Reciprocal Causal Relationship between Laryngopharyngeal Reflux and Eustachian Tube Obstruction

My own experience in the medical treatment of a lot of patients for 20 years has proved that many cases have both Laryngopharyngeal reflux (LPR) and Eustachian tube obstruction (ETO) at the same time. In these cases, ETO can be a cause of LPR, or, conversely, LPR can be a cause of ETO, and hence it is natural that a concept of a ‘reciprocal causal relationship between LPR and ETO’ emerges from it. A combination like ‘hearing loss’ or/and ‘ear fullness’ or/and ‘dizziness (vertigo) or/and ‘tinnitus’ or/and ‘headache (migraine)’ due to ETO, is regarded as consisting of major symptoms originating from ETO. In addition to nausea, vomiting and perspiration as the common symptoms accompanied by vertigo, any other multiple complaints from LPR or Gastro esophageal reflux disease (GERD) also may be clinical manifestations originating from ETO. Reversely, the fact that LPR can be a cause of ETO also has been proved by recent researches. In conclusion, treating patients regardless in an emergency room or outpatient department, a wide and diverse variety of symptoms and diseases originating from both LPR or GERD, and ETO, has to be considered with the mutual connection observantly. And they should be subjected to the therapeutic test of inflation of the tubes as a first step in a thorough clinical investigation. Ideally normal middle ear cavity pressure with perfectly equal balance between both ears is the core prerequisite before diagnosis and treatment for any symptoms and diseases.