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Tricks of the Trade

Making Eustachian Tube Physiotherapy Fun For Kids

Author: Ali Ahmadizadeh, MD

Author Information: Ali Ahmadizadeh is a Fellow at New York Head and Neck Institute, New York, NY.

Eustachian tube dysfunction/obstruction is common and in most cases, a developmental presentation in the pediatric population. In the urgent care setting, it commonly presents as an earache and patients may think they have an ear infection. Eustachian tube dysfunction/obstruction often is associated with allergic rhinitis and upper respiratory infections as a result of temporary obstruction of the eustachian tube from inflamed mucous membranes.

The best nonsurgical approach to this complaint remains kinesitherapy of the eustachian tube, which can be explained and taught to adults in two ways:

  1. Valsalva maneuver, which is a well-known technique; and
  2. Attempting to say “K” without sounding it and with the mouth closed, which is less well known but equally efficient.

It would be very unlikely, however, for any child younger than age 6 years to learn and apply either of the above maneuvers. I have found that the following method can easily be taught to children and it is both practical and fun.

First, I attach a non-inflated party balloon to one end of a straw, using a rubber band. Next, I ask the child’s parents to put the open end of the straw in one of the child’s nostrils and to pinch his or her nose. I then ask the child to inflate the balloon by exhaling through the now-closed nostrils.

It is obviously impossible to inflate the balloon in this way. (No adult can do this, perhaps except the Incredible Hulk!!) Instead, the pressurized air behind the closed nostril is directed to the next potential anatomic passage, which is the eustachian tube.

Repeating this game several times with balloons of different colors achieves the therapeutic goal and underscores the function of a “lazy” eustachian tube.

Tricks of the Trade: Making Eustachian Tube Physiotherapy Fun For Kids