Eustachian tube dysfunction is estimated to occur as a chronic condition in approximately 4% of adults worldwide, but it is an intermittent problem in an unknown higher percentage (Clin Otolaryngol. 1992;17:317-321). The condition is multifactorial. In many cases, inflammation of the mucous membranes in and around the Eustachian tube produces obstruction. Uncoordinated movement of the muscles that open and close the tube may also play a role. Extrinsic factors such as excessive lymphoid tissue around the Eustachian tube opening may also be seen. If chronic Eustachian tube dysfunction remains untreated, it can lead to cholesteatoma and hearing loss.
Explore this issue:January 2016
Initial treatment targets the potential causes of mucosal inflammation, such as allergic rhinitis and acid reflux. This often includes topical or oral steroids, antihistamines, and acid-suppressant medications. “However, none of these have proven to be reliably effective,” said Edward McCoul, MD, MPH, director of rhinology and sinus surgery at Ochsner Clinic and Health System in New Orleans, La.
The indications for surgery are still being determined, and research is ongoing. Surgery may be appropriate for patients with chronic Eustachian tube dysfunction that is moderately severe and disrupts daily function or in the presence of chronic middle ear fluid that produces hearing loss.