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Pressure in the ears - ventilation disorder?

This rather unpleasant sensation can occur at any age, even in the first year of life.
Symptoms: Feeling of pressure, ringing in the ears (e.g. also when swallowing), possibly limited hearing.

How does it happen?

  • Pressure is equalised between the outside air and the middle ear via the 3 to 4 cm long Eustachian tube (Eustachian tube). It is the "connecting piece" between the middle ear and the nasopharynx. It is therefore possible that ear problems often originate in the nose and thus the treatment of ear pressure starts via the nose.

  • Pressure equalisation is important when we ride a cable car, fly or dive, for example.

  • In order to hear "normally", the eardrum, as the "door" to the middle ear, must be able to vibrate freely. This only works if the pressure in front of and behind the eardrum is the same. Short-term disturbances of the pressure balance can normally be eliminated by yawning or swallowing. However, if the feeling of pressure persists, there may be an inflammation (tubal catarrh) or swelling of the Eustachian tube, so that the pressure can no longer be equalised. As a result, ventilation no longer works, negative pressure develops in the middle ear, the eardrum no longer vibrates freely - you have the feeling of being deaf.

Diagnosis:

The first step is to see an ENT doctor, who will take a thorough medical history (how long have the symptoms existed, reasons for possible triggers). Then the eardrum is examined with a special microscope to detect possible pre-existing complications and to include them in the diagnosis. Since it is a nose-ear problem, the examination of the nose with the endoscope and the functional testing of the nose are another important step. This is followed by a hearing test (audiogram) and a measurement of the current ventilation status of the ear (tympanogram).

Based on all the diagnostic results, the ENT specialist decides which therapeutic measures to initiate.

Conservative therapy or minimally invasive surgery?

In conservative therapy, nasal rinsing with a special saline solution, the use of a cortisone-containing nasal spray and pressure equalisation training (inflating a small balloon through the nose) are recommended.

For the minimally invasive surgery (tube dilation), the patient is put under a short anaesthetic. The ENT doctor inserts a small instrument through the nose towards the ear, where he or she inserts a small catheter (balloon) into the eustachian tube, inflates it briefly to loosen adhesions or expand constrictions and thus allow the eardrum to swing freely again. After about 6-8 days, the still slight pressure in the ear disappears and the eustachian tube functions properly again.

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