Ears? What could possibly be in there?

Bad things happen, and they will always happen. Sometimes we find ourselves in a bleak nightmare wrapped in despair. The key to navigating these terrible times is knowledge. With knowledge we can unlock the door and escape our hellish nightmare. We can learn from the past and prepare for the future and make the most of our moments. I do my best to be my own advocate, it can be a hard task and sometimes the job becomes overwhelming. In these moments it is great when someone reaches out their hand to help me stand. Normally I am not particularly interested in the ears, it doesn’t have much to do with my cancer or massage therapy, but today I want to help a great friend by offering him my hand to stand. Though the entire ear is discussed in this article, my primary focus is the Eustachian tube.

When pain locks us down and hopelessness begins to set in it is hard to imagine the hardship will ever end. In these terrible times we need a guide, to help us navigate these mad moments and remind us there is more than the scary sea.

Lets get this article into gear and learn about our ears.

The ear has many important parts: the outer ear, middle ear, inner ear and the eustachian tube. The outer ear is the visible area, it is the flappy  floppy skin and the hole, also known as the ear canal. Next, is the middle ear, this is the location of the tiny ear bones: stapes, incus and malleus. The inner ear, includes the chochlea and semicircular. Between the outer and middle ear is the tympanic membrane (also known as the ear drum). Finally, we have the eustachian tube, this important structure functions like a valve, controlled by the levator veli palatine, tensor veli palatine, salpingopharyngeus, and tensor tympani muscles.

What can you tell me about the External Ear?

The outer ear, also known as the auricle or the pinna is a structure primarily composed of cartilage. Its primary function is to gather sound and deliver it to the ear canal.

What do I need to know about the Middle Ear?

The Eustachian tube connects the middle ear cavity with the nasopharynx. It aerates the middle ear system and clears mucus from the middle ear into the nasopharynx. [1] The Eustachian tube is closed when it is at rest, and will open when we swallow, yawn or sneeze (or when performing the Valsalva Maneuver).  It helps equalize pressure between our external environment and our middle ear.

What is their to know about the Inner Ear?

The Inner ear is used to detect and interpret sound and balance.

What could possible go wrong with an our ears? 

External ear
  •  Otitis externa
  •  Wax impaction
Middle ear
  •  Eustachian tube dysfunction
  •  Otitis media with effusion
  •  Chronic suppurative otitis media
  •  Acute otitis media
Inner ear
  •  Sensorineural hearing loss
  •  Ménière’s disease

External Ear

Otitis externa

Wax impaction

Middle Ear and the Eustachian Tube

Eustachian tube dysfunction 

Eustachian tube dysfunction is a relatively common problem. Many otolaryngologists have patients who say their ears are blocked but show no severe pathology on examination, which often leads to a diagnosis of intermittent eustachian tube obstruction. This condition can wear down the eardrum, causing scarring or rupture. This in turn, may cause patients to experience hearing loss or cholesteatoma. [2]

There are various pathologies of the Eustachian tube, like Patulous Eustachian tube disease, otitus Media (OM), Acute Otitus MediaOM with effusion, Chronic Suppurative otitis media and Adhesive OM to mention a few.

Acid reflux and eustachian tube dysfunction 

Could ET dysfunction be caused by acid reflux? It has been reported that eustachian tube dysfunction was more likely to be associated with a higher number of nasopharyngeal reflux events and higher reflux finding score. Nasopharyngeal reflux may have a role in the pathogenesis of eustachian tube dysfunction. [3]  It has also been discovered that Reflux is likely present in a significant number of adult cases with otitis media and may lead to Eustachian tube dysfunction.[4]

What are some treatment options for this disease?

Eustachian tuboplasty

Balloon Dilation 

Eustachian Tube Bypass surgery

Drug-Eluding ET Stents 

Patulous ET


Medicinal options

  • Nasal steroid spray (Flonase, Nasonex)
  • Anti-histamines (Claritin, loratadine)
  • Leukotriene Inhibitors (Singulair)
  • Corticosteroids (Medrol dose pack, prednisone)
  • Afrin (for short-term relief only)
  • Sudafed (for short-term relief only)
  • Anti-reflux medications (Prevacid, Zantac, omeprazole)

Inner Ear

Sensorineural hearing loss

Ménière’s disease


Shawn White Blog





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