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Research Letter
August 1, 2019

Prevalence of Eustachian Tube Dysfunction in Adults in the United States

Author Affiliations
  • 1Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 2Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 3Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 4Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. Published online August 1, 2019. doi:10.1001/jamaoto.2019.1917

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 when open, and prevents transmission of pathogens, material, and sounds when closed.1 Eustachian tube dysfunction (ETD) is a common diagnosis applied to conditions where the eustachian tube is incapable of performing its functions adequately, resulting in symptoms including hearing loss, aural fullness, otalgia, and autophony. Eustachian tube dysfunction occurs with a variable range of severity between 2 distinct subtypes (obstructive and patulous), and patients may fluctuate along this spectrum of disease, even between subtypes. The exact causes of ETD are not clearly understood, but there are associations with inflammatory disease. Eustachian tube dysfunction is diagnosed through a combination of clinical history, physical examination, tympanometry, audiometry, and other tests as indicated. A recently presented clinical consensus statement defined obstructive ETD in terms of medical history and/or evidence of negative middle ear pressure.1

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