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Eustachian Tube Dysfunction

(ETD; Barotitis Media; Barotrauma; Ear Popping; Pressure-related Ear Pain)
  • 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
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  • 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.
    Factors that may increase your chance of getting ETD include:
    • 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 known as 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:
  • 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, 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.
    • 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.

    American Hearing Research Foundation

    Family Doctor—American Academy of Family Physicians


    Canadian Academy of Audiology

    The Canadian Hearing Society


    Barotrauma. American Hearing Research Foundation website. Available at: Updated October 2012. Accessed September 17, 2015.

    Eustachian tube dysfunction. McKinley Health Center, University of Illinois at Urbana-Champaign website. Available at: Accessed September 17, 2015.

    Eustachian tube dysfunction. Patient UK website. Available at: Updated February 24, 2015. Accessed September 17, 2015.

    General information about nasopharyngeal cancer. National Cancer Institute website. Available at: Updated August 12, 2015. Accessed September 17, 2015.

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