Dysfunction of the eustachian tube: The Daily PANCE Blueprint

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Dysfunction of the eustachian tube: The Daily PANCE Blueprint

A 25-year-old woman with a history of frequent sinus infections presents to the clinic for evaluation of ear pain. She reports that she recently returned from a vacation that included several flights. During the descent of her last flight, she experienced severe pressure and pain in her ears, followed by a sensation of fullness and reduced hearing in her right ear. She has tried over-the-counter decongestants and nasal sprays without relief. On examination, the tympanic membrane appears retracted and immobile on pneumatic otoscopy. Which of the following is the most likely diagnosis?

A. Acute otitis media
B. Otitis externa
C. Eustachian tube dysfunction
D. Chronic otitis media
E. Tympanic membrane perforation

Answer and topic summary

The answer is C. Eustachian tube dysfunction

Eustachian tube dysfunction is the most likely diagnosis in this patient who experienced ear pain and fullness associated with flying. The Eustachian tube helps to equalize pressure between the middle ear and the external environment. Rapid changes in altitude, such as during flight descent, can cause pressure imbalances if the Eustachian tube does not function properly. The retracted and immobile tympanic membrane on pneumatic otoscopy supports the diagnosis of Eustachian tube dysfunction.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Ear Disorders (PEARLS) ⇒ Inner ear (PEARLS) ⇒ Dysfunction of the eustachian tube

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