be made to alleviate some of that pressure and avoid a rupture.

A tube may be placed inside of the ear for up to a six month period to keep the eustachian tube open. For children, this is a more serious medical procedure that requires sedation, and is performed as an inpatient surgery. Adults are usually able to have these tubes placed while in an audiologist’s office, under local anesthetic.

Tympanometry Testing

The best test for eustachian tube dysfunction is tympanometry. This delicate test uses a small probe on the outside of the ear, which monitors the amount of sound that is being transferred through the ear. This tells the audiologist two things: if the eardrum has retracted due to pressure (and possibly fluid), and if too much sound is being bounced back due to the eustachian tube not properly opening.

Since only an audiologist can perform this test, it is important that you have one examine you or your child if you suspect a hearing impairment problem. Many children will not experience pain with their condition, so pay attention for any signs that they are having trouble hearing. That includes academic regressions, speech impairment, or learning difficulties.

In the meantime, have you and your family checked annually to monitor hearing health. Learn more at Hearing Doctors.