What treatment do you recommend for eustachian-tube dysfunction when all previously tried medications (i.e., antihistamines, decongestants, and sprays) have failed?
—Joan E. Rigdon, NP, Pasadena, Calif.

If you have not tried long-term intranasal corticosteroids, their use is appropriate in this patient. Exercising the eustachian tube by performing Valsalva maneuvers or “popping” the ear multiple times every day is also recommended by ENT specialists as a way to improve dysfunction. If the patient is a smoker, make sure to stress cessation, as smoking is a prime irritant of the eustachian tubes and surrounding tissues.
—Sherril Sego, MSN, FNP (113-1)