Background
The mucosa-lined Eustachian tube (eustachian tube, tuba auditiva) is the connection between the nasopharynx and the tympanic cavity of the middle ear. Its main function is to equalize pressure between the middle ear and the external ambient pressure. The tube is normally closed and opens when swallowing or yawning. Two other important functions are mucociliary transport of secretions and germs from the middle ear to the nasopharynx and protection from transient differences in sound and pressure.
Symptoms
Caused by the lack of pressure equalization via the Eustachian tube:
- Feeling of pressure and fullness in the ear
- Impairment of hearing
- Ringing in the ears
- Slight pain
- Dizziness
In the case of a cold, accompanying symptoms such as rhinitis, nasal congestion, sinusitis, sore throat. The closure of the Eustachi tube prevents the removal of secretions and germs and promotes the development of otitis media.
Causes
- Infectious diseases, for example, a cold or otitis media.
- Allergic diseases
- Chronic inflammation of the nasopharynx
A lack of pressure equalization also occurs (non-inflammatory) when there is a rapid change in pressure, for example, diving, driving a car in a cable car or flying (barotrauma). Another cause of obstruction of the Eustachi tube is benign or malignant tumors.
Risk factors
Young children are more susceptible to middle ear infections because of a short, horizontal, and not fully formed Eustachi tube.
Diagnosis
Similar symptoms are caused, for example, by an ear plug (blockage of the external ear canal with earwax).
Nonpharmacologic therapy
Try to reopen the eustachian tube with swallowing, yawning, moving the jaw, and chewing. Sometimes physical exertion, such as a walk or jog, also helps. Valsalva maneuver:
- 1.Close the mouth and hold the nose with thumb and index finger.
- 2. try to blow air out of the closed nose.
Further measures in medical treatment, such as suction of the fluid in the middle ear or insertion of a tympanic tube.
Drug therapy
Decongestant nasal sprays:
- For decongestion and inhibition of secretion, e.g., naphazoline, oxymetazoline, phenylephrine, tetryzoline, xylometazoline. They may only be used for a short time during a maximum of 5-7 days.
Glucocorticoid nasal sprays:
- For decongestion in allergic-inflammatory cause.
Sympathomimetics administered internally:
- For systemic decongestion and inhibition of secretion, for example, phenylephrine and pseudoephedrine. Contraindications must be considered and there are potentially more adverse effects than with local use.
Anti-inflammatory drugs:
- Short-term for pain and inflammation, such as ibuprofen, acetylsalicylic acid or diclofenac.
Antibiotics:
- Are used with restraint in otitis media (see there).
Painkillers:
- Such as ibuprofen or paracetamol for pain and inflammation.
In the presence of viscous mucus in the airways and nasal obstruction: mucolytics:
- Dissolve viscous mucus, for example, acetylcysteine, bromhexine or ambroxol.
Nasal rinses:
- For nasal removal of mucus and encrustations with saline solution or seawater.
Inhalations:
- For mucus loosening and anti-inflammation
Heat treatment:
- To loosen mucus, e.g. medicinal baths or heat pads.
