Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 8-04: Diseases of the Eustachian Tube + Key Features Download Section PDF Listen +++ +++ Essentials of Diagnosis ++ Blocked eustachian tube remains for a prolonged period Resultant negative pressure will cause transudation of fluid +++ General Considerations ++ Especially common in children because their eustachian tubes are narrower and more horizontal in orientation than in adults Less common in adults, in whom it usually occurs After an upper respiratory tract infection With barotrauma With chronic allergic rhinitis In an adult with persistent unilateral serous otitis media, nasopharyngeal carcinoma must be excluded + Clinical Findings Download Section PDF Listen +++ ++ Tympanic membrane is dull and hypomobile Occasionally accompanied by air bubbles in the middle ear and conductive hearing loss + Diagnosis Download Section PDF Listen +++ ++ Clinical + Treatment Download Section PDF Listen +++ +++ Medications ++ Short course oral corticosteroids (eg, prednisone, 40 mg daily orally for 7 days) Oral antibiotics (eg, amoxicillin, 250 mg three times daily for 7 days) Combination of oral corticosteroids and antibiotics The role of these regimens remains controversial; they are probably of little lasting benefit +++ Surgery ++ When medication fails to bring relief after several months, a ventilating tube placed through the tympanic membrane may restore hearing and alleviate the sense of aural fullness +++ Therapeutic Procedures ++ Endoscopically guided laser expansion of the nasopharyngeal orifice of the eustachian tube or balloon dilation may improve function in recalcitrant cases + Outcome Download Section PDF Listen +++ +++ When to Refer ++ For persistent or recurrent symptoms + References Download Section PDF Listen +++ + +Huisman JML et al. Treatment of eustachian tube dysfunction with balloon dilation: a systematic review. Laryngoscope. 2018 Jan;128(1):237–47. [PubMed: 28799657] + +Roditi RE et al. Otitis media with effusion: our national practice. Otolaryngol Head Neck Surg. 2017 Aug;157(2):171–2. [PubMed: 28535139] + +Vanneste P et al. Otitis media with effusion in children: pathophysiology, diagnosis, and treatment. A review. J Otol. 2019 Jun;14(2):33–9. [PubMed: 31223299]