Eustachian Tube Dysfunction
(ETD; Barotitis Media; 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
This condition is more common in children.
Other factors that may increase your chances of ETD:
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
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:
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.
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.
- 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 Hearing Society
Canadian Society of Otolaryngology—Head and Neck Surgery
Barotrauma. American Hearing Research Foundation website. Available at: http://american-hearing.org/disorders/barotrauma. Updated October 2012. Accessed September 27, 2017.
Eustachian tube dysfunction. Patient website. Available at: https://patient.info/health/eustachian-tube-dysfunction. Updated February 24, 2015. Accessed September 27, 2017.
General information about nasopharyngeal cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/head-and-neck/patient/nasopharyngeal-treatment-pdq. Updated August 19, 2016. Accessed September 27, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Marcie L. Sidman, MD Last Updated: 9/17/2015