Eustachitis (tubootitis)

The Eustachian tube is a canal in the middle ear of a person that connects the nasopharynx and the tympanic cavity. Normally he:

• drains mucous membranes, removing exudate and transudate;
• provides air exchange between the cavity and the nasopharynx, moving apart when swallowing;
• produces a bactericidal secret.

If one or all of the functions are impaired, eustachitis (other names are tubotympanitis, tubootitis, salpingootitis) is an inflammatory process that affects the mucous membrane of the auditory canal and often develops into otitis media.

Causes

One- or two-sided eustachitis is a consequence of low air exchange in the tympanic cavity, caused by certain factors. It:

Complications after:

• ARVI;
• measles, whooping cough, flu;
• sore throats;
• sinusitis.

Structural pathologies, neoplasms:

• overgrowth of the adenoids;
• polyps of the nasopharynx;
• irregular shape of the nasal septum;
• enlargement of the posterior ends of the inferior turbinates (hypertrophy).

Medical manipulations:

• tamponade of the nose in the treatment of bleeding;
• condition after operations on ENT organs.

Abrupt pressure changes:

• for divers, divers during a quick dive or ascent (mareotitis);
• in an airplane during climb and landing (aerotitis).

Allergic reactions with constant inflammation of the mucous membranes (allergic eustachitis becomes a consequence of vasomotor rhinitis).

Regardless of the cause, the mechanism of occurrence of the disease is the same:

• the tympanic cavity is not sufficiently ventilated;
• the mucous membrane of the Eustachian tube absorbs air;
• the pressure in the middle ear decreases;
• a transudate (liquid) is formed, inflammation of the auditory tube develops, then otitis media joins.

How long is eustachitis treated? The process often proceeds in an acute form and takes place in a week, but without proper attention it can become chronic. In order to cope with the disease as soon as possible, it is important to consult an otolaryngologist in time for diagnosis and treatment.

Symptoms of eustachitis

With the disease, one side is more often affected and left or right-sided eustachitis develops, but both auditory canals can become infected. Tubo-otitis rarely gives a high fever and a strong deterioration in well-being, the main complaints are associated with changes in hearing, congestion of the ears, and discomfort.

In children

The disease usually becomes a consequence of SARS and upper respiratory tract infections. The younger the child, the more often bilateral eustachitis is diagnosed. Older children suffer from unilateral lesions of the auditory tube. Painful otitis media can quickly join without treatment. The temperature is normal or slightly elevated, but the child gets tired quickly and does not eat well.

With inflammation of the Eustachian tube, children complain of:

• slight periodic congestion in one or both ears;
• unsharp pain;
• nausea, dizziness, noise;
• balance disorders;
• feeling in the head of an "echo" of one's own voice, its unusual volume;
• a feeling of water overflowing in the ear or ears.

Babies react to feeling unwell with low-grade fever, tearfulness, refusal to eat, lethargy, poor sleep at night, regurgitation.

In adults

Adult patients are characterized by left- or right-sided eustachitis affecting one side without fever, but with a complex of unpleasant symptoms. Patients suffer from:

• congestion in the ears, decreased hearing (low frequencies are almost not perceived);
• autophony (loud distorted perception of one's own voice in the form of an echo);
• sensation of fluid in the ear;
• headaches or ear pains.

Improvement of the condition occurs for a short time when chewing or after swallowing saliva, food, or during tilting of the head due to a short-term opening of the Eustachian tube and a change in fluid level.

Diagnostics

Since the symptoms of the disease are sometimes disguised as other ailments, a doctor is needed for an accurate diagnosis. Treatment of eustachitis in adults and children should be carried out exclusively by specialists after clarifying the diagnosis.

To confirm the disease, the following are used:

1. Otoscopy.

The doctor examines the outer ear, ear canal, and eardrum with an otoscope. The examination reveals the characteristic signs of tubo-otitis:

• the eardrum is cloudy and retracted;
• the location of the structural components is disturbed;
• the auditory canal is narrowed.

2. Audiometry.

Measurement of hearing indicators with an electroacoustic audiometer, speech tests. With tubo-otitis, it reveals a decrease in perception up to 20-35 dB.

3. Laboratory examination of the discharge (smear).

It is done to determine the causative agents of infection or the allergic nature of the disease.

Acute eustachitis

The acute form of inflammation is a common complication of viruses and infections of the nasopharynx. In case of insufficient treatment, the inflammation continues in the auditory tube. In babies, both ears are more likely to hurt, adolescents and adults suffer from one-sided manifestations. When asked how much eustachitis is treated, doctors answer: adequate measures allow you to get rid of it in 5-7 days. If:

• no treatment;
• therapy is insufficient or prescribed incorrectly;
• the course has not been completed;
• there are pathologies in the nasopharynx or nasal cavities;
• there is a persistent allergic inflammation of the mucous membrane

the likelihood of a prolonged course of tubo-otitis and its chronicity is high.

Chronic eustachitis

In advanced cases, when examined with an otoscope, the doctor determines:

• stenosis, adhesions and even obstruction of the auditory canal;
• atrophy, hardening of the tube and membrane;
• reduced mobility of the auditory ossicles.

These changes mean the chronization of the process. The symptoms of the acute period become permanent.

Complications

Over time, untreated eustachitis causes:

• acute otitis media after ARVI;
• hearing impairment;
• unpleasant sensations of echo, congestion, fluid in the ear;
• coordination problems;
• headache.

During flights, or when diving, patients with chronic eustachitis experience severe discomfort.

It is important to diagnose inflammation of the auditory canals in a child in time, since without treatment ARVI will be complicated by catarrhal otitis media. Chronic eustachitis and the changes it causes in the middle ear gradually impair hearing.

Eustachitis treatment

For the treatment of eustachitis in adults and children in the acute period, the following can be used:

1. Medicines for the destruction of infection (antiseptics, antibiotics, anti-inflammatory), removal of edema (vasoconstrictor, antihistamines).

2. Physiotherapy to shorten the duration of the illness. Prescribe UV irradiation, sessions on UHF devices, electrical stimulation.

3. Medical manipulations - blowing out the ear (Politzer's method), injecting drugs directly into the auditory canal through a catheter.

To eliminate allergic eustachitis, or tubo-otitis caused by the pathology of ENT organs, one should work with the root causes of the disease - allergies, deviated nasal septum, adenoid growths, etc.

In the multidisciplinary clinic "K + 31", the treatment of eustachitis in adults and young patients is carried out in the department of otolaryngology. Specialists perform diagnostics, develop an action plan, monitor the course of therapy and strive to prevent relapses of the disease.

Among the advantages of the medical center:

• qualified assistance to the patient on an outpatient basis or as a day hospital;
• a full range of necessary laboratory and hardware tests for diagnostics;
• drawing up a treatment regimen using medicinal and physiotherapy, innovative techniques;
• if necessary, the involvement of doctors of other profiles;
• results in the form of recovery or attenuation of the chronic process.

For accurate diagnostics, expert level equipment is used:

• special installation MODULA EUROPA Paris (Duo) HEINEMANN. It helps to make a diagnosis, works as an apparatus for medical manipulations;
• audiometer-impedance meter for analyzing hearing of patients of young and adult age.

Thanks to the professionalism of the doctors and the modern equipment of the department, diagnostics are carried out quickly and accurately. After the first visit, the course of treatment begins.

Prevention of eustachitis

To prevent illness, you should:

1. Get hardened.

   Strengthening the body increases immunity, reduces the incidence of ARVI and the likelihood of eustachitis.

2. Correctly "use" the nose.

   From an early age, children should blow their nose at each nostril in turn. It is better to cover the nose when diving.

3. Visit an otolaryngologist during illness and prophylactically.

   Visits to the doctor will allow you to treat acute diseases and identify asymptomatic pathologies.

4. Fight allergies.

   By identifying the allergen and excluding contact with it, you can improve the condition of the mucous ENT organs and prevent eustachitis.