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Eustachian tube dysfunction (ETD) is a condition where the Eustachian tube (ET) fails to properly ventilate and equalize pressure between the middle ear and the nasopharynx, leading to middle ear pressure abnormalities, fluid retention, or infection.

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https://www.youtube.com/watch?v=H29571Ex-kY

https://youtu.be/-9f0KX-Z-uM

https://youtu.be/m2Mh1mq2Hro

Classification


Type Description
Obstructive ETD Failure to open due to inflammation, adenoids, allergy, tumor
Patulous ETD Tube remains abnormally open, causing autophony
Baro-challenge-induced ETD Symptoms occur only during pressure changes (e.g., flying, diving)

Etiopathogenesis


Normal Physiology of the Eustachian Tube

Etiology:

Type Causes
Obstructive Causes
(Most Common) Upper respiratory tract infections
Allergic rhinitis
Adenoid hypertrophy
Sinusitis
Nasopharyngeal masses (e.g., NPC, lymphoma)
• ‣ (e.g., cleft palate)
Patulous Causes • Rapid weight loss
• Hormonal changes
• Neuromuscular disorders

Clinical Features


Symptom Type
Aural fullness or pressure Obstructive
Hearing loss (conductive) Obstructive (effusion)
Popping or crackling sound Obstructive
Autophony (hearing one’s own voice/breathing loudly) Patulous
Tinnitus Either type
Recurrent otitis media or otitis media with effusion Chronic obstructive ETD

Audiological and Functional Testing