What is the recommended steroid burst regimen for Eustachian (auditory) tube dysfunction?

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Last updated: June 26, 2025View editorial policy

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From the Research

The recommended treatment for Eustachian tube dysfunction involves the use of nasal steroid sprays, such as fluticasone or mometasone, rather than a traditional steroid burst regimen, as evidenced by the most recent and highest quality study 1.

Key Points to Consider

  • The study published in 2023 1 found that intranasal Azelastine-Fluticasone dipropionate combination treatment was effective in reducing adenoid tissue hypertrophy and improving Eustachian tube function in children with Eustachian tube dysfunction.
  • Another study published in 2024 2 found that dupilumab rapidly improved Eustachian tube dysfunction and otologic symptoms in patients with aspirin-exacerbated respiratory disease.
  • The use of oral prednisone or methylprednisolone may not be the most effective treatment option for Eustachian tube dysfunction, as the evidence suggests that nasal steroid sprays and other targeted therapies may be more effective.
  • Patients with Eustachian tube dysfunction should be aware of the potential benefits and risks of treatment options and work closely with their healthcare provider to determine the best course of treatment.

Treatment Options

  • Nasal steroid sprays, such as fluticasone or mometasone, applied 1-2 sprays in each nostril daily
  • Intranasal Azelastine-Fluticasone dipropionate combination treatment
  • Dupilumab for patients with aspirin-exacerbated respiratory disease

Important Considerations

  • Patients with diabetes should monitor their blood glucose levels closely during treatment, as steroids can temporarily increase blood sugar.
  • Patients should be aware of the potential short-term side effects of treatment, such as increased appetite, mood changes, and insomnia.
  • Regular follow-up with a healthcare provider is necessary to monitor the effectiveness of treatment and adjust the treatment plan as needed.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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