Brief Answer: not likely for both! Detailed Answer: hello and welcome to health care magic, I am Dr Sriram Nathan, an ENT surgeon and I have an experience of lakhs of patients with Eustachian tube dysfunction but your questioning is very fresh and interesting! Let me try to help you out with your doubts. You must understand that Eustachian tube is a tube which connects the ear to the throat and its main function is to maintain an almost equal pressure with the ear as the atmosphere. You can imagine it to be our pressures valve so to speak. The common symptoms of dysfunction is usually ear block, tinnitus or a sound in the ear and heaviness or headache. Balance is not a function of middle ear which is connected to the Eustachian tube (our inner ear is connected with balance). Nevertheless, in many patients a feeling of heaviness can be easily misconstrued as balance problem. Also rarely an inner ear infection can be present with Eustachian tube dysfunction and this may also cause balance problem although theoretically there is no direct connection. In simple words although there is no direct connection between balance problem and Eustachian tube dysfunction, they may still co-exist. Since our body is not a machine, there can be no absolute so to speak. Valsalva maneuver is the forceful exhalation against a closed mouth and nose. This is a common recommended ENT technique for treatment of Eustachian tube block and dysfunction and is also used in ENT examination. A simple Valsalva maneuver would not cause any direct damage to the ear or any part of the body. However in my experience and also in literature we have seen that if you do a Valsalva maneuver when there is infection in the tube area, there is chance that the infection may spread and also rarely the ear drum may get damaged. So make sure that you do not over enthusiastically do the same and always consult your doctor before you do the same. In my patients with Eustachian tube dysfunction, I would usually recommend another safer maneuver. Swallow after against a closed nose! This is more better and safer and also a very effective maneuver. I am assuming that you have Eustachian tube dysfunction and that why you have these doubts. You can do these for the same: -steam inhalation with menthol or any other vaporiser at least three times in a day for a week or so -the maneuver which I described above -take a course of antihistamine like levocetrizine. Your doctor will know about this -if you have respiratory infection, you must take the proper medication for the control of the same in consultation with your doctor. Hope this helps, I have tried not to be too technical. If you have any more doubts you can get back to me and I shall answer with pleasure regards Dr Sriram Nathan

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