Ear Conditions

Eustachian Tube Dysfunction: Definition, Symptoms and Treatments

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What is an Eustachian Tube?

The Eustachian tube is a narrow tube connecting the back of the nose and the middle ear. Normally, the tube is filled with air and opens when we yawn, swallow or chew. It functions to protect the middle ear from pathogens; to ventilate the middle ear, which allows the eardrum to work and vibrate properly; and, to help drain mucus from the middle ear.

What is Eustachian Tube Dysfunction?

Chronic blockage of the Eustachian tube is called Eustachian Tube Dysfunction (ETD). This can occur from inflammation of the mucous membranes from allergies or a sinus, nose or ear infection, or excessive lymphoid tissue around the tube. In some cases, the Eustachian tube just does not open or close properly. Young children (especially ages 1 to 6 years) are at particular risk because they have very narrow Eustachian tubes. Also, enlarged adenoids can block the opening of the Eustachian tube.

Blockage of the Eustachian tube causes the lining of the middle ear to absorb the trapped air. This creates a negative pressure that pulls the eardrum inward. When this occurs, people may experience muffled hearing, pain, tinnitus, reduced hearing, pressure, or problems with balance. Long-term ETD has been associated with damage to the middle ear and the eardrum from fluid buildup. If bacteria contaminates this fluid, a middle ear infection occurs. If chronic ETD remains untreated, it can lead to hearing loss.

Treatment of Eustachian Tube Dysfunction

Blocked Eustachian tubes can be relieved by nasal sprays, decongestants and antihistamines, which reduce inflammation and congestion. Medications or shots that treat allergies may also help. People can also relieve pressure by pinching their noses and "popping their ears," although this is not recommended if a cold or sinus infection is present because it can drive mucus into the middle ear and cause an ear infection. Recurrent Eustachian Tube Dysfunction requires the surgical placement of ear tubes, which allow pressure to equalize in the middle ear.

If you have experienced symptoms of ETD, contact our office or consult with your physician.

Meniere's Disease

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What is Meniere's Disease?

Named after French physician Prosper Meniere after he experienced this condition in the 1800s, Ménière’s Disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or pressure in the ear. 

Meniere's Disease is caused by the buildup of fluid in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and hearing (the cochlea). When it fills with fluid, it interferes with the normal balance and hearing signals between the inner ear and brain. This interference causes vertigo, tinnitus, and other symptoms. 

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A Meniere's episode generally involves severe vertigo, imbalance, nausea, and vomiting, and may come on suddenly or after a short period of tinnitus, hearing fluctuations, or "fullness" in the ear. A sudden fall without warning, called "drop attacks," may also occur if patients feel they are tilted or off balance (although they are standing straight). These episodes of vertigo can last anywhere from 2-4 hours and are usually followed by extreme fatigue. There may be no other symptoms between these attacks, which can be years apart, although hearing loss tends to get progressively worse with time. 

Ménière’s disease can develop at any age, but it is more likely to happen to adults between 40 and 60 years of age.

Causes of Meniere's Disease

Although still relatively unknown, Meniere's Disease is often associated with autoimmune disease, head injuries, allergies, viral infection, and genetics. 

Meniere’s Disease and Hearing Loss

Hearing loss associated with Meniere’s disease usually affects low frequencies and is present in one ear. Hearing tends to decline during an attack and improve after an attack. In the initial stages of the disease, hearing may be normal between attacks. As the disease progresses, however, hearing can permanently decrease in the low frequencies and eventually extend to all frequencies. Hearing loss associated with Meniere’s disease is a “sensorineural” hearing loss, meaning that it is the nerve endings that are affected. In most cases, a sensorineural hearing loss entails permanent loss; a fluctuating sensorineural hearing loss is unusual and a strong indicator of Meniere’s disease. 

Diagnosing Meniere's Disease

Diagnosing Meniere's Disease can be difficult. Often, other conditions need to be considered and ruled out, as there are many conditions that can cause symptoms of vertigo, tinnitus, and hearing loss. Diagnosing Meniere's involves looking closely at the symptoms and conducting a hearing test to document hearing loss after an attack. It may also include an ENG test to measure eye movement, blood tests, or a MRI. 

Treatment of Meniere’s Disease

Unfortunately, there is no cure for Meniere’s disease, nor is there any one treatment that covers all cases. Treatments may include reducing salt, caffeine, processed foods, alcohol and nicotine in your diet; medications, such as diuretics, vestibular suppressants, steroids, and immune system suppressants; and, surgery for extreme cases. If permanent hearing loss is detected, it can be treated with hearing aid technologies.

It is important to note that Meniere's Disease should not be self-diagnosed or self-treated. If you are experiencing symptoms similar to Meniere's, please seek the care of a medical professional, such as your primary physician, audiologist, or ENT specialist.