Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about eustation tube dysfunction.

And you can find written notes on this topic at zero definals.com slash eustation tube dysfunction or in the ear, nose and throat section of the

zero to finals surgery book. So let's get straight into it. Eustation tube dysfunction is when the tube

between the middle ear and the throat is not functioning properly. The eustation tube is mainly present to equalize the air in the

middle ear and to drain fluid from the middle ear. When the eustation tube is not functioning

correctly or it becomes blocked, the air pressure in the middle ear cannot equalize properly

and fluid cannot drain freely from the middle ear.

The air pressure between the middle ear and the environment can become unequal and the middle ear can

fill with fluid. Eustation tube dysfunction may be related to a viral upper respiratory tract infection, to allergies,

for example in hay fever or to smoking.

Let's talk about the presentation.

Eustation tube dysfunction may present with reduced or altered hearing,

popping noises or popping sensations in the ear, a feeling of fullness

in the ear, pain or discomfort in the ear, or tinnitus, which is an added sound or ringing

heard in the ear. Symptoms tend to get worse when the external air pressure changes and the middle ear pressure cannot equalize to the outside pressure.

This may happen, for example, during air travel, when the aeroplane is rising, climbing a mountain, or when scuba diving.

Autoscopy to visualize the tympanic membrane may appear normal, but it's important to do this

in order to exclude other causes, for example a middle ear infection or rotitis media.

Let's talk about investigations.

Often, eustachian tube dysfunction gives a typical set of symptoms and it's associated with a clear cause,

for example a recent viral upper respiratory tract infection or hay fever.

In this situation, the diagnosis can be obvious and investigations are not required as the symptoms will resolve with

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