Wow! Thank you, Dr Veer. This is the clearest explanation & diagram I've seen re ETD. Have watched a dozen or more videos that were much more complicated. But your video teaches it so easily that I now can draw your diagram from memory & share the concepts with husband with ETD. Sincere thanks.
Btw: husband sees his ear surgeon, again, in a few days (Chicago area, IL, USA). Since tubes were inserted several years ago, he's had recurrent ear infections & multiple tube replacements when infections cleared (bilateral AND unilateral). Hearing with hearing aids has been drastically reduced, improving briefly, but only til infection recurs. Last month, ear surgeon said there were NO further options. Your video & others will help us to be better informed & ask good questions re the Balloon procedure. Your video is a great public service. Sincere thanks.
I have this problem right now . This video was very helpful except the bit where you said it can sometimes be "life limiting " ! Now I'm a bit scared .
Outstanding presentation. Incredibly clear. And I’ve watched a lot of vids on this topic to understand what an aggressive cold virus did to my Eustachian tube. This illustration is exactly what happened to me. Would love to see a part two that explains the loud ocean noise that came after my drum burst and leaked fluid and a little bit of blood. A few days later, it is now sounds like crickets. My tube still feels very inflamed with head under water. Will try antihistamines to calm things more. Seeing the ENT in three days from now. Thank you for the vid!!!
Great video. I have this problem. Would rather see you narrate. Can I get the ballon procedure done In Australian? I have tried everything. I have severe hearing loss and seen many specialist. Also had one grommet. Appreciate any advice. Thank You 🙏🏽
Doctor can we expirience ringing in our ears due to this issue? I can feel like there is some fluid in my ears and I am hearing ringing in my ear otherwise my hearing is perfect.
Tinnitus is one of the signs of eustachian tube dysfunction (please see the ETDQ7 questionnaire). Difficult to know why it causes tinnitus, but the ideas are that it distorts the sound enough to cause tinnitus, or leads you to focus on your ear so much that tinnitus becomes more likely.
@@VikVeerENTSurgeon I’m having excruciating pain especially at night, sharp stabbing pain, any treatment you know of for this? I can’t sleep, I’ve seen so many Drs and only one said mild Eustachian tube dysfunction but never game me a remedy. I’m going nuts with what feels like a very full ear, its one of the worst pains I’ve ever felt. Please help 😢
Using the balloon dilation in ET does mean a permanent cure? Or do the patient need to return to the doctor in a scheduled basis? Also, I have this clicking/popping sound everytime I swallow. When I try to yawn, there is no clicking sound when I swallow but the moment I do the next swallow the sound return. There is also a time when there is no clicking sound, but the moment I ate my food the clicking sound returns. I do not feel any pain and no fullness, just this annoying clicking sound.
Very helpful video doctor, but my ear is clogged for almost 3 years now and I tried every way to unclog it but nothing helped, I think I have a strong blockage on the Eustachian tube because I bought a device that is called earpopper and it didn’t help, any advice I would be thankful
My right ear has been quieter than the left with a full feeling for almost 3 years. Saw 2 ENTs, 2 audiologists. Both hearing tests were “ fine”One ENT said it was ETD and wanted to put in tubes but wouldn’t answer my questions. The other ENT said it was TMJ causing the problem. Sometimes my ear drains a minor amount of fluid. I also have a Deviated septum, on the right which keeps my nose plugged up on that side. Neither of the ENTs said that would cause the problem. I wish I knew what I could do. Been dealing with this way too long
It's really hard when you have a conflict of opinions. I would try an otovent balloon and then see if this helps. Also speak to a MaxFax surgeon who specialises in TMJ, and seek their opinion.
I have been in pain with what the doctors call ETD for quite some time. The pain at the moment is excruciating. I cried into a bowl of steam the other night :'(
Too bad I am not in UK... I learned from this video, thank you Dr. Veer. Sounds like I have had this condition for 3 days. But, in Calgary, Canada, it will take me three weeks to see my GP (in order to get a referral to see an ENT, the wait time which will take months). So, in addition, I stopped in at a General Hospital. After a seven hour wait (and I do understand that this is not an emergency) the Resident physician inspected my ear canal and told me that I have no infection. And to see my regular doctor. See notes above. I am pretty sure thus this is a eustachian tube problem because my symptoms match. But I am not going to self-treat without a professional diagnosis.
Wow ever since my pregnancy my ears would get plugged up and I’d have to hold my nose and blow a little to release the pressure and clear my hearing way but it would only give me a couple of seconds of relief 😮💨 but it comes and goes almost daily I don’t know why I didn’t consider going to see a doctor about it and I had no idea how much damage it could potentially cause if left untreated
Hi doc. Do these symptoms match with ETD? I have also filled the ETD questionnaire. - Amplified popping / crackling in both ears when swallowing saliva or water. - High pitched ringing in one ear. - Sometimes my Tinnitus-ear feels stuffy even though nothing is present. - Chronic Postnasal drip - Urge to cough after drinking milk.
I also have a similar issue, when I went to the doctor they did a Tympanometry test, and pressure was more in the affected ear than the other one. they gave me medicine like saline nasal drops and advised me to take steam every day. but it didn't help me much. I tried salt water sinus flush then it helped me a bit to balance the pressure in the ear. I am sure when you will do the Tympanometry test you will have a completely different view of what is happening in your ear. try this it might help - www.healthline.com/health/sinus-flush#how-to
Thanks for the reply - I'm afraid that Healthline doesn't work in Europe. But if the tympanometry is different then that is a very good test. If it is not positive however, you could still have this problem.
@@VikVeerENTSurgeon thank you for replying, I am waiting for my doctor to perform ETD dilation but due to covid its getting delayed. for now I tried sinus salt water flush which is basically drinking salt water from nose and throwing out water from mouth. it did help in pressure relief.
Can a displaced disc in the TMJ give the sensation of a blocked ear? And if the TMJ disc is displaced, would that mean the eustachian tube balloon dilation treatment wouldn't help?
Hi doc! Thanks for this video It’s recently come to my attention that I’ve been suffering tinnitus for quite a while. I’ve always had issues with my ears since I was a kid, but it’s just now I’m starting to realize that I have a condition that not many people have. After some research I’ve realized it can be dude to my ET being blocked/unpressurized properly. - ears crack/pop all the time - I can make them crack/pop on command - constant tinnitus Could it be due to my tinnitus?
@@VikVeerENTSurgeon thanks for the input. Would you say I’m suspected of having etd? My ENT is being lazy I feel. Just did a CT scan & said one side of my sinuses is slightly inflamed most likely due to my deviated septum. Then just gave me a nasal spray called dymista. Should I seek another ent?
If unable to “pop” the ears with holding your nose, filled cheeks with air trying to press it through ears doesn’t work does that indicate a eustachian tube dysfunction? Also, can this dysfunction be effected by blockage of the osteomeatal complex? And can a dysfunction like this cause pain in upper mouth and teeth pressure? And cause pain while lying down? And when waking up, even after a quick nap have the feeling of something being mashed/broken with a lot of pressure inside the sick side?
Hi doc can allergic rhinitis be the cause of ETD? I have been diagnosed lately with allergic rhinitis but I don't have the typical symptoms of AR such as runny nose, or watery eyes. My symptoms include annoying tinnitus, dizziness and loss of balance.
Such a good video! However now I feel that this isn’t what I have going on at all. I’ve been suffering with distortion in my right ear ever since I can remember, but only when the sound is loud or if there is other noise around. For example, listening to a song in the car but their being road noise. It isn’t painful just very annoying. I’ve been out with friends in the past and had to put ear plugs in to stop the distortion due to the music. I remember my mum taking me to ENT when I was younger and they did a hearing test which was fine, but this was more than likely because the sounds did not become distorted. I also have large nasal polyps in both nostrils which I thought were normal until someone else pointed them out (sounds ridiculous I know!!). They’ve never really caused me any problems, however I sometimes wake up in the mornings, sit up, and my nose is running like a tap!! It’s soo frustrating and I feel like regardless of all of the go visits that I’m just not getting anywhere. I don’t suppose you have any ideas or advice?
The distortion of music could be auditory processing disorder or diplacusis, hard to tell without lots of tests. Treatment for polyps is generally easy, chemical polypectomy, with nasal spray, and if that doesn't work surgical polypectomy with FESS and then nasal sprays.
I have a problem with hearing loss mostly in left ear but tinnitus and hyperacusis in both. My own voice vibrates inside my ears but varies in severity. My hearing also gets distorted with another sound and my voice. My own voice often seems to close my nasal passages; vibration? I also have bruxism, worn & cracked teeth with a possible TMJ, eustachian Tube issue? My ears feel full with slight pain. Others voices sound normal but my own voice is distorted in my own hearing; any thoughts?
Hello doctor, can Etd cause symptoms like dull/distorted hearing and noise sensitivity? I’ve been having these symptoms for weeks now accompanied by ringing that responds to noise and mild lightheadedness
Hello doctor, I have had a blocked Eustachian tube since 2018, but I have never had otitis media, what does that mean? is it possible that it is blocked without having otitis
Idk if mine did or not I smoked weed everyday for pretty much 4 years and my ears started acting up. Now I quit smoking in general cause I always deal with constant pain plus I can't handle the surround sound of head phones and ear buds
I think it can by giving you sinusitis quiker. And you may never 'heal' because the smoking keeps things inflammed? I am also a smoker (cigarettes) and currently dealing with this for 1 week now.
I woke up about a week ago and my left ear was clogged, sound distorted, and was having tinnitus. Doctor said I had pretty significant hearing loss in that ear and started me on prednisone. Could something like this lead to permanent hearing loss? And is there anything else I can do at home to try to get my hearing back to normal?
Your doctor thinks you have sudden sensorineural hearing loss, which can lead to permanent hearing loss. do make sure you have a hearing test and you might need a few spaced a few weeks apart to make sure you are getting better. The evidence for treatment is very sketchy, but it makes sense to take multivitamins, drink plenty of water and see an ENT surgeon.
I'm thankful that you shared this information. Is the mucus that is formed ear wax or something else? I can pop my ears, in fact I do it very often now. My right ear has been muffled for at least 2 years now. The problem is, when I pop my ears, they open & for a brief moment I can hear clearly out of my right ear, but it immediately muffles again. I had tubes in my ears as a child & unfortunately they removed my tonsils. I'm hoping to fix this not only to be able to finally hear again but because I believe it caused me to be dizzy, like vertigo, a few times. Note: I just had my doctor clean my ear yesterday & nothing has changed. My hearing in my right ear is still muffled.
Can inflammation in the middle ear cause swelling around the front of the ear (sideburn area) and below the ear? This is the second time I’m experiencing this and last time I had a fever and was given an IV antibiotics. Both times I drank a milkshake and didn’t think anything of it until last night when I had one the evening before. The first sip through the straw, I had pain in my ear, same ear as last month. It’s red also where it’s swollen. I’ve a history of ear infections.
Ear infections can do this, but honestly it sounds more like a parotid stone / infection. See your ENT doctor ASAP. Standard advice is to drink lots of water and avoid caffeine and alcohol (or anything that dehydrates you). They might advise antibiotics, scans etc.
Can adults have ETD that can go undetected for most of their lives until they develop an upper respiratory tract infection? Is it also possible to get an ear infection with hearing that fluctuates after the infection?
In ETD, I can visualise the end of the Eustachian tube with a nasendoscope. I was wondering how rare are tumours within the Eustachian tube. Are there any particular symptoms of which we should be aware?
I don't think i've ever heard of a case - so it must be quite rare. fullness sensation, bleeding from the tube (nose and ear) and symptoms of ETD? just guessing.
will hearing come back after a ear infection has cleared and the Eustachian tube has expanded again? or could hearing still be not improved after the tube has opened? or is there a time frame this has to be resolved in after a ear infection? I'm on day 10, on second dose anti biotics and ear infection pain and swelling has now gone (according to my GP who checked my ear a few days ago) BUT my hearing has not come back and i am also getting tinnitus. This is effecting my anxiety and mental health not knowing if i have permanently lost my hearing or damaged it or if it will ever come back, how soon? any advice would be great Thank you.
My right ear is ringing and feelings fullness in ear while yawning all the time ..sometimes yawning is abnormall 7-8 times in a minute ...i got swollen lower parts of ears and jaw ...what should i do ?
doctor i have an issue with my left ear when i talk loud or hear some random loud noise like my dog barking my left ear pops no pain just annoying and clue?
difficult to say without seeing you. if you can bring on this noise at will, do it whilst someone experienced is looking at your eardrum. if they see it move, then you might have this problem.
@@VikVeerENTSurgeon yeah i got a perforated eardrum is that it? is it not etd? it doesn’t hurt ear feels full, watery feeing it’s just so annoying every time i hear a loud sudden noise my ear pops to the noise
I think it is extremely hard to have symptoms of ETD with a perforation. It is more likely to be due to the perforation. I would still see someone who is a good otologist.
When i drink yawn eustian tube does not open it does nit pop i steam it does not work sometime i cant hear rarely it open its getting worser left ear hearing muffled. How can ent test for tube dysfunction also i have nose probkem too my nose get severly blocked i think that affect the eustian tube
Hello doctor, awesome explanation, I have a question please! My left ear has been making a clicking sound whenever i hear something, it feels a little bit full and sound on it is a little distorted/muffled. When i visited the doctor he only inspected me by looking at the inside of my ear with his eyes and told me it's just stress, hasn't said anything about etd. Can etd be inspected only with eyes? Every time i hear something or someone talks to met it makes this clicking sound at the end of the sound and i feel a bit of jerk movement inside it, like a small muscle spasm. thank you!
Both my ears have had a full sensation, feeling as though there is a fluid stuck somewhere in them following a sinus infection in November. I have been suffering with vertigo and a lack of balance ever since. I wanted to know if this is a sign that I have ETD?
In addition to this, I haven’t had much loss in hearing although i do experience clicking in the ears at times. I have been prescribed 3 sets of antibiotics which hasn’t done a thing and im currently taking Dymista nasal spray which i am not noticing any differences. I just wanted to get some advice from a professional as I feel as though I have been shrugged off by my gp for months :(
Vertigo is not a symptom of ETD, but dizziness or imbalance is. Ask someone to look at your eyes when you have these symptoms and if your eyes are involuntarily repeatedly darting from left to right, then you have vertigo. If you have this, you ought to get checked out immediately.
Sounds like you aren't getting better, ask your GP for a referral to your local Otologist (ear doctor). It doesn't sound like a classic example of ETD, so be prepared to have investigations for other conditions as well.
@@VikVeerENTSurgeon I have the feeling like I am moving at times, but my eyes don’t move so I’m assuming its dizziness or imbalance. I have been referred to an ENT by my gp so I hope I can get a solution soon🤞🏾
Would greatly appreciate a response, Doctor. I am experiencing reverberations in my left ear when I hear dogs barking. It has gotten to the point where I am anxious and upset because I live in a neighborhood with a lot of dogs. The reverberation is like a bubbling sound that ends within seconds of the ceasing of barking. I have yet to get an appointment with an ENT specialist arranged. Thank you.
I'm afraid that I've not heard this before with tinnitus or eustachian tube dysfunction. It does not sound very ear related to me, but I agree getting checked out by an ENT surgeon would be prudent.
Distorted sounds can come from lots of different causes - most of them are due to abnormal processing of sound in the brain / auditory cortex. I would get completely checked out by a team of audiologists / neurologists / psychiatrists / ENT
Hello Anthony, How are you doing now? I have a “vibration” in my left ear with certain sounds like airplane rumbles or certain cars. I also had distorted hearing like a “rumble vibrating” with like in the shower. I got all this from ear inflammation which left me with Tinnitus and Hyperacusis.
Hi Dr, Veer, thanks, I have the ETD problem, but I'm wondering which potion is the best Balloon or Grommets tube, please? I think the Grommet tube is not a long-term solution! But the balloon dilation catheter tool doesn't have the suction ability, After 2 min still fluid and glue remains inside the middle ear? whoever invent this Ballone dilation tool, did not think about the suction capability that's a pity isn't Dr?
I believe I had this in both ears both my ears feel blocked most of the time they also crack and pop alot even when opening my mouth. What treatment is there for ETD ?
It's not a rule, it would be desirable. Occasionally I have to make the decision to go ahead and operate if it seems the ear is always infected. On saying that however, chronically discharging ears often won't get better with a simple ear drum repair, they often need a mastoidectomy as well. You need to clear the infection before you can hope for the ear to heal.
Hi Doctor yes I'm having the same symptoms I feel pressure in my face bothe ears feel plugged up and my nose feels dried up I'm drinking alot of water and some wellness products I'm guessing it's from the cold as well do you think I need to see an ear doctor?
I have bubbling and gurgling in the ear, and wondering if it has anything to do with this tube being blocked. It doesn't happen all day but it happens every day for various amounts of time. Any suggestions please ?
Probably, very difficult to answer this one unless you are seen by a good ENT/otologist surgeon. . Try this - when you pop your ears (pinch your nose and blow hard until your ears go pop), do your symptoms resolve for a short while? If so, then you might have ETD - go checked out.
@@VikVeerENTSurgeon At first both the ent consultant and the ent doctor thought it was Meniers but now they are not too sure. It's been going on for over a year !
@@davesfilmingservices4377 Dave: I'm afraid I'm in for the same "run around" from doctors who can't solve what I have. How long will I suffer undiagnosed and untreated?
My hearing has experienced a need to ask my GP to examine my ears but she found nothing that she could diagnose. But whilst my right ears "pops" with squeezed nose pressure, the left ears takes longer with more of a "squelch" sort of sound/feeling. My hearing seems OK using headphones to watch home entertainment but the fullness experienced on occasions suggests a problem with the eustachian tube on the left especially? Could I be correct and - if so, what - and how to treat it?
I feel heaviness, tinnitus at times and pain while yawning or burping since 2 day I tried Valsalva and it helped reducing the pain what shall I do next? It's a lockdown in my country
I have lpr. That my doctor said lpr reached the nose and ET So i have now tinnitus some days my ear collect fuild then drained some times only feel drops and it drained but still have T for 3 months hoow to treat that aloso my sinus was inflamed because of lpr
Great video Dr. Veer ...I am not sure if this is my issue? I feel slightly off balance all the time. I cant seem to pop my left ear...also when I do the Valsalva Technique I can still hear the air in my left ear even after taking my fingers of my nose. When I swallow the air sound goes away. My balance is also restored for a minute or so. I think my ET is not opening correctly and I also have nasal polyps in that left sinus and a deviated septum to the right. Also when I do a Neti Pot wash or have a steamy shower the tinnitus I have goes very quiet then slowly comes back over the day and again my balance is restored for a small while. Anyone else have this set of symptoms? Thanks in advance :)
I got the grommets last summer in my right ear just to see if it would help since I have etd in both ears and it didn’t help. I feel like my Eustachian tube is swollen but I was never given any drops to help
In these situations I do an MRI (I normally do it before treatment actually), as the swollen feeling could be from something else. ask to be seen again and try and get this sorted. Good Luck!
My left ear have plugged for 7 months. I have already hearing loss. it doesn't hurt, ı can hear the click sound when trying to open my eustachian tube and it doesn't hurt. My left nose is plugged most of time a day as well ( ım using nasorinse and burazin but there is no change in hearing ) Please help me I don't know what to do. I did go 4 doctors (including professor) and they said that there is no problem :'(
I normally perform a myringotomy to see if the symptoms all go away. I'm sorry you are having such a bad time of it. If you are in the UK, ask your GP to refer you to me, I will be happy to try and help you on the NHS.
Dr. Veer, Thank you for the video. My student and I are conducting NSF-funded customer discovery study on ETD/OME. We would be very grateful if you could have time to talk/zoom with us or if any of your patients have time to talk/zoom with us. We will not take more than 15 min to understand the scope of the problem with middle ear problems. Many thanks!
Can ETD cause retracted eardrums? I have ETD, and I was told by an ENT that both my eardrums are retracting. I pop my ears and the eardrums retract again later. Can it also cause a bulging grey eardrum? Also, is it necessary to have an abnormal CT or hearing test to have grommets or the balloon treatment? My ENT won't do either since both came back normal.
If he is working based on local guidelines, then that would explain his actions. Most people use the ETDQ7, and with retracted TMs, that would be enough for me. I normally do a myringotomy just to be sure Happy to see you on the NHS.
Had grommet surgery a week ago to correct negative pressure on left ear. Not feeling great… ear feels full and now I have a humming noise that only goes away for a few seconds after clenching my teeth or sometimes at random. I am using drops 3 times a day to prevent infections. I have been told by surgeon that all will be good once a finish drops and let things settle. Although, I don’t believe it. Pleas help. I am 42 btw and healthy.
Can this cause regular headaches? I have had sinus congestion & severe headaches for a few years now and and currently I have some symptoms of tinnitus and worsened hearing.
@@VikVeerENTSurgeon Thanks for the reply. No I haven't had a scan yet. I see my GP on Monday so hopefully he'll refer me to an ENT specialist. I'm hoping if I get to the bottom of this it will help with my debilitating headaches!
Hi Doctor, I hope you can guide me. I have been having issues with my ears the last number of years. It feels like they get blocked and I have to try pop them them. When I swallow they pop and can hear clicking noise. It has gradually got worse over the years and eventually when I got a bad ringing noise like tinnitus I went to an ENT. He performed microsurgery as he found a build up of dry skin on my ear drums. I don’t think he knows what’s wrong with me. I had an idea this wouldn’t fix it so I’m now trying to diagnose my own issue. I recently came across an ear popper device which says helps with middle ear and ETD issues? Have you come across my symptoms before? I’m at my whits end with it now so would really appreciate your thoughts! Many thanks Daryl
excess skin in your ear drum sounds like cholesteatoma? perhaps see someone who you trust and get a diagnosis. there are a lot of things it could be, but if you have cholesteatoma, you ought to sort that asap.
I would then use an Ear Popper device or an Otovent balloon which can be bought from amazon. keep using those, and they will eventually solve the problem assuming everything else is normal. it does take a long time though.
For the past 3 years I haven't been wearing headphones cause I have lots of pressure in my head/ears, also whenever I swallow my ears have a crackling noise. I use to smoke weed and now when I try to my ears are in great pain and lots of pressure do you have any idea what it could be Doctor?
Have the same problem as you described for the past year and a half...I was too smoked weed and whenever I tried again I felt also strong pressure and pain. it's a very terrible thing to live with... did you go see a ENT surgeon eventually?
I'm 20 years old and two months ago I had a ETD surgery with balloon but it didn't help me. Doctor said to nose blow 5 times everyday for three months but still I don't recognize any difference. Any advice except grommets?
I had balloon dilation surgery and it improved my ETD. However, months on, the swollen lining of the tube still causes semi-chronic pain and continued tinnitus. Do I wait years for it to heal or do I just keep having balloon dilation surgery over and over; until it’s fixed?
I wouldn't say so, no. If the balloon has dealt with the ETD, then I would not do it again. Did the balloon cause the pain, or did you have this before the operation, I've not heard of this before? You ought to deal with the tinnitus the normal way, and ask your ENT / Audiologist to help you with that.
@@VikVeerENTSurgeon To clarify, it’s not the balloon that caused the pain or tinnitus; that existed before the surgery and was much worse prior to the surgery. I still have ETD; the surgery improved conditions but didn’t cure me of it. The balloon helped the first time - is there any medical reason not to do it a second time?
My apologies, I misunderstood. No reason at all not to do it again. I think I have needed to repeat the procedure a few times for people who partially improve. All but one case has improved to the point they were happy to be discharged.
Doctor I have messaged you before but just wanted to ask I suffer frim eustachian tube dysfunction and really need the balloon dilation, I live in sheffield uk and as soon as I can wish to book and appoinment to see you on the nhs when possible how may I do so?
@@VikVeerENTSurgeon Ive heared grommets can make enustachen tube worse and Ive had this issue for a long time since 2007 my ears make a crackling noise when I swallow, It all started after a scuba diving expedition in 2007 I've lived in agony with it since. After learning about the balloon dilation treatment I was trying to fund the money to have it done with spire with yourself however heard that I can now get the treatment on the NHS with you is this true?
Sorry for not answering earlier - Its hard for me to find comments when they are replies to other comments on this system. I would not say that grommets make eustachian tube dysfunction worse. I have seen no evidence for this statement. ETD after scuba diving is a very common way of getting this problem, however you need to make sure you also do not have barotrauma, and therefore perhaps a grommet is the best advice. Please do not save up money to see me privately, I would ask to see me at Queens Hospital in Romford, I'll do it for free for you there. Only go private if the money is not a problem, it feels wrong to me otherwise.
È un peccato che non hai attivato i sottotitoli, linguaggio globale sotto il tuo, in questo caso limiti molto la visualizzazione a chi non sa l'inglese, peccato la RU-vid permette gratuitamente di tradurlo in tutte le lingue del mondo , Mi ero iscritto al tuo canale perché reputavo il video interessante il contenuto altrettanto ma visto che non hai attivato questa opzione non mi rimane altro che cancellarmi bye
