Eustachian tube dysfunction diagnosis

I just had a chat with a friend of mine, who saw an ENT that put an endoscope into his nose and told him, by looking right AT his eustachian tubes, that they were fine. Meanwhile, I have suspected ET issues, and have seen a few ENTs (including an otologist specialist at MUSC) who looked at tympanomatry to diagnose ETD, and even with normal results were suggesting balloon dilation because of the fullness I’ve had in my R ear ever since my sudden hearing loss 9 months ago. They didn’t even even suggest putting a scope in and actually looking at the tubes to see if they looked ok. Can anyone guess why they wouldn’t have just looked at them with a camera? I’m very reluctant to throw 4k at a procedure that could help a problem I don’t even have a solid diagnosis for, except based on symptom description. I didn’t even know a camera COULD see the eustachian tubes until today. wouldn’t that be the way to see what’s going on?Thoughts?

I sure hope you get some answers here … cuz I’ve toyed with the idea of a full ENT exam for like DECADES precisely to ascertain if I have physical issues with my eustachian tubes. As a kid, I was always getting ear infections, and one pediatrician said I likely have very narrow eustachian tubes.

I’ve even contemplated the procedure of getting those tube stents or whatever they call them put in my eustachian tubes. I have trouble clearing my ears, and it seems narrow tubes could be an issue.

Well, let’s hope someone here can comment on the best procedure to find out FOR SURE if someone has physical issues with their eustachian tubes. :thinking:

@user172 I’ve had issues with Eustachian tube dysfunction on and off for many years ( comes and go’s with when i have allergies) sometime’s from what i gather the tympanomatry reading can be enough to show if there is Eustachian tube dysfunction based on the reading sometimes it may not be so clear and need further examination but I’ve never had that and always had the diagnosis based on the results of the tympanomatry and symptoms i have displayed with like feeling of fullness in my ear and muffled sounds or a kind of crackling sensation.

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I have had Eustachian tube dysfunction since I was a teenager (now 64) and have had hearing issues the whole time - despite hearing tests always being normal until now. I would be cautious about any procedure without evidence that it’s required. I would also advise you to do your research about the longevity of the results as I have heard that the benefit of the results only lasts a few years, but I don’t know if this is correct.

I asked my GP (UK) to refer me to ENT back in 2019, but he refused saying “there’s no point as there’s nothing they can do about it” my reply was “so I have to carry on with my husband calling me a deaf old bat” (NB this is fun banter which is part of us) and he laughed and said yes.

I would very much like to know from any professionals on here what an audiogram would look like in the case of Eustachian tube dysfunction as I have wondered how much of my hearing loss can be explained by it. I did put this question on the ask a professional section quite a while ago, but have not had an answer.

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So, was he saying that there is NO such thing as a straw-like tube to force the eustachian tube OPEN? Or is your issue something different? I’d only heard that the tube insert may cause infection, and that if children have one placed, they may be able to remove it at some point in the future when it has “shaped” their eustachian tubes OPEN.

When I clear my ears, there is a noticeable improvement in hearing, so that’s why I fantasize about having those tubes FORCED open like with a stent, straw or something.

Me too. My hearing aids are suddenly way too loud, and cleaner, crisper and clearer than prior to ear clearing. I can notice it with and without HAs in. How long has this been going on for you? For me it’s been 9 months. I do think I’m having less and less success with the clearing as time goes on, which concerns me. I think the balloon dilation does what you’re describing - forcing them open. I had ONE of several audiologists and ENTs I asked say it’s the eardrum going concave/or convex? and making sound louder because of that shape temporarily. It used to only last a few seconds, Now it can last many minutes, but it feels spatially weird and ends up feeling a little more blocked.

@1Bluejay the tubes here in the uk are mainly used with children for a condition called glue ear which can clear up of it’s own accord in some cases.

In adults it is of general believe from what I have been told that eustachian tube dysfunction can clear up of it’s own accord and can be managed with general treatment such as nasal sprays and antihistamines and steam inhalation with menthol to help with symptoms .

Surgery by the NHS to insert a balloon in to open up the eustachian tubes is quite often a last resort usage in the treatment of chronic Eustachian tube dysfunction where no other conventional treatment has been know to help.

I’ve had Eustachian tube dysfunction my whole life, although I only learned this about 20 years ago. I had major cholesteotoma issues that destroyed my hammer, anvil and stirrup in both ears. This was due to ETD, apparently. Luckily, I had reconstructive surgery but my right ear surgery was less than successful, let’s say.
Anyway, I’ve been pestering my various ENTs over the years about what can be done for my obvious ETD. Especially in allergy season. The response has been the same: there’s almost nothing to be done. The balloon tubes they’ve been playing with have not had good results. I’ve had atrial fibrillation in the past, so Sudafed is out. My best answer by far has been getting a Bone Assisted Hearing Aid. this device bypasses the whole middle ear and amplifies the cochlear nerve through the mastoid bond. No ETD in the mastoid bone!
Other than that, I’ve not heard of an effective treatment.

Well wow gents! I am kind of nonplussed at the lack of options for what “seems” to be a physical issue relatively easy to fix?! That’s like saying, well, you were born with lenses on your eyes that make you far- or short-sighted, so you’d best just squint and bear it!

Hum. Not very satisfying. :face_with_diagonal_mouth:

there’s no cure for the cold yet either. Or dementia or altzhiemers. Or Lyme’s disease. As the song says, there ain’[t no cure for love. or death for that matter.
whatcha gonna do?

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I think he was most likely saying that the NHS did not have any treatment options for it. I now know that the balloon dilation became available later in 2019. What annoys me looking back, is that he did not ask me how much of an issue my hearing was and did not suggest a hearing test.

Yes, that’s right, but what I was talking to him about was Eustachian tube dysfunction that I had had for decades. No infection, no fluid, just problems with pressure equalisation especially in windy weather (sometimes also hearing my own voice booming in my ears).

I had the same issue of ETD, since many years, after repeated consultation I went to another doc, where he suggested me to avoid certain foods and it worked somehow but not fully, but happy

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I have actually read the opposite - 97% success rate. My otologist felt it would ameliorate the fullness/pressure issue, but didn’t think it would address any hearing - which is odd, because ballon dilation is touted as relieving the “symptoms” of ETD, one of which is always listed as muffled hearing or hearing loss. I might have had it done already if not for the fact that my insurance won’t cover it until a year after the issue manifests - which will be November/23.

which foods did he recommend you avoid, please?

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YOU SANG IT, BRO’! :rofl:

Okaaaaaaayy… With that kinda logic, what else will insurance companies deny coverage for until a year has passed: heart attack, stroke, cancer, bowel obstruction …

Or perhaps most people have just fleeting ETD issues? All I know is I’ve had mine since birth and I’m 68 now, so I’d hope an insurance company would be a little more flexible with that restriction. :face_with_raised_eyebrow:

I hope you’re right about the success rate! I’m still uncerftain if the balloons stay in the ETs to hold them open, or if they blow them up and are removed. If the latter, I would imagine my tubes might just collapse again, as the do after the pressurizing maneuver whose name I forget. For me, the hearing issue is paramount. I hope you get the procedure done soon and report back!!

they insert, inflate., wait 2 minutes and remove.

I think ETD can include both a blocked eustachian tube (the most typical problem) and a tube stuck open, or patulous euctachian tube.

After a COVID infection, I did a nasal rinse usian a bottle from NeilMed, and squirted water into both ears through my nose. This resulted in me being able to hear my own voice too loud, and my heartbeat, but external sounds were greatly diminished, even with HAs. I saw my ENT, tympanometry was done, and he diagnosed patulous eustachian tube. He had no advice other than to wait. It lasted for months and gradually got better. Eventually tympanometry and hearing was back to my previous levels.