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What Is The Causes And Treatment For Eustachian Tube Dysfunction?

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Posted on Tue, 11 Mar 2014
Question: To any professional ENT out there, I went scuba-diving over a year ago, only to 45 feet. It had been a couple years since I went diving and in that time I found I developed adult allergies. When I tried to equalize underwater, I heard this squealing sound. It sounded unusual. When I came back up to the surface, my nose was bleeding. I couple a days later I was having this loud cracking sound when I swallowed. I lived with it for months trying to research what was going on. By about the fourth month, I went and saw an ENT in my hometown in North XXXXXXX He spent all of 4 minutes with me and was a passive listener to say the least. The hearing test came out fine. I havent been dizzy or anything like that, just the crackling sound. All this doctor did was give me some Flonase (not even Dymista) and I took it for 3-4 weeks as recommended, even laying on my back thinking this would reach my tubes. 1 month later, this July I went and saw a 2nd ENT referred from D.A.N. (the only one in the state that is specialized in dive medicine, who even dives herself, and so did the nurse!) I thought to myself, surely they will know something. Thinking I needed tubes, they did the fluid test, none at all. They couldn't diagnose anything either, or give me any logical reasons why this is happening. This ENT just took my money and said to keep taking Dymista and find out what I'm allergic to. Since then I have found some new info, because I wasn't coming up with any relevant search results. Evidently it has the characteristics as Eustachian Tube Dysfunction and/or "Glue Ear" there are currently 2 products sold on the market to tackle that problem, so I ordered them after reading the 5 star reviews. 1. Earpopper by summit medical -$200 2. Otovent(an inflatable balloon sold out of the UK to help with blocked tubes) Neither one have irradicated the problem. I have even bought some nasal rinse called Alkolol, the only rinse that claims to dissolve mucus. Once again I have tried this laid down/upside down, swallowing and yawning. This has been going on for 1 year and 3 months now. I never had my tonsils or adenoids removed. Any recommendations on getting adenoids taken out or is there any kind of surgery that can clear blockages or could any kind of other inner ear parts be causing this? Everyone keeps saying I'm fine, but they aren't the ones with the loud crackling sound every time they swallow. This problem has taken a slight change in my daily self-esteem. I plain and simply think my tubes are blocked with some allergy mucus residue. Is there an expert that can give me any answers or solutions?
doctor
Answered by Dr. Rajkishori Godhi (45 minutes later)
Brief Answer: eustachian tube dysfuction can be managed Detailed Answer: Hello sir, You are right. You seem to have Eustachian tube dysfunction. It is seen in people with nasal allergies, long standing infections of the nose and sinuses, malformations of the head and neck. The muscles that assist in swallowing are attached to the Eustachian tube, so every time you swallow these muscles contract and in the process open the tubes as well. This is normal physiology. Only in your case the opening and closing of the tube is very noisy. It may be because the tube is partially blocked. The tubes open into the backside of the nose. The allergic process in the nose extends into the tubes and causes excessive mucus secretion in the tube thereby blocking them. To control your symptoms it is important that your allergies of the nose are brought under control. You can ask your ENT to prescribe local steroid nasal spray. The spray can reach the opening of the tube at the back of the nose and control the allergic process going on inside the tubes. You have alreadyused flonase earlier but it should be used for a minimum of 6 weeks to have improvement. Do not use decongestant nose sprays or drops for more than 6 days at a time. They can cause side effects. Regular steam inhalation with plain water 4 times daily will help you. The steam liquefies the secretions thereby helps drainage . Try blowing 2 balloons per day and practice valsalva manoeuvre regularly. Adenoid regress and disappear by 15 years. So you have no adenoids now. Surgeries have been tried for eustachian tube dysfunction but with very little success. Unfortunately there is no other treatment for Eustachian tube dysfuction. Inspite of all the efforts at best patients get partial relief. Regards, Dr Rajkishori Godhi.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rajkishori Godhi (2 days later)
1. Should I continue to use Flonase or Dymista? 2. Is there any way of clearing out the passages by using a sucking force instead of a blowing force(balloon)? 3. Would the problem get self-corrected if I were to go scubadiving again?
doctor
Answered by Dr. Rajkishori Godhi (18 minutes later)
Brief Answer: not recieved any followup question. Detailed Answer: Hello sir, You can use flonase. Flonase contains only steroid whereas dymista contains an antihistamine in addition to a local steroid. Dymista is indicated only when there is running and itching in the nose during an episode of allergic rhinitis. Also the anithistamine in dymista causes thickening of nasal secretions which can enhance the eustachian tube block. I would suggest that you start flonase under medical supervision only. It is unwise to start or stop treatment without examination. Sucking force tends to create a negative pressure in the midlle ear thereby enhancing the block. A positive pressure will force the tube open thereby draining the secretions. I do not think it is a good idea to go scuba diving now. The eustachian tube is under lot of stress when there are changes in atmospheric pressure. Since your tube is already malfunctioning it can get completely blocked and can result in a ear infection. Once again I would like to stress that faulty eustachian tubes are hard to fix and frequently patients remain unsatisfied. Feel free to follow up. I have not recieved any other follow up from you, Regards, Dr Rajkishori Godhi.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Rajkishori Godhi

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Practicing since :2003

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What Is The Causes And Treatment For Eustachian Tube Dysfunction?

Brief Answer: eustachian tube dysfuction can be managed Detailed Answer: Hello sir, You are right. You seem to have Eustachian tube dysfunction. It is seen in people with nasal allergies, long standing infections of the nose and sinuses, malformations of the head and neck. The muscles that assist in swallowing are attached to the Eustachian tube, so every time you swallow these muscles contract and in the process open the tubes as well. This is normal physiology. Only in your case the opening and closing of the tube is very noisy. It may be because the tube is partially blocked. The tubes open into the backside of the nose. The allergic process in the nose extends into the tubes and causes excessive mucus secretion in the tube thereby blocking them. To control your symptoms it is important that your allergies of the nose are brought under control. You can ask your ENT to prescribe local steroid nasal spray. The spray can reach the opening of the tube at the back of the nose and control the allergic process going on inside the tubes. You have alreadyused flonase earlier but it should be used for a minimum of 6 weeks to have improvement. Do not use decongestant nose sprays or drops for more than 6 days at a time. They can cause side effects. Regular steam inhalation with plain water 4 times daily will help you. The steam liquefies the secretions thereby helps drainage . Try blowing 2 balloons per day and practice valsalva manoeuvre regularly. Adenoid regress and disappear by 15 years. So you have no adenoids now. Surgeries have been tried for eustachian tube dysfunction but with very little success. Unfortunately there is no other treatment for Eustachian tube dysfuction. Inspite of all the efforts at best patients get partial relief. Regards, Dr Rajkishori Godhi.