Extrinsic Eustachian Tube Compression: due to nasopharyngeal tumor or enlarged adenoid
Mucosal Disease: due to inflammatory etiology, immunologic impairment, or immotile cilia
Seasonal Allergic Rhinitis
Upper Respiratory Tract Infection
Physiology
Eustachian Tube Dysfunction: most important etiologic factor which contributes to the development of acute otitis media
Although descent of the soft palate muscle sling relative to the eustachian tube orifice during adolescence improves eustachian tube patency (and decreases the incidence of acute otitis media with age), poor tubal function may persist into adulthood
Persistent eustachian tube dysfunction results in a relative negative pressure in the middle ear space: consequently, lack of aeration and accumulation of middle ear effusion increase the risk of acute otitis media and otitis media with effusion