Summary
Definition
Disfunção da tuba auditiva é a incapacidade da tuba auditiva de regular adequadamente a pressão de ar no interior da orelha média e/ou drenar, com eficácia, as secreções da fenda auditiva. Ocasionalmente, a disfunção pode envolver refluxo de secreções nasofaríngeas na orelha média. Esses problemas podem ser decorrentes de uma variedade de alterações fisiopatológicas que, de alguma forma, impedem a abertura e o fechamento normais da tuba auditiva.[Figure caption and citation for the preceding image starts]: Tuba auditiva esquerda normal observada por endoscopia a partir da cavidade nasal posterior.Do acervo de Edward D. McCoul; usado com permissão [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
- incapacidade de desobstruir ou desentupir a orelha quando ocorrem alterações na pressão barométrica
- exame físico normal da cabeça e do pescoço
Other diagnostic factors
- plenitude aural
- perda auditiva subjetiva
- autofonia
- história de otite média serosa ou de otite média crônica
- edema do orifício da tuba auditiva
- história de membrana timpânica retraída ou com hipermobilidade
Risk factors
- fenda palatina
- hipertrofia das adenoides
- rinite alérgica
- rinossinusite crônica
- neoplasia da nasofaringe ou da fossa infratemporal
- trauma da tuba auditiva
- infecção da tuba auditiva
- idade <5 anos
- tabagismo
- Doença do refluxo gastroesofágico (DRGE)
- exposição à radiação
- história de perda de peso recente
Diagnostic tests
1st tests to order
- endoscopia nasal
- timpanometria
Tests to consider
- nasofaringoscopia
- Tomografia computadorizada (TC)
Treatment algorithm
todos os pacientes
Contributors
Authors
Edward D. McCoul, MD, MPH
Associate Professor
Department of Otorhinolaryngology
Ochsner Clinical School
University of Queensland School of Medicine
New Orleans
LA
Disclosures
EDM is the author of references cited in this topic and is a consultant for Stryker.
Acknowledgements
Dr Edward D. McCoul would like to gratefully acknowledge Dr Erica R. Thaler, the previous contributor to this topic.
Disclosures
ERT declared that she had no competing interests.
Peer reviewers
Alan G. Micco, MD
Associate Professor
Otolaryngology: Head and Neck Surgery
Northwestern University Feinberg School of Medicine
Chicago
IL
Disclosures
AGM declares that he has no competing interests.
Niels van Heerbeek, MD, PhD
Consultant
Department of Otorhinolaryngology, Head & Neck Surgery
University Medical Centre
Nijmegen
The Netherlands
Disclosures
NVH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Bluestone CD. Eustachian tube: structure, function, role in otitis media. Hamilton, Ontario: BC Decker, Inc.; 2005.
Monsell EM, Harley RE. Eustachian tube dysfunction. Otolaryngol Clin N Am. 1996;29:437-444. Abstract
Schilder AG, Bhutta MF, Butler CC, et al. Eustachian tube dysfunction: consensus statement on definition, types, clinical presentation and diagnosis. Clin Otolaryngol. 2015 Oct;40(5):407-11.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Perda auditiva neurossensorial
More DifferentialsGuidelines
- Balloon dilation for chronic Eustachian tube dysfunction
- Balloon dilation of the Eustachian tube
More GuidelinesPatient information
Infecção da orelha média
Cerume
More Patient information
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