Ear Canal Blocked (Eustachian Tube Dysfunction) Manual Therapy by Osteopaths

Eustachian Tube Dysfunction (Blocked Ear Canal)

Eustachian tube dysfunction (Blocked Ear Canal) is defined as the failure of the eustachian tube (ear canal) to open sufficiently during swallowing or yawning, causing a difference in air pressure inside and outside the middle ear. Allergies, upper respiratory infections, rapid altitude changes (eg, airplane ascent and descent, scuba diving), a narrow eustachian tube, tumors in the nasopharynx, and large adenoids can all contribute to eustachian tube dysfunction (Channell, 2008).

Ear Canal

 

 

Several symptoms and conditions can occur as a result of eustachian tube (ear canal) dysfunction, including barotitis media, serous and suppurative otitis media, otalgia, temporary hearing problems, tinnitus, and vertigo. Treatment options range from antibiotics to surgery, but simple solutions exist in little-documented osteopathic manipulative techniques (Channell, 2008).

The eustachian tube has three physiologic functions:

  1. ventilation and pressure regulation of the middle ear
  2. protection of the middle ear from nasopharyngeal secretions and sound pressures
  3. clearance and drainage of middle ear secretions into the nasopharynx

(Channell, 2008)

Anatomy of Eustachian Tube

The adult eustachian tube (ear canal) is approximately 3.5 cm in length. It is directed inferiorly, anteriorly, and medially from the middle ear. It consists of a lateral bony portion, which arises from the anterior wall of the tympanic cavity, and a medial portion, which is fibrocartilaginous and enters the nasopharynx. The tube opens posterior to, and slightly inferior to, the posterior end of the inferior nasal concha. The muscles of the eustachian tube system (ie, salpingopharyngeus, levator veli palatini, tensor veli palatini, and tensor tympani) help open and close the tube. A functional and patent eustachian tube is necessary for ideal middle-ear sound mechanics (Channell, 2008).

Blocked Eustachian Tube (Ear Canal)

Ear CanalEar Canal

 

The Gallbreath Technique for Blocked Ear Canal

The Galbreath technique is a lymphatic drainage technique that may be used to treat a patient of any age. As described elsewhere, the physician turns the patient’s head so that the affected ear faces away. With the other hand, the physician applies an inferior and medial force across the mandible of the affected side. This technique may be used in conjunction with the Muncie technique (Channell, 2008).

The Muncie Technique for Blocked Ear Canal

The Muncie Technique is a manipulative technique to relieve eustachian tube (ear canal) dysfunction. The procedure for treating a patient’s right eustachian tube orifice involves the osteopath inserting a gloved right index finger into the patient’s mouth, placing the finger against the inferior part of the posterior pillar of the palatine tonsil. Moving the finger tip cephalad and slightly lateral to the Rosenmüller fossa, posterior to the opening of the eustachian tube (ear canal), the osteopathic physician should apply a pumping motion with the finger pad to lyse any adhesions and, ultimately, restore the eustachian tube opening. However, this technique may cause gagging and can be traumatic for children. Patients are advised to pant through the mouth to avoid gagging (Channell, 2008).

Modified Muncie Technique for Blocked Ear Canal

The use of a modified Muncie technique, which has been used by osteopathic specialists but has not been previously described in the literature, can improve patient tolerance. It is better to do this technique with the patient in a supine or reclined position for head stabilization, but it may be done with the patient seated as well. To treat the right eustachian tube (ear canal), insert the right index finger, gloved, into the patient’s mouth. Place the finger against the posterior pillar of the palatine tonsil. Apply lateral pressure while making a circular motion into the soft tissue. This motion exerts traction on the superior soft tissue and the opening of the eustachian tube, which is directly superior to this point above the soft palate. This technique helps break the vacuum, normalize pressure on both sides of the tympanic membrane, and allow fluid drainage. Because of its indirect nature, the modified Muncie technique may require several applications. However, it is less likely to induce gagging and therefore may be preferred by patients (Channell, 2008).

Is Treatment Effective?

At this time, we are unsure if treatment is effective for everyone and there isn’t much in the way of research to back up the claim for the effectiveness of osteopathic treatment for Eustachian Tube Dysfunction (Blocked Ear Canal). Though the proposed treatment could be interesting area of research to explore in the future.

Treatment at Cam Osteopathy

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Reference List

Channell MK (2008). Modified Muncie Technique: Osteopathic Manipulation for Eustachian Tube Dysfunction and Illustrative Report of Case.  JAOA  Vol 108 (5) May.

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