The Eustachian tube is the narrow channel connecting the back of the nose with the middle ear space. It lies deep within the head and is made of cartilage and bone. Dysfunction of the Eustachian tube can result in ear fullness along with associated discomfort, popping or crackling sounds, sensation of pressure, and diminished hearing.
The Eustachian tube acts as a pressure-equalizing valve for the middle ear, which is normally filled with air. Blockage of the Eustachian tube opening leads to a negative middle ear pressure because air can’t enter the middle ear space from the back of the nose. Over time, continued blockage of the Eustachian tube, with the associated negative middle ear pressure, can lead to fluid being drawn out of the tissue lining the middle ear. This leads to a condition called otitis media with effusion (OME). If the fluid in the middle ear becomes infected, it’s called acute otitis media. OME is the most common cause of hearing loss in children and is often call Glue ear.
Chronic OME may result from continued and persistent Eustachian tube blockage or from thickening of the fluid such that it can’t be absorbed or drained through the Eustachian tube.
Treatment of OME is initially medical and usually directed towards treatment of the upper respiratory infection or allergy attacks. When the middle ear fluid is infected (acute otitis media), antibiotic treatment is needed. If antibiotics don’t clear the ear, a surgical procedure may be required. These include myringotomy with or without insertion of a ventilation tube. Like acute OME, treatment of chronic OME may be either medical or surgical, such as antibiotics, allergy treatment or myringotomy with insertion of a ventilation tube and, at times, adenoidectomy.