question-icon

What is eustachian tube dysfunction?

default
Posted on Thu, 26 Mar 2015
Question: I have a long history of this question. My hearing was damaged after snorkeling for 4 hours in salt water about 2 feet under water. They have given me long medical terms but never an answer to why water damaged my ears. Only terms or acronyms like ETD.

Can one of you experts tell me how a little water damaged my ears and if my hearing will ever come back? It has been a year now since the loss.

I just want to know why and how?
doctor
Answered by Dr. Abubakar Siddiqh (1 hour later)
Brief Answer:
needs audiometry.

Detailed Answer:
Hi,

I had gone through your question and understand your concerns that you are having loss of hearing.

Answers for your queries.

1. ETD -Eustachian tube dysfunction,(tube connecting the middle ear and nose) occurs due to allergic rhinitis, sinus infection or barotrauma.

2. Barotrauma- An ear barotrauma occurs when a diver (Snorkeling ) can not properly equalize the pressure in his ears with the surrounding water pressure. Common causes of an ear barotrauma are ineffective equalization techniques.

Depending on the duration of snorkelling, co-existent factors (allergy, deviated septum) and underwater pressure. It could be simple pain over external ear, rupture of ear drum, congested ear drum, rupture of windows (inner ear apparatus responsible for hearing).

It is not the water, under water pressure causes the damage.

3. As such, middle ear damage, ruptured ear drum or ossicles derangement causes conductive deafness, can be managed with surgery. Inner ear damage (windows-oval/round) damage can lead to senorineural deafness, can not be corrected by surgery. hearing aids or cochlear implants will be helpful.

4. In my opinion, you need to evaluate with audiometry, to differentiate the type of deafness (sensorineural/conductive). Depending on the type , treatment can be started.

Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.

Wishing you good health.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Abubakar Siddiqh (56 minutes later)
There were tests charts I uploaded to this site.
I had no pain or discomfort.
I woke up 2 days later and had less than 50% of my hearing in the right ear.
Two day after that I had 50% less in my left ear.

This is what I am seeking someone to explain since it was not an immediate reaction to the under water pressure.

Also when on a plane I hear fine. When no allergies and my ears are clear I hear at B level with A being the best. It still seems I have water or something in my ears to prevent me from hearing. When I place my hands over my ears, I hear the same. When I use nasal spray I hear better.

A 10 - 25 DB
B 25 - 50 DB
doctor
Answered by Dr. Abubakar Siddiqh (53 minutes later)
Brief Answer:
pure tone & impedence audiometry

Detailed Answer:
Hello again,

Thanks for considering my answer and for your follow up.

Fluctuating hearing loss, getting better with nasal sprays suggests Eustachian tube dysfunction secondary to allergic rhinitis.

Kindly upload the reports (pure tone audiogram and impedence audiogram), so that I can comment on your deafness. If not done, kindly go ahead.

Deafness due to ETD (Eustachian tube dysfunction) always conductive type, can be managed with medications (anti allergic medications for allergy, valsalva exercises ), surgically (correction of nasal septum, turbinectomy, sinus surgery and myringotomy with grommet for ear drum effusion).

Hope, I have answered your query.

Take care.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Abubakar Siddiqh (44 hours later)
Can you not see the Audiogram I uploaded?

In this phase, my goal is to better understand what happen and why a few hours under water did such damage to my ears 2-4 days later after snorkeling a few feet under water.

I believe the ETD that several Dr's have suggested is a placeholder to drop those items that cannot be evaluated or diagnosed. Otherwise I would read something like....

The salt water permeated your eardrum and found residence in the middle ear causing you to only hear at a 50% capacity. There is no known remedy other than tubes that will drain the middle ear of fluids. However, there is not guarantee this will work.

Please tell me more. I uploaded the Audiogram again.
doctor
Answered by Dr. Abubakar Siddiqh (2 hours later)
Brief Answer:
needs fresh audiogram

Detailed Answer:

Hello again,


Yes. I can see your uploaded audiogram now. Profound sensorineural hearing loss, needs hearing aid/cochlear implant surgery.


Answers for your queries.


1. Barotrauma can affect the external, middle, or inner ear. Middle ear barotrauma (MEBT) is the most common being experienced by between 10% and 30% of divers and is due to insufficient equilibration of the middle ear.


External ear barotrauma may occur on ascent if high pressure air is trapped in the external auditory canal either by tight fitting diving equipment or ear wax.


Mechanical trauma to the inner ear ( windows rupture, damage to hair cells) can lead to varying degrees of conductive and sensorineural hearing loss as well as vertigo.


Damage can occur under water or some times after 2-4 days.


2. ETD (euchacian tube dysfunction) always occurs secondary to nasal pathology (allergy, deviated septum, cleft lip, ).

Correction of these factors through medications, surgery will relieve ETD.


3. salt water or normal water which will not reside at ear drum. It is a ear drum inflammation with effussion (due to ETD) causes fluid behind the intact ear drum, it can be drained through surgery (myringotomy with grommet tubes). These tubes drains the excess fluid makes Eustachian tube functional and helps in regaining the hearing.

Good surgical outcome in case of ETD causing serous otiitis media (ear drum infection).


In my opinion, you need to undergo audiometry again (previous 3/4/2014) to know the current status of hearing.

All the best. Take care.


Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
Answered by
Dr.
Dr. Abubakar Siddiqh

ENT Specialist

Practicing since :1994

Answered : 2038 Questions

premium_optimized

The User accepted the expert's answer

Share on
What is eustachian tube dysfunction?

Brief Answer: needs audiometry. Detailed Answer: Hi, I had gone through your question and understand your concerns that you are having loss of hearing. Answers for your queries. 1. ETD -Eustachian tube dysfunction,(tube connecting the middle ear and nose) occurs due to allergic rhinitis, sinus infection or barotrauma. 2. Barotrauma- An ear barotrauma occurs when a diver (Snorkeling ) can not properly equalize the pressure in his ears with the surrounding water pressure. Common causes of an ear barotrauma are ineffective equalization techniques. Depending on the duration of snorkelling, co-existent factors (allergy, deviated septum) and underwater pressure. It could be simple pain over external ear, rupture of ear drum, congested ear drum, rupture of windows (inner ear apparatus responsible for hearing). It is not the water, under water pressure causes the damage. 3. As such, middle ear damage, ruptured ear drum or ossicles derangement causes conductive deafness, can be managed with surgery. Inner ear damage (windows-oval/round) damage can lead to senorineural deafness, can not be corrected by surgery. hearing aids or cochlear implants will be helpful. 4. In my opinion, you need to evaluate with audiometry, to differentiate the type of deafness (sensorineural/conductive). Depending on the type , treatment can be started. Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions. Wishing you good health.