Eustachian Tube Dysfunction
Eustachian Tube Dysfunction (ETD)
Eustachian Tube Dysfunction (ETD) is a common problem in babies and children. However, it is not always diagnosed as the symptoms often correct themselves in the first 2 years of life.
The Eustachian tube connects the back of the throat behind the nose to the middle ear; it allows air to enter to the middle ear in order for the ear to function normally. Most people will have experienced discomfort in the Eustachian tube when in a plane, a lift or when you drive up a hill and the pressure builds in your ears. That is the tube temporarily not allowing the air in the middle ear to equalise. However, when you swallow, your ears “pop” and the discomfort is relieved.
In babies and children, the Eustachian tube does not always work as efficiently as in adults. When this occurs over a period of time, the air in the middle ear is absorbed by the body and replaced by a fluid. The fluid itself does not cause any damage to the ear but it does cause discomfort. During the day time when a child eats and drinks, they swallow and so regulate the pressure within the ear. At night time however, they do not swallow and so the fluid in the middle ear builds up, and causes pain. This can cause the baby or child to wake in pain and generally be distressed.
I had not heard of this condition until I happened to see a different GP at our surgery about Ella having an ear infection. As we chatted about her symptoms, he asked how she slept at night, to which I replied – she doesn’t! Ella has never, to this day, slept through. Before diagnosis, she would wake screaming hysterically and be inconsolable every few hours. We had tried controlled crying but she would get herself into a lather and vomit. Whenever we went to her, she would be pulling on her ear. After an examination and discussion, the doctor diagnosed Ella as having ETD.
The symptoms of ETD are easily treated – give the child a drink! They then have to swallow which regulates the pressure in the ear. In Ella’s case, hers is managed with a combination of drinking and a painkiller/mild sedative.
Most children grow out of this by the age of 2. If they haven’t, ear tubes or grommets can be fitted. The fluid is drained under anaesthetic and the grommet inserted. This allows the fluid to drain away and gives the tube a chance to function properly. In most cases, the condition is resolved with 1 set of grommets, but if not, a further set can be given.
Ella was diagnosed at 7 months. I was beginning to think that I was going mad as it seemed that everyone else’s child slept through, but not mine! Her ears do still bother her, but she’s only 13 months so there is still time for her Eustachian tube to develop itself. If it doesn’t, she will be referred for grommets. The following symptoms are an indication of ETD: