Dysfunction of the auditory tube may affect the reduction of hearing acuity. This pathology is equally often recorded by specialists in children, adults. This violation is due to the deterioration of the channel's patency, its complete blockage. In this case, such functions of the auditory tube are violated, as: drainage, ventilation, protection.
Auditory tube: structure
An auditory tube is the element that connects the tympanic cavity, nasopharynx. The length of this organ is 36 - 47 mm. It is similar to the two cones that are pivoted to each other. In its composition, the following departments are distinguished:
- cartilaginous( 24 - 30 mm);
- bone( 10 - 15 mm).
At the base of the cone from the bone tissue is the tympanic estuary. This opening opens into the drum cavity. At the base of the cartilaginous cone is the pharyngeal estuary. Between the two above-mentioned departments is located the anatomical isthmus.
Types of
According to Pautov N.A, these types of auditory tubes are distinguished:
- First. Such a pipe is like a pipe of children, animals. Its shape is straight, the lumen widens gradually( from the tympanic cavity to the pharyngeal mouth).In this case, the narrowing is practically expressed.
- Second. His doctors consider the most common. The narrowing of the auditory tube is very pronounced. The pipe is curved S-shaped.
- Third. The pipe is characterized by a very narrow constriction, a bend. The tube is endowed with a knee-like inflection, which is localized at the point of constriction. This type of pipe is fixed in leptoprozopic, dolichocephalic skulls.
Features of the structure of the auditory tube of an adult and a child
Functions
The auditory tube performs the following functions:
- Opening / closing the pharyngeal estuary. It is carried out reflexively when swallowing, chewing, talking.
- Protective drainage. It is carried out through the mucosa, epithelium( ciliate).
- Protective acoustic. It manifests itself in the reflex contraction of the muscles that close the pharyngeal mouth with loud sound. Thus, acoustic trauma to the structure of the ear is prevented.
ICD classification 10
- H68.0 Inflammation of the eustachian tube
- H68.1 Eustachian tube obstruction
Causes of
Dysfunction of the auditory tube can develop for various reasons. We will point out the most common:
- allergy;
- pathological changes in the nasopharynx. They can be of two types( congenital, acquired);
- atmospheric pressure differences;
- pathology in the development of the auditory tube.
Causes of auditory tube dysfunction in our video:
Anatomical disorders of
In this group of reasons that cause a violation of the function of the auditory tube, specialists include such pathologies:
- mucosal edema( if it is a consequence of allergy, infection);
- cleft palate;
- adenoids;
- a tumor of a nasopharynx.
Functional
This group includes:
- incomplete opening of the pharyngeal opening, which is observed with muscle dysfunction;
- a fall of the walls of the auditory tube, which can cause a decrease in elasticity.
Allergic
In the presence of allergic rhinitis, moderate serous otitis often develops. The swelling of the nasal mucosa provokes malfunctions in the regulation of pressure inside the middle ear cavity. This is the reason that the contents of the nasopharynx penetrate into the middle ear after swallowing.
With seasonal increase in the level of air allergens in almost a third of children suffering from allergic rhinitis, malfunctions in the auditory tube are recorded.
Complications after mastoidectomy
This operation is necessary to remove pus, granulations contained within the cavity of the mastoid process. The accumulation of these substances occurs with inflammation within the shoot. Very rare such complications after surgery:
- hearing loss;
- persistent discharge of pus from the ear;
- dizziness;
- infectious complications( meningitis, cerebral abscess);
- loss of taste in one half of the tongue;
- lesion of the facial nerve.
Types of dysfunctions
Specialists distinguish several types of dysfunction:
- obstruction of the ear of the auditory tube;
- pathological processes occurring inside the mouth of the tympanic tube;
- is a "gaping" pipe.
Pathological reflux
Pathological reflux, which is performed inside the pharyngeal estuary, manifests itself as follows:
- gaping of the auditory tube. It is observed in premature infants, people who have suffered craniocerebral trauma;
- discordance of tube rollers;
- reflux, which manifests itself in casting a secret when opening the auditory tube.
Obstruction
Obstructive dysfunction( internal) manifests itself in:
- cyst;
- post-traumatic scar process;
- granulation.
Mixed obstruction manifests itself as:
- edematous catarrhal rhinosalpingitis;
- of the vasomotor rhinosalpingitis.
Paretic obstruction is also recognized.
"Yawning" pipe
This pathology is represented by the appearance of a wide lumen, flabbiness of the auditory tube. Such changes in the tube can be a consequence of muscle atrophy, the function of which is to tighten the auditory tube.
Species
Specialists distinguish such types of obstruction of the auditory tube:
- acute;
- is chronic.
Acute form of
Obstruction in adults often occurs with colds. This condition can occur even in the absence of effusion in the middle ear. The patient is suffering from hearing loss, pain in his ear.
Chronic
Due to chronic obstruction, secretory otitis may develop. Chronic dysfunction often manifests itself in allergies, infections of the upper respiratory tract. Chronic effusion inside the middle ear( unilateral) may indicate the presence of voluminous formation( lymphoma, cancer).
Chronic congestion as one of the signs of auditory tube dysfunction:
Diagnosis
If a patient has symptoms suggestive of auditory tube dysfunction, a diagnosis is required. To clarify the diagnosis, to detect damage to the hearing aid will help such methods:
- Audiometry.
- Timpanometry.
- Ventilation function.
- Study of drainage function.
- Other tests to be performed.
Audiometry
This diagnostic method is necessary for the study of hearing acuity. The doctor-audiologist establishes an individual sensitivity to sound waves of different frequencies. Audiometry can be tonal, speech, computer. After diagnosis, the doctor receives an audiogram( chart).
Timpanometry
This examination of the tympanic membrane is performed by specialists using a special probe. This probe is able to reproduce a series of different frequencies( 200 - 1500 Hz.).Diagnosis helps to establish the resonance frequency of the middle ear system.
Ventilation
This study consists of blowing the pipe, listening to the sounds that pass through it. For the diagnosis, you need an otoscope, a POLITZER balloon, ear catheters( their sizes can be from 1 to 6).
Study of the drainage function
Evaluation of the drainage function is performed with the passive flow of liquid substances into the nasopharynx from the tympanic membrane. To determine the presence of substances inside the nasopharynx, doctors use dyes. This function is also determined by the taste sensations when the tube is roentgen.
Other tests to be performed by the
The patient may also receive radiation diagnostics( axial projection, according to Mayer, CT, oblique projection, according to Stenvers, diagnosis of the Schuller's temporal bones.)
Diagnosis of the auditory tube with the
probe. Treatment
If auditory tube dysfunctionhas arisen because of diseases of the upper respiratory tract, the doctors prescribe drug therapy. Now puffiness, inflammation will help corticosteroids
Conservative
Therapy consists of the application of thattheir preparations:
- vasoconstrictors( drops);
- anti-inflammatory drugs;
- antihistamines;
- medicines for edema removal.
Surgical
The need for this method of therapy arises when there are irreversible structural changes of this organ.to provoke tumor growth. A gentle method is laser therapy. Electrocoagulation is also used.
Physiotherapy
In addition to medical and surgical treatment, the physician can prescribe physiotherapy( self-inflation using the Valsalva method, using a POLITZER bottle), endaural phonoelectrophoresis).
Physiotherapy for the treatment of auditory tube dysfunction:
Exercises
A doctor can prescribe a series of exercises that can be performed at home:
- Broad yawns.
- Samples Toynbee, Valsalva.
- Movement of the lower jaw to the sides.
- Self-purification( inhale / exhale alternately with each nostril).
Exercises to improve the function of the auditory tube
Possible complications and consequences of
In the absence of proper treatment,
- may result in conductive hearing loss;
- tumor growth;
- ulcers, excrescences on the lower wall of the nasal concha.
Forecast
If the treatment is carried out under the supervision of a specialist, the patient is guaranteed recovery. Without proper therapy, the above complications may occur. The disease can go into a chronic form.