Definition

The eustachian tube is a small canal that connects the middle ear to the back of the nose and upper throat. Its purpose is to equalize the air pressure in the middle ear with the pressure outside it.

Eustachian tube dysfunction (ETD) occurs when the tube fails to open during swallowing or yawning. This results in a difference between the air pressure inside and outside the middle ear.

Eustachian Tube Copyright © Nucleus Medical Media, Inc.

Causes

ETD is caused by poor function or blockage of the eustachian tube, including:

• Inability of the tiny hairs inside the ear to remove fluid and infection
• Poor squeezing function within the eustachian tube
• Narrow eustachian tube—in infants
• Adenoid tissue blocking eustachian tube—in children
• Swollen nasal secretions that cause a blockage
• Tumors—in adults

Risk Factors

This condition is more common in children.

Other factors that may increase your chances of ETD:

• Nasal congestion from an allergy
• Cold or other upper respiratory infection
• Ear or sinus infections
• Environmental allergies
• Children with large adenoids
• Activities with large, rapid altitude changes, such as flying in an airplane or scuba diving
• Presence of obstructing tumors in the nasopharynx

Symptoms

Symptoms can include:

• Feeling of fullness or clogging in the ear
• Discomfort or pain in the ear
• Hearing loss
• Ringing in the ear
• A sensation of spinning when standing still— vertigo
• Symptoms that cannot be relieved by swallowing, yawning, or chewing
• Pain if the blockage results in an infection

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your ears will be examined. If your case is severe, you may need to see an otolaryngologist, a doctor who specializes in ear disorders.

You may have tests done on your ears. This may include:

• Tympanogram
• Audiogram

Treatment

The following measures may improve clogging, discomfort, or pain:

• Swallowing, yawning, or chewing gum to relieve the pressure
• Clearing your ears by breathing in and then gently breathing out while holding your nostrils and mouth closed
• Blowing up balloons or inflation devices

If the symptoms do not go away within a few hours or are severe, your doctor may advise the following medications:

• Oral antihistamines if allergies are present
• Nasal steroids to relieve nasal congestion and swelling to enable the eustachian tube to open
• Pain medications such as acetaminophen or ibuprofen
• Brief (3 days or less) use of nasal or oral decongestants

In rare cases, a myringotomy may be necessary. An incision will be made in the eardrum to allow the pressure to equalize and the fluid to drain.

Prevention

To help reduce your chances of getting ETD:

• Treat allergies as advised by your doctor.
• Avoid flying in an airplane or going scuba diving if you have allergies or a cold.
• When flying:
  • Use decongestants or antihistamines if you have an allergy or a cold.
  • Yawn or chew gum. Encourage swallowing by sucking on hard candy or drinking water.
  • When taking off and landing, clear your ears by breathing in and then gently breathing out while holding your nostrils and mouth closed.
  • Try special earplugs that slowly equalize the pressure in your ear. These earplugs can be found at drugstores and airports.