Eustachian tube lies closed most of the time. Opens during yawning, swallowing, chewing, etc.,. with the help of muscles like tensor veli palatini, levator veli palatini and salpingopharyngeus.
Instead, if Eustachian tube stays constantly open, then that condition is called as patulous Eustachian tube. Here, the patient will hear his own voice (autophony), his own breath sounds. On otoscopy, tympanic membrane movements can be seen synchronised with inspiration (inward) and expiration (outward). Few causes include rapid weight loss, 3rd trimester of pregnancy, multiple sclerosis. No treatment required for acute cases. Weight gain, oral KI can be given. Cauterisation of ET or grommet insertion can be planned in chronic cases.
If Eustachian tube fails to open after flight journeys or deep sea diving, then sudden retraction of TM occurs causing severe pain. This attack due to pressure changes is called as barotrauma. Rx –Valsalva (forced expiration with closed nose & mouth). Symptomatic medication. If not cured, then myringotomy with grommet should be done.
Infant Eustachian tube differs from adult tube, due to which, regurgitation of feeds occur frequently into middle ear causing inflammations and infections in middle ear.
Any parents presenting with the complaint of their child getting repeated ear problems should be taught of “feeding the child in slightly upright position.”