Eustachian Tube Dysfunction

What is the Eustachian tube and what does it do?

The Eustachian tube is a narrow tube that connects the middle ear with the back of the nose. In adults it is about 3-4 cm long. The middle ear space behind the eardrum is normally filled with air. The air in the middle ear is constantly being absorbed by the cells that line the middle ear. So, fresh supplies of air are needed to get to the middle ear from time to time.

The Eustachian tube is normally closed but opens from time to time when we swallow, yawn or chew. This allows air to flow into the middle ear, and any mucus to flow out. This keeps the air pressure equal either side of the eardrum. Having equal air pressure on each side of the eardrum, and the middle ear free of mucus, enables the eardrum to work and vibrate properly which is needed to hear properly.

What is Eustachian tube dysfunction?

Eustachian tube dysfunction (ETD) means that the Eustachian tube is blocked or does not open properly. Air cannot then get into the middle ear. Therefore, the air pressure on the outer side of the eardrum becomes greater than the air pressure in the middle ear. This pushes the eardrum inward. The eardrum becomes tense, and does not vibrate so well when hit by sound waves.

What are the symptoms?

The main symptom is a blocked ear or muffled hearing. You may also have ear pain because the eardrum is tensed and stretched. Other symptoms that may also develop include: a feeling of fullness in the ear; tinnitus (ringing or buzzing in the ear); dizziness. One or both ears may be affected.

Symptoms can last from a few hours to several weeks or more. It depends on the cause. In most cases due to a cold (the common cause – see below) the symptoms are likely to go within a week or so. As symptoms are easing, you may get popping sensations or noises in the ear. Also, the dulled hearing may come and go for a short time before getting fully back to normal.

What are the causes of Eustachian tube dysfunction?

  • Colds and other nose, sinus, ear or throat infections

  • Middle ear infection (otitis media)
  • Allergies
  • Blockage at back of nose – nose cancer or adenoids

What is the treatment? 

  • Nasal endoscopy to exclude nose cancer or adenoids blocking the Eustachian tube opening.
  • Try to get air-flow into the Eustachian tube by yawning, “popping the ears” (the Valsalva maneuver), or swallowing
  • Decongestant medication, sprays or drops
  • Steroid nasal sprays for allergies or sinus infections
  • Antibiotics for sinus infections
  • Balloon dilatation