New Developments in the Management of Eustachian Tube Dysfunction - ENTtoday

I’ve put this under ‘Other’ but I personally believe this has a relationship to MAV. For me definitely.

This quote was particularly interesting:

"More research into Eustachian tube function, dysfunction, and pathogenesis of otitis media is needed. “If we determine that inflammation in the ccartilaginous Eustachian tube is the main cause for dilatory dysfunction of the Eustachian tube, then we should be able to treat the condition medically,” Dr. Poe said. “While surgical developments are great solutions in light of the fact that current medications don’t suffice, we are ultimately hoping to have medications that can treat the Eustachian tube for dilatory dysfunction.”

I have a suspicion that we are already to some extent there as drugs like Effexor & Amitriptyline influence mucosa production which might have an effect on recovery from inflammation …

Me, too.

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I am at a loss how your initial injury can affect the ET.

Sets off inflammation and over production of mucus causing general irritation all the way down. My ET still gets stuck and ‘cracks’ open on opening jaw or turning neck periodically. Only on my bad side.

Somehow it’s hard to beleive pressure on ear drum cause ET inflammation ! Walls of ET secretes mucus, they got inflamed by a forceful passage of air ? Does not add up.

Cold, sinus infection, allergies can cause inflammation of the ET.

Surely injury to muscles, tendons, anchor points of middle ear bones or injury to the oval window itself is going to create an inflammatory response which would increase mucus production above normal levels and thicken the walls. It may all be evolved to do that.

If that be the case a Valsalva maneuver should be able to cause same inflammatory effect. Which it does not.

That’s air going in the opposite direction. Not a physical clout.

Calorie testing when they pump forced hot air into ear everyone walks out with migraine not ETD.

I recognise migraine may also cause changes in the ET but mine was never migraine lead, it caused me migraines.

I had significant fluid sensation in my middle ear 6 months before MAV and an entire year before a full migraine.

So my issue was always something physical in the ear to begin with.

The only thing I’ve been wrestling with is inner or middle.

The only symptoms I have now are ear related.

It is clear my ET is not working 100% because of the sticking. If the ET is sticking heaven knows what is happening further up around the middle ear bones. Probably stuck up with crud, dampening frequency response and causing tinnitus.

My case in point is ETD is definitely prevalent in MAV but I dont think is the sole perpetrator of the dizziness and imbalance.

Oh sure not. Who knows. It’s perhaps just a variant.

I don’t know about ‘sole perpetrator’ but whatever the root cause of MAV, and there would appear to be quite a few, I think that there are several things that keep it perpetuating symptoms, apart from its apparent inherent instability, the two that come readily to mind are constant re-exposure to triggers and over a protracted period of time maladaptation. Helen


Yep, I think where I (and not just I) differ from some MAVers is that I started getting migraines from vestibular instability.

I believe my ET and/or middle ear was already a problem and this was the source of my vestibular instability. I suspect it wasn’t functioning as my brain expected and unexpected pressures were experienced by my labyrinth in contradiction to my other ear, resulting in confusion with the lack of correlation.

External stimulus might well act as triggers to make your MAV symptoms worse and for some people if this escalates to migraine, this might impact their ET due to physiological fallout of the migraine. It’s not hard to see a vicious cycle in this process.

It’s hard to tell whether I ever had ET fallout from migraines, but then again I only had migraines for a distinct phase of the condition (maybe for maximum 3 months when they were truly terrible before almost completely controlled by Amitriptyline). I had neurological trouble for much much longer, but that rarely escalated to migraine. Vestibular attacks continued, but they weren’t what I would describe as migraines - something physiological was messed up in my ear I suspect. A swollen middle ear is likely I believe. Who knows what mischief that can do to someone’s experience of space and movement.

I take @GetBetter’s point that Valsalva action would just push out the ear drum and this doesn’t usually make one dizzy, right? However, dizziness from ET dysfunction is well reported.

@turnitaround if you had a swollen middle ear would this be seen in a test?

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Brilliant question!!!

I received only one test to confirm that I apparently did not have ETD (pressure waves fired at the ear drum. Theory is that if the shape of the response is wrong, something is up; mine apparently looked healthy).

However, only one doctor attempted to explain all the weird sensations, like fluid, squishing sensation, cracking jaw, and his conclusion was this was down to perilymph from a PLF!

Given I have these sensations still (4.5 years later) but zero vestibular problems I’m not sure they are or ever were down to a PLF.

Maybe your brain compensated to a new ‘normal’. Learnt to ignore any faulty signals.

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yeah, but there’s more to it … I think the issue with MAV is that you can’t compensate because the noise in the system is too great - there are changes in response going on which don’t correlate with stimuli. These changes in response are so large that they overwhelm the brain.

The brain can never learn to correlate changes in response when the changes don’t correlate - it’s impossible. Something physiological is going on which alters the sensory response and the brain cannot cope.

I know that my physical symptoms have improved - my hearing has improved a lot for example. I used to get massive rumbles in my ear like a broken hifi whenever I took the tube train. That no longer happens.

I used to get a lot of fluid in my ear by morning, but now there’s not even a drip most days.

I used to get a ‘ticking’ in my left ear that would go in spasms. That no longer happens anywhere near as much or for as long.

I used to have hyperacusis quite badly. No longer.

So I reckon the ‘noise in the system’ has died down because the physiological fluctuation has got down to a level which permits the brain to compensate.

So you are right, but it’s not the whole story. 2 years ago I was not in a place where my brain could fully compensate. Things have calmed down, and now I can.

Absolutely. You cannot build a house on shifting sand. It needs stable ground.

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Or on marshmallows! :slight_smile:

(I laugh now but that feeling is extremely scary when it first happens and uncomfortable from then on …)

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