II. Definition

  1. Failed pressure equalization via the eustachian tube, typically at its valve-like opening in the nasopharynx

III. Causes

  1. Upper Respiratory Infection
  2. Allergic Rhinitis
  3. Environmental irritants (e.g. Tobacco smoke)
  4. Gastroesophageal Reflux
  5. Pregnancy (esp. third trimester)
  6. Conditions affecting ciliary function (e.g. primary ciliary Dyskinesia)
  7. Mass lesions
    1. Adenoid hypertrophy
    2. Nasopharyngeal carcinoma

IV. Symptoms

  1. Sense of ear fullness or plugging of the affected ear
  2. Muffled hearing
  3. Valsalva does not clear ear discomfort (and may cause pain)
  4. Tinnitus or crackling sensation in the affected ear
  5. Vertigo or sense of Dysequilibrium

V. Signs

  1. Tympanic Membrane retraction
  2. Tympanic Membrane does no move (or moves poorly) with provocative maneuvers
    1. Pneumatic Otoscopy
    2. Valsalva Maneuver

VI. Diagnostics

VIII. Management

  1. No single measure is uniformly effective
    1. Watchful waiting for spontaneous resolution over time is consistently effective
    2. Empiric measures such as Intranasal Corticosteroids alone may not speed resolution
      1. Gluth (2011) Arch Otolaryngol Head Neck Surg 137(5):449-55 [PubMed]
  2. Treat underlying causes
    1. Upper Respiratory Infection (e.g. Nasal Saline, Guaifenesin, Decongestants)
    2. Allergic Rhinitis (e.g. Intranasal Corticosteroids)
    3. Esophageal reflux (e.g. lifestyle changes, Proton Pump Inhibitor)
  3. Refractory cases or prolonged cases
    1. Consider differential diagnosis (see above)
    2. Tympanostomy Tube

IX. References

  1. Poe et. al. in Park (2015) Eustachian Tube Dysfunction, UpToDate, Wolters Kluwer, accessed 11/22/2015
  2. Meek in Myers (2015) Middle Ear, Eustachian Tube..., EMedicine, accessed 11/22/2015
    1. http://emedicine.medscape.com/article/858777-overview#showall

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Ontology: Obstruction of Eustachian tube (C0149508)

Concepts Finding (T033)
ICD9 381.60, 381.6
ICD10 H68.1 , H68.10
SnomedCT 194271002, 194275006, 155221004, 267755000, 48145001
English Eustachian tube obstruct. NOS, Eustachian tube obstruct.unsp., Eustachian tube obstruction NOS, Obstruction of Eustachian tube, unspecified, Unspecified eustachian tube obstruction, obstruction of eustachian tube (diagnosis), obstruction of eustachian tube, Eustachian block, Obstr eustach tube NOS, Unspecified obstruction of Eustachian tube, Blocked;eustachian tube, eustachian tube obstruction, Obstruction;eustachian tube, eustachian tube block, blocked eustachian tubes, Eustachian tube obstruction NOS (disorder), Unspecified eustachian tube obstruction (disorder), Obstruction of Eustachian tube, Block - eustachian tube, Eustachian tube obstruction, Obstruction of Eustachian tube (disorder), eustachian tube; obstruction, obstruction; eustachian tube, Obstruction of eustachian tube, NOS, blocked eustachian tube
Italian Ostruzione della tuba di Eustachio, Ostruzione della tromba di Eustachio, Ostruzione della tromba di Eustachio, non specificata
Dutch Eustachius blokkade, obstructie van buis van Eustachius, niet-gespecificeerde obstructie van buis van Eustachius, buis van Eustachius; obstructie, obstructie; buis van Eustachius, tuba Eustachii; obstructie, Obstructie van tuba Eustachii, buis van Eustachius obstructie
French Obstruction de la trompe d'Eustache, non précisée, Blocage de la trompe d'Eustache, Obstruction de la trompe d'Eustache
German Obstruktion der Tuba eustachii, unspezifisch, Tuba eustachii Blockierung, Verschluss der Tuba auditiva, Obstruktion der Tuba eustachii
Portuguese Bloqueio da trompa de Eustáquio, Obstrução da trompa de Eustáquio NE, Obstrução da trompa de Eustáquio
Spanish Bloqueo de la trompa de Eustaquio, Obstrucción de la trompa de Eustaquio no especificada, obstrucción de la trompa de Eustaquio (trastorno), obstrucción de la trompa de Eustaquio, obstrucción de trompa de Eustaquio (trastorno), obstrucción de trompa de Eustaquio, obstrucción de la trompa de Eustaquio, SAI, obstrucción de la trompa de Eustaquio, SAI (trastorno), obstrucción de la trompa de Eustaquio, no especificada (trastorno), obstrucción de la trompa de Eustaquio, no especificada, Obstrucción de la trompa de Eustaquio
Japanese 詳細不明の耳管閉塞, 耳管閉塞, 耳管ブロック, ジカンヘイソク, ジカンブロック, ショウサイフメイノジカンヘイソク
Czech Obstrukce Eustachovy trubice, Obstrukce Eustachovy trubice, blíže neurčená, Blokáda Eustachovy trubice
Korean 귀인두관의 폐색
Hungarian Eustach-kürt nem meghatározott obstructioja, Eustach-vezeték-obstructio, Eustach-kürt obstructio, Eustach-kürt elzáródás

Ontology: Eustachian tube disorder (C0271468)

Concepts Disease or Syndrome (T047)
ICD9 381.81, 381.9
ICD10 H69.9 , H69.90
SnomedCT 56713002, 69494008, 155221004, 267755000, 194279000
English Dysfunction of Eustachian tube, Unspecified Eustachian tube disorder, Eustachian tube disorder NOS, Eustachian tube disorder, unspecified, ETD - Eustachian tube dysfunct, disorder of eustachian tube, eustachian tube dysfunction (diagnosis), eustachian tube dysfunction, disorder of eustachian tube (diagnosis), Eustachian tube disorders, Dysfunct eustachian tube, Eustachian tube dis NOS, Unspecified Eustachian tube disorder, unspecified ear, tube disorders eustachian, Dysfunction;eustachian tube, dysfunction eustachian tubes, eustachian tube disorders, dysfunction eustachian tube, diseases eustachian tube, eustachian tube disorder, Eustachian tube disorder NOS (disorder), Eustachian tube dis., Dysfunction of eustachian tube, Auditory tube disorder, Disorder of Eustachian tube, ET - Eustachian tube disorder, Eustachian tube dysfunction, ETD - Eustachian tube dysfunction, Eustachian tube disorder, Disease of Eustachian tube, Dysfunction of eustachian tube (disorder), Eustachian tube disorder (disorder), disease (or disorder); eustachian tube, Eustachian tube disorder, NOS
Italian Disfunzione della tuba di Eustachio, Patologia della tuba di Eustachio, Patologie della tuba di Eustachio, Disfunzione della tromba di Eustachio, Disturbo non specificato della tromba di Eustachio, Patologia della tuba di Eustachio NAS
Dutch aandoening aan buis van Eustachius, niet-gespecificeerd, disfunctie van buis van Eustachius, niet-gespecificeerde aandoening aan buis van Eustachius, buis van Eustachius aandoening NAO, aandoening; buis van Eustachius, Aandoening van tuba Eustachii, niet gespecificeerd, buis van Eustachius aandoeningen, buis van Eustachius aandoening, buis van Eustachius disfunctie
French Affection de la trompe d'Eustache SAI, Trouble de la trompe d'Eustache, non précisé, Affection non précisée de la trompe d'Eustache, Affection de la trompe d'Eustache, Affections de la trompe d'Eustache, Dysfonctionnement de la trompe d'Eustache
German Tuba eustachii, Erkrankung, unspezifisch, Erkrankung der Tuba eustachii NNB, unspezifisch Tuba eustachii Erkrankung, Krankheit der Tuba auditiva, nicht naeher bezeichnet, Erkrankung der Tuba eustachii, Erkrankungen der Tuba eustachii, Funktionsstoerung der Tuba eustachii
Portuguese Alteração da trompa de Eustáquio NE, Afecção da trompa de Eustáquio NE, Alteração da trompa de Eustáquio, Alterações da trompa de Eustáquio, Disfunção da trompa de Eustáquio
Spanish Trastorno no especificado de la trompa de Eustaquio, Trastorno de la trompa de Eustaquio NEOM, Trastorno de la trompa de Eustaquio, no especificado, trastorno de trompa de Eustaquio (trastorno), trastorno de la trompa de Eustaquio (trastorno), disfunción de la trompa de Eustaquio, disfunción de la trompa de Eustaquio (trastorno), trastorno de la trompa de Eustaquio, disfunción de trompa de Eustaquio, disfunción de trompa de Eustaquio (trastorno), trastorno de trompa de Eustaquio, trastorno de la trompa de Eustaquio, SAI, trastorno de la trompa de Eustaquio, SAI (trastorno), Trastornos de la trompa de Eustaquio, Disfunción de la trompa de Eustaquio, Trastorno de la trompa de Eustaquio
Japanese 耳管機能障害, 耳管障害NOS, 詳細不明の耳管障害, 耳管障害, ショウサイフメイノジカンショウガイ, ジカンショウガイNOS, ジカンキノウショウガイ, ジカンショウガイ
Czech Porucha Eustachovy trubice NOS, Porucha Eustachovy trubice, blíže neurčená, Poruchy Eustachovy trubice, Dysfunkce Eustachovy trubice, Porucha Eustachovy trubice, Blíže neurčená porucha Eustachovy trubice
Korean 상세불명의 귀인두관의 장애
Hungarian Eustach-kürt betegségek, Eustach-kürt működési zavara, Eustac-kürt dysfunctio, Eustach-kürt betegség, Eustach-kürt betegség k.m.n., Eustach-vezeték betegség, nem meghatározott, Nem meghatározott Eustach-kürt betegség