Ear pain, pressure, crackling and ringing: What is it?

(BPT) – Ear pain, pressure, ringing, crackling and popping in the ears? These symptoms can often be mistaken for allergies, a cold or wax buildup — but it could be Eustachian tube dysfunction. And for people who fly, it is a major inconvenience.The Eustachian tube is a dynamic, tubular structure linking the middle ear to the nasal cavity. It ventilates and clears fluid from the middle ear, and prevents transmission of pathogens, material and sounds when closed.[1] When the lining of the Eustachian tube becomes inflamed it can narrow or block the tube, resulting in Eustachian tube dysfunction (ETD). According to a study in JAMA Otolaryngology – Head & Neck Surgery, ETD affects 4.6% of adults or 11 million individuals in the United States.[1] Symptoms can include chronic ear problems like pain, pressure and ringing in the ears.[2] It’s important to see an ear, nose and throat (ENT) physician to receive a proper diagnosis and treatment plan. A potential solution is a relatively new minimally invasive procedure, called balloon dilation. Eustachian tube balloon dilation has associated risks, including tissue and mucosal trauma, infection or possible carotid artery injury.Jonathan W. was treated with balloon dilation of the Eustachian tubes after developing ear pain and fullness that worsened significantly when flying. Jonathan has a long history of ear challenges including tympanic membrane perforation (ear drum rupture) and surgery to restore his hearing. He had a tube placed in his ear that alleviated some pain, but tubes fall out.“Before I had the balloon dilation procedure done, I would try using over the counter decongestant medications. I would try to pop my ears on planes, but had little success, which made flying uncomfortable and difficult. On several occasions my ear drum would rupture while in flight. I knew a more permanent solution was needed.”Like many people, over-the-counter medication wasn’t working for Jonathan’s ETD. In discussion with his ENT, Jonathan opted for Eustachian tube balloon dilation in both ears.“Since having the balloon dilation procedure, I have not had any problems with ear pain or pressure, and no longer have to think about my ears on a regular basis when traveling. I can get on a plane and not have any discomfort or worsening in my hearing,” said Jonathan. “This has been a huge blessing in allowing me to fully enjoy international travel and has made a tremendous improvement in my quality of life. I would absolutely recommend the procedure to others who have similar symptoms.”Jonathan’s ENT, Karen Hoffmann, MD, a board-certified ENT physician, notes, “The most important thing is to confirm that the ear fullness and pressure symptoms are due to obstructive ETD and not another cause. We do this with objective testing and visualizing the ET in the office with a scope. Many patients prefer to have the procedure done in their ENT physician’s office, which provides a level of convenience, familiarity, and comfort.”“I have been pleased to work with many patients with Eustachian tube problems, including Jonathan, and find great joy knowing that I can help improve their quality of life with a simple procedure. For balloon dilation of the Eustachian tube, which may directly treat inflammation of the lining of the ET, we use medications to anesthetize the nose and the opening of the ET. During the brief procedure, a patient can expect to feel a bit of pressure when the balloon is placed in the ET and then slowly inflated. The balloon is usually left inflated for 2 minutes, then deflated and removed. There can be some temporary ear fullness after the procedure, but typically a patient can get back to normal daily activities a day following their procedure.”What You Need to Know About Eustachian Tube DysfunctionETD symptoms can be mild and may resolve after a few days. However, persistent ETD occurs when symptoms such as muffled hearing, fullness of the ear, tinnitus, and fluid in the middle ear last more than 12 weeks.[2] If you have mild symptoms, simple actions such as swallowing, yawning, chewing or gentle exhalation with a closed mouth and nose (Valsalva maneuver) can help to equalize pressure in the middle ear and resolve mild symptoms. For people who have persistent symptoms, medical management may be an option determined by an ENT.Your doctor should determine the right treatments based on your symptoms, but the following are treatment options for obstructive ETD available to consider:Medical Management includes oral and topical decongestants, nasal spray preparations, antihistamines, steroids, and antibiotics. Your ENT will determine if these medical management options are the best treatment for your ETD, and they are often used in conjunction with surgical procedures.Surgical Procedures may be recommended when medical management methods are not enough to relieve symptoms.Ear tubes are tiny cylinders inserted through the eardrum to equalize the pressure in the middle ear. It’s important to note tubes typically fall out in 6 months to 1-2 years; if needed the procedure can be repeated.Eustachian tube balloon dilation is a minimally invasive procedure that inserts and inflates a small balloon in the Eustachian tube to open a narrow or clogged tube. This is typically an outpatient operating room or office surgical procedure with no cuts or incisions that preserves your natural anatomy and requires a short recovery time.To find an ENT near you to discuss your ETD symptoms, treatment options, new technologies from companies like Acclarent, or general questions about your ENT health, visit https://www.jnjmedtech.com/en-US/locator to find a doctor in your area.[1] Shan A, Ward BK, Goman AM, et al. Prevalence of Eustachian Tube Dysfunction in Adults in the United States. JAMA Otolaryngol Head Neck Surg. 2019;145(10):974–975. doi:10.1001/jamaoto.2019.1917[2] Randrup, TS & Ovesen, T. Balloon Eustachian Tuboplasty: A Systematic Review. Otolaryngology–Head and Neck Surgery, 2015;152(3); 383–392. doi:10.1177/0194599814567105