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Although a temporary solution, surgical ventilation tube placement in the ear drum has also proven to be an effective treatment option. This treatment is known as either a unilateral or bilateral myringotomy. 50% of patients reported relief of patulous Eustachian tube symptoms when given this treatment. [15]
The Frenzel Maneuver is named after Hermann Frenzel (German ear, nose and throat physician and Luftwaffe commander). The maneuver was developed in 1938 and originally was taught to dive bomber pilots during World War II. The maneuver is used to equalize pressure in the middle ear.
Variations of the maneuver can be used either in medical examination as a test of cardiac function and autonomic nervous control of the heart, or to clear the ears and sinuses (that is, to equalize pressure between them) when ambient pressure changes, as in scuba diving, hyperbaric oxygen therapy, or air travel.
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The sinus will fill with fluid or blood unless the pressure differential is neutralized. [6] If the outlet is blocked during ascent, the situation is reversed and "reverse squeeze" appears. [7] Pressure inside the sinus increases, affecting the walls of the sinus and producing pain or epistaxis.
There was no evidence of disc edema in the left eye or choroidal folds in either eye (Figure 13). MRI of the brain and eyes days postflight revealed bilateral flattening of the posterior globe, right greater than left, and a mildly distended right optic nerve sheath. There was also evidence of optic-disc edema in the right eye.
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First-line treatment options are generally aimed at treating the underlying cause and include attempting to "pop" the ears, usually via the Valsalva maneuver, the use of oral or topical decongestants, oral steroids, oral antihistamines, and topical nasal steroid sprays, such as Flonase.