Eustachian Tube Dysfunction
(ETD; Barotitis Media; Ear Popping; Pressure-related Ear Pain)
Eustachian tube dysfunction (ETD) is when the tube does not open when swallowing or yawning. This tube connects the middle ear to the back of the nose and upper throat. Its purpose is to equalize air pressure in the middle ear with the pressure outside it. This does not happen with ETD.
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ETD happens when the eustachian tube is blocked or not working as it should. Causes may be:
- Tiny hairs inside the ear are not able to remove fluid and infection
- Poor squeezing function within the eustachian tube
- A narrow tube—in infants
- Adenoid tissue is blocking the tube—in children
- Swollen nasal passages that cause a blockage
- Tumors—in adults
ETD is more common in children. Other things that may raise the risk are:
Problems may be:
- A feeling of fullness or clogging in the ear
- Discomfort or pain in the ear
- Hearing loss
- Ringing in the ear
- A feeling of spinning when standing still
- Problems that are not eased by swallowing, yawning, or chewing
The doctor will ask about symptoms and health history. A physical exam will be done that will focus on the ears. Hearing tests may be done.
A doctor who treats the ears, nose, and throat may need to be seen.
Most people get better without treatment. Things like swallowing, yawning, or chewing may help ease pressure.
People who do not improve or have severe symptoms of ETD may need treatment. The goal of treatment is to ease pressure. Medicines may be given, such as:
- Pain relievers, such as acetaminophen or ibuprofen
- Oral antihistamines to ease allergies
- Decongestants to make the nose less stuffy
- Nasal steroids to ease congestion and swelling
Rarely, people who are not helped by these methods may need a myringotomy. An incision is made in the eardrum to let the pressure equalize and fluid drain.
Managing things like allergies and colds may lower the risk of having ETD.
The risk may be lowered when traveling by plane by:
- Swallowing often, such as by sucking on hard candy, chewing gum, or drinking water
- Breathing in and breathing out while holding the nostrils and keeping the mouth closed while the plane takes off and lands
- Wearing earplugs that equalize pressure in the ears
- Eustachian tube dysfunction. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/eustachian-tube-dysfunction.
- Nasopharyngeal cancer treatment (Adult). National Cancer Institute website. Available at: https://www.cancer.gov/types/head-and-neck/patient/adult/nasopharyngeal-treatment-pdq.
- Otitis media with effusion (OME). EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/otitis-media-with-effusion-ome.
- Schilder, A.G., Chonmaitree, T., et al. Otitis media. Nat Rev Dis Primers. 2016; 2: 16063.
- James P. Cornell, MD
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