Eustachian Tube Dysfunction
(ETD; Barotitis Media; Barotrauma; Ear Popping; Pressure-related Ear Pain)
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.
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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
Factors that may increase your chance of getting ETD include:
- Age: Children
Nasal congestion from an
other upper respiratory infection
- 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 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 known as vertigo
- Symptoms that cannot be relieved by swallowing, yawning, or chewing
- Pain if the blockage results in an infection
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your ears will be examined. If your case is severe, your may need to see an otolaryngologist, a doctor who specializes in ear disorders.
You may have tests done on your ears. This may include:
To deal with ear clogging, discomfort, or pain, you can try:
- 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
If the symptoms do not go away within a few hours or are severe, your doctor may recommend the following medications:
- Nasal or oral decongestants
- Oral antihistamines
- Nasal steroids to relieve nasal congestion and enable the eustachian tube to open
- Pain medications such as acetaminophen
In rare cases, a
may be necessary. The doctor makes an incision in the eardrum to allow the pressure to equalize and the fluid to drain.
To help reduce your chances of getting ETD, take the following steps:
- Treat allergies as advised by your doctor.
- Avoid flying in an airplane or going scuba diving if you have allergies or a cold.
- 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.
American Academy of Family Physicians http://familydoctor.org
American Hearing Research Foundation http://www.american-hearing.org
Canadian Academy of Audiology http://www.canadianaudiology.ca
The Canadian Hearing Society http://www.chs.ca
Barotrauma. American Hearing Research Foundation website. Available at:
. Updated October 2012. Accessed September 13, 2013.
Eustachian tube dysfunction. McKinley Health Center, University of Illinois at Urbana-Champaign website. Available at:
. Updated March 24, 2007. Accessed September 13, 2013.
General information about nasopharyngeal cancer. National Cancer Institute website. Available at:
Updated June 21, 2013. Accessed September 13, 2013.
Eustachian tube dysfunction. Patient UK website. Available at:
. Updated March 15, 2012. Accessed September 13, 2013.