Why Does ETD (Eustachian Tube Dysfunction) Take So Long to Heal?

[Sugarpuddle]

Seriously I had never heard of ETD before I got an ear infection. I'm now going on 7 months of hissing in my left ear from it.

Apparently I have ETD and some turbinate inflammation / swelling in my left nose from having so many infections. I also have crackling sometimes when I swallow and an eardrum retraction. All on the left side. Right side has zero symptoms.

I've now been infection free for 3 weeks.

I've tried 4 different types of nasal steroids and anti-allergy sprays and drops and oh boy, they make it WORSE.

Everything the ENTs have suggested makes it 10x worse. If I spray, the inflammation gets worse, the hissing gets worse, so I'm not touching them again. It makes no sense as they should technically be helping but it irritates it further. I imagine because I've used them for so many months now without improvement that all it does is irritate it now which I've read can happen. Overuse of steroid nasal sprays can make things a lot worse.

I've also tried anti-allergy tablets and Prednisolone at a high dosage for a week. No improvement. Nada. The eardrum is still retracted. Had an MRI scan - came back clear. No blockages, no scarring, no tumors, nada. Seen 3 ENTs at 3 different hospitals local to me. Nobody can explain why, when the scans and the nasal swabs are clear, my tubes and turbinates are still so swollen when I have no other symptoms (no congestion, no nasal drip).

Seriously though, why does ETD take so damn long to heal? Does anyone know why the tube's inflammation just doesn't go down for such a long time? Why am I not healing?

 

[Lane]

Why am I not healing?

Hi @Sugarpuddle -- My first thought is that you're going to conventional doctors instead of going to a Naturopathic Physician. Lots of things an ND might suggest that could likely begin to clear things up for you. Are you doing any kind of nebulizing? That could also likely go a long way toward healing all areas of the oral cavity, sinuses, ET, etc.

 

[InNeedOfHelp]

If you are still up for trying a nasal spray, I'd try XHANCE from Optinose. Early trials show 80% of people with ETD improve. Use the search function, I have posted some research on it.

 

[Uklawyer]

I'd try XHANCE from Optinose.

Have you tried it?

 

[Karl28]

Have you actually downed that camera down the nose to confirm you have ETD?

 

[InNeedOfHelp]

Have you tried it?

Unfortunately it is not EMA approved yet, so not available in the EU. Would love to try though as the research is very encouraging.

 

[Sugarpuddle]

Have you actually downed that camera down the nose to confirm you have ETD?

Yes. I have a retracted eardrum too. It's being sucked right in. Had an MRI and they said there's no scarring, no tumours, so it must be inflammation based.

I've seen my eardrums with the camera. The right one is normal. The left hissing one has the membrane being sucked slightly inwards, by about 60%.

 

[Sugarpuddle]

Unfortunately it is not EMA approved yet, so not available in the EU. Would love to try though as the research is very encouraging.

I'm in the EU too so that'll be a no for me. Nasal sprays seem to make it worse anyway. The only thing that seems to be helping is Vitamin A.

 

[Scarfacesaints]

This sounds exactly like me. Middle Ear infection at the beginning of July. 4 antibiotics, a steroid, and now prescription ear drops. I have a follow-up appointment tomorrow with the doctor to see if the inflammation has gone down that I apparently had. Left hear has the slight hissing/ringing, and right ear is completely fine. They say ETD goes away on it's own... Not sure when that is. Which is why insurance won't cover any procedures for like 6 months.

I moved from Buffalo NY to Florida and one ENT suspects allergies is cauing the ETD. I've been here for almost a year so not sure what I'm all of a sudden allergic to. They want to send me for an allergy test. I've been on Flonase, Claritin, and Mucinex. Mucinex seems to help break up the mucus but it just doesn't drain properly it seems because of the ETD. Not sure if the Flonase and Claritin are doing anything.

 

[Ryan Edwards]

Similar issue - I took antibiotics, Doxycycline, and the pressure in my ears, most specifically my left ear, changed (later found out it went negative). I have uncomfortable ear pressure, lots of popping all the time and some mild ear pain at times. Significant increase in the loudness of my tinnitus, especially in the left ear.

Six weeks on, no sign of improvement. I tried antihistamines, they made it worse, ENT prescribed steroid nasal drops, they made it worse. Now waiting a couple of weeks to see another ENT and slowly going out of my mind...

 

[Sugarpuddle]

Similar issue - I took antibiotics, Doxycycline, and the pressure in my ears, most specifically my left ear, changed (later found out it went negative). I have uncomfortable ear pressure, lots of popping all the time and some mild ear pain at times. Significant increase in the loudness of my tinnitus, especially in the left ear.

Six weeks on, no sign of improvement. I tried antihistamines, they made it worse, ENT prescribed steroid nasal drops, they made it worse. Now waiting a couple of weeks to see another ENT and slowly going out of my mind...

Everything you mentioned also makes mine worse. The steroid nasal drops makes it 10x worse. The antihisamines also makes it 10x worse. I'm beginning to think ETD is permanent. I've tried everything. Nasal steroids, oral steroids, vitamin A, Ginkgo, Magnesium, garlic, CBD, ginger, everything. Nothing is helping. It makes no sense that the tubes are still inflamed because they have no reason to be. The body sends blood to the place that needs healing - but there's no healing to be done. So why isn't the inflammation settling down?

I've been infection free for amost a month now and it's still incredibly inflamed. I went up a skyscraper this weekend and literally felt the pressure in my tube on my left side inflate as the pressure changed. It makes zero sense why it's not going down and the ENTs simply do not care nor want to know. None of them have the solution. It's a field infamous for attracting vending machine degree doctors (i.e. it's the only thing they could specialize in and it requires almost zero to no smarts to become an ENT).

 

[Sugarpuddle]

Similar issue - I took antibiotics, Doxycycline, and the pressure in my ears, most specifically my left ear, changed (later found out it went negative). I have uncomfortable ear pressure, lots of popping all the time and some mild ear pain at times. Significant increase in the loudness of my tinnitus, especially in the left ear.

Six weeks on, no sign of improvement. I tried antihistamines, they made it worse, ENT prescribed steroid nasal drops, they made it worse. Now waiting a couple of weeks to see another ENT and slowly going out of my mind...

How are you doing now Ryan? Any improvement?

 

[Ryan Edwards]

How are you doing now Ryan? Any improvement?

Nothing yet I'm afraid. I'm coming to terms with the worsening but strangely a hearing test showed some mild hearing loss in the 4 - 8 kHz range, but not in the higher frequencies which are supposed to go fast, so if Doxycycline was the cause, why did it hit the mid range, I wonder?

 

[Sugarpuddle]

Nothing yet I'm afraid. I'm coming to terms with the worsening but strangely a hearing test showed some mild hearing loss in the 4 - 8 kHz range, but not in the higher frequencies which are supposed to go fast, so if Doxycycline was the cause, why did it hit the mid range, I wonder?

I mean... if you have ETD, of course you have hearing loss. Your tubes are almost swollen shut. I've had an update since this anyway.

• Try massaging your jaw joints on both sides. If they're tender/painful/sore, then they have too much lactic acid build up from the infection. Massage them to release the mucus. Even better if you use arthritis gel/cream as it will help settle down the inflammation.

• Use menthol nasal sprays. I've been using it for 24 hours and the hissing has almost gone. They're not addictive or rebound like the steroid sprays ENTs give you so there's no withdrawal from them. You can get them off Amazon.

 

[Ryan Edwards]

I mean... if you have ETD, of course you have hearing loss. Your tubes are almost swollen shut. I've had an update since this anyway.

• Try massaging your jaw joints on both sides. If they're tender/painful/sore, then they have too much lactic acid build up from the infection. Massage them to release the mucus. Even better if you use arthritis gel/cream as it will help settle down the inflammation.

• Use menthol nasal sprays. I've been using it for 24 hours and the hissing has almost gone. They're not addictive or rebound like the steroid sprays ENTs give you so there's no withdrawal from them. You can get them off Amazon.

Thanks, I will try that!

I saw another ENT today and they insisted on giving me microsuction on my right ear. I didn't enjoy the experience, I also think it's made my tinnitus slightly worse.

 

[Sugarpuddle]

Thanks, I will try that!

I saw another ENT today and they insisted on giving me microsuction on my right ear. I didn't enjoy the experience, I also think it's made my tinnitus slightly worse.

Oh dear. There are many, many posts on this website warning people to stay far away from microsuction because of how dangerous it is. My god ENTs are useless.

In the future, please look up procedures online before agreeing to them. Ask for a few moments to think about it and google what it is and the dangers of it or come back another day. ENT's are infamous for being clueless. I'm in the UK, same as you, I've seen 3 at 3 different hospitals and they've all been completely useless, incorrect and foul. Absolute vending machine degrees type of doctors.

One of them who I'm sure just walked in off the street told me after 3 seconds that I had irreverisible nerve damage - he was incorrect. The audiologist, who has far more training, confirmed I have ETD and a retracted eardrum and that with time, it will go down. This was physically confirmed to me when I went up a skyscraper in London last week. We went down the lift and I felt the tube in my ear suddenly inflate on the left side with the pressure. That 100% confirmed to me that yep, I have ETD inflammation.

Ask I suggested before, use menthol nasal sprays. Once a day. Try it for a week or two. If no improvement, stop using them. And just allow time and your body to fix this. No more insane procedures. And definitely do not agree to grommets whatever you do. They love jumping to that but it's extraordinarily invasive and dangerous for your ears.

Be more patient. This is a marathon, not a sprint. It takes time for your tubes to calm down and reset after an infection. Just please - do not agree to any more intensive procedures on your ears without getting a second opinion and looking online for other people's experiences first.

The Dangers of Microsuction

 

[Ryan Edwards]

And definitely do not agree to grommets whatever you do.

Thanks for the advice! What are grommets?

 

[Sugarpuddle]

Thanks for the advice! What are grommets?

They are massive rubber holes they put in your eardrums to equalize the pressure. Which makes no sense, as the pressure is usually off because of swelling. So unless the swelling goes down, there's literally no point for a doctor to cut a huge hole in your eardrum to insert a rubber tube.

Please get familiar with the things they're going to offer you because you can't immediately say yes to massive procedures like this. Some doctors are sadists and just enjoy doing it as part of their job, regardless if you need it or not. There's so many safer options out there, for example, than microsuction. If my ENT suggested that I probably would had scoffed in his face. I'll stick with natural ear cleaners, thanks.

 

[Greg Sacramento]

@Sugarpuddle, ear may have formed very small retraction spaces. These blank areas may accumulate dust or be a little dry as your nose turbinates may not be completely moistening and warming up inhaled air - or high moisture. Dry air may also cause slight drynesss in mouth and throat. Turbinates don't need to be enlarged. Often reletes to climate, weather and sometimes dust or indoor air pollutants. MRI isn't very useful to note this.

Some background:

Relative humidity greater than approximately 50% increases indoor dust mite levels. Low ventilation rates may thus increase the prevalence or intensity of allergic and other symptoms.

Moisture control and ventilation - WHO Guidelines for Indoor Air Quality - NCBI Bookshelf (nih.gov)

 

[Sugarpuddle]

I saw another ENT today and they insisted on giving me microsuction on my right ear. I didn't enjoy the experience, I also think it's made my tinnitus slightly worse.

Have you had any improvement Ryan?

 

[Ryan Edwards]

Have you had any improvement Ryan?

I have I'm relieved to say. I think it took me a good 3+ months, but habituation has kicked in thank goodness so now I can sleep again without listening to sounds on my phone much to my significant relief. I have also invested in some custom fit earplugs so I am looking forward to them arriving next week

 

[Sugarpuddle]

I have I'm relieved to say. I think it took me a good 3+ months, but habituation has kicked in thank goodness so now I can sleep again without listening to sounds on my phone much to my significant relief. I have also invested in some custom fit earplugs so I am looking forward to them arriving next week

Wait, so you did something to make it disappear or it's still there and you just got used to it?

 

[Ryan Edwards]

Wait, so you did something to make it disappear or it's still there and you just got used to it?

I just got used to it!

 

[hopefuldede]

Hi @Sugarpuddle and @Ryan Edwards, just checking if you had any updates on your ETD? Has it alleviated with time?

 

[just1morething]

Oh dear. There are many, many posts on this website warning people to stay far away from microsuction because of how dangerous it is. My god ENTs are useless.

In the future, please look up procedures online before agreeing to them. Ask for a few moments to think about it and google what it is and the dangers of it or come back another day. ENT's are infamous for being clueless. I'm in the UK, same as you, I've seen 3 at 3 different hospitals and they've all been completely useless, incorrect and foul. Absolute vending machine degrees type of doctors.

One of them who I'm sure just walked in off the street told me after 3 seconds that I had irreverisible nerve damage - he was incorrect. The audiologist, who has far more training, confirmed I have ETD and a retracted eardrum and that with time, it will go down. This was physically confirmed to me when I went up a skyscraper in London last week. We went down the lift and I felt the tube in my ear suddenly inflate on the left side with the pressure. That 100% confirmed to me that yep, I have ETD inflammation.

Ask I suggested before, use menthol nasal sprays. Once a day. Try it for a week or two. If no improvement, stop using them. And just allow time and your body to fix this. No more insane procedures. And definitely do not agree to grommets whatever you do. They love jumping to that but it's extraordinarily invasive and dangerous for your ears.

Be more patient. This is a marathon, not a sprint. It takes time for your tubes to calm down and reset after an infection. Just please - do not agree to any more intensive procedures on your ears without getting a second opinion and looking online for other people's experiences first.

The Dangers of Microsuction

I tried to quote just a paragraph of your post. I recently had microsuction of my ears. He just did it without asking. It was super loud and seemed to make my tinnitus worse. I think they can view the ear canal and eardrum while they suck your earwax. I wished the ENT would have used a curette.

The ENT said I have negative pressure in both ears. He said he would put grommets in my ear(s) but I had that done years ago. I have a lot of annoying hissing, especially in my left ear. I'm seeing another ENT tomorrow and will ask about balloon dilation. This hissing is driving me crazy. I will try your suggestion of menthol sprays. I've tried almost everything including Left TMJ surgery. I had bone on bone on that side so it was repaired with fat around my belly button. No help with my tinnitus unfortunately.

 

[Strawberryblonde]

try your suggestion of menthol sprays.

I use Olbas oil nasal sticks and Vicks version and use them as and when needed. They seem to help the fullness and horrible mucusy feeling I have behind my nose and throat (not sure if it is post nasal drip catarrh or something else as I have never seen an ENT). Using it during steam inhalation can also help.

 

[Supersix]

• Use menthol nasal sprays. I've been using it for 24 hours and the hissing has almost gone. They're not addictive or rebound like the steroid sprays ENTs give you so there's no withdrawal from them. You can get them off Amazon.

What brand of menthol nasal sprays are you using?

 

[Sugarpuddle]

I have officially had ETD now for 2 years. It started due to an ear infection and since then I've had ringing, hissing, a constant white noise, and now I have a combination of a consistent hum and hiss.

It's mind numbing and infuriating. I have tried EVERYTHING. Everything. Antibiotics, antifungals, Vitamin D, C, B, A, garlic supplements, ginger, oregano, Magnesium, NAC, steroid sprays, steroid tablets. You name it, I've tried it.

Nothing is resolving it. I first started having problems with my left Eustachian tube when I was on a flight in 2011 and the pilot did not pressurize the cabin correctly, and my sinuses completely swelled up. That gave me bad hearing.

Then the ear infection in 2021 set off the hissing / humming / ringing which hasn't stopped.

My ENT told me to use a saline rinse as much as possible to keep things from drying up in my nasal passages. I managed to get some in my Eustachian tube and suddenly felt this burning and itching sensation, sort of like a skin infection. I did that over the course of 4 days and the stinging / burning pain vanished. I thought finally, I have found the cause of the tube being swollen.

But nope, it's still in full swing. When I use the EarPopper device, the tube opens up all the way and the hissing / humming sound vanishes, then comes straight back again. That's how I know it's completely swollen - but why? I have no active infection and haven't for months.

Does anyone know what keeps the sinuses so inflamed and swollen months after an infection clears up?

Thank you.