What is a Eustachian tube?
You have one in each of your ears. The Eustachian tube connects the middle ear, the part behind your ear drum, to the pharynx, the back of your nose and throat. Usually it is closed but when you swallow, sneeze or yawn the Eustachian tube opens naturally and helps prevent air pressure and fluid from building up inside your ear
Symptoms of Eustachian tube dysfunction
ETD symptoms vary from person to person, but you may have one or more of the following:
- Muffled hearing or hearing loss
- Your ears may feel blocked or ‘full of water’
- A clicking, popping or tickling sensation in your ears
- Ringing in your ears, known as tinnitus
- Pain or tenderness in one or both ears
- Trouble keeping your balance, or dizziness
Your symptoms may last from only a few hours to several days or longer, depending on the cause. They may be mild or severe and may worsen when you move up or down, for example: flying in planes, climbing several flights of stairs, riding in a lift, travelling up hilly roads, or diving underwater.
Causes of Eustachian tube dysfunction
ETD is relatively common and may happen for a variety of reasons.
The most common cause is an inflammation of the Eustachian tube, which leads to a build-up of mucus or fluid. This can be from something as simple as a common cold or the flu. Sinus infections, seasonal allergies and hay fever can also affect the Eustachian tube. As you recover from your cold or flu, your hearing should return to normal and the symptoms of ETD should go away, although it can take up to a week after your cold is gone for all the mucus to dissipate.
Changes in altitude may also contribute to ETD symptoms. If you are on a plane, you may notice they worsen as the plane ascends or descends during flight. However, the symptoms should go away after you touch down again. Please read Can I fly with Eustachian tube dysfunction? below.
Symptoms of ETD which are caused by illness or infection may be more persistent. If you have had symptoms for more than two weeks, please consult your doctor.
Who is more at risk of Eustachian tube dysfunction?
Many people will experience ETD occasionally and it will pass with minimal effect on your life and without any cause for alarm. However, some people are likely to get symptoms more regularly:
- People with allergies. More persistent allergies or conditions that affect the nose, such as persistent rhinitis, can cause more mucus and increase the chance of congestion.
- Children. Their tubes are smaller than an adult’s, so germs can reach the middle ear more easily. Also, a child’s immune system is not yet fully developed, which can mean they are more susceptible to infections.
- Smokers. Smoking damages the tiny hairs that help direct mucus from the middle ear into the back of the nose and so mucus can build up in the tubes. Smoking can also cause the tissues at the back of the nose and throat, including the adenoids, to enlarge and block the Eustachian tubes.
- People who are greatly overweight. Being obese can lead to fatty deposits around the tubes, also causing a mucus build-up and a greater chance of ETD.
Treatment for Eustachian tube dysfunction
Symptoms of ETD may go away without any need for treatment and there is plenty you can do to help yourself.
Swallowing, yawning, chewing gum or sucking on a sweet can open the tubes and relieve symptoms and discomfort. This is especially the case when in a plane that’s taking off or landing. You can also take a deep breath, pinch your nose, and blow hard with your mouth shut.
Babies with ETD symptoms can be helped by feeding them milk or giving them a dummy, which encourages the swallow reflex and opens the tubes. Children with ongoing ETD symptoms should be taken to a doctor, as the symptoms can be similar to, or mask, a more serious ear infection.
Your ETD can be relieved with a decongestant or antihistamine. Your doctor or pharmacist will be able to advise you. For more severe, persistent or chronic ETD (lasting more than two weeks), please consult your doctor. They may suggest other medical procedures. Please read Can surgery help Eustachian tube dysfunction? below.
Flying with Eustachian tube dysfunction
If you have or are prone to ETD, flying can be a pain in the ear. As the plane ascends or descends, air pressure in the cabin changes and if you can’t equalise the pressure difference between in your middle ear because of ETD, you will likely get earache.
Simple solutions include sucking a sweet, yawning, chewing gum or holding your nose and blowing with a closed mouth.
The following will also help with most instances of ETD:
- Nasal decongestant sprays
- Saline sprays
- Steroid sprays
- Ear plugs
However, please be aware that there may be a risk of middle ear damage (and possibly inner ear damage, in severe cases) if you fly with ETD and cannot adequately clear your Eustachian tubes to equalise the air pressure in your ears.
Surgery for Eustachian tube dysfunction
Can surgery help Eustachian tube dysfunction?
Yes, surgery may be a solution to chronic or severe ETD. It can restore your hearing, relieve any feeling of pressure or blockage in your ears, and reduce the likelihood of repeated infections. Your doctor will recommend the appropriate course of treatment.
What types of surgery are there?
Surgery to relieve ETD involves making a small incision in the eardrum and removing fluid in the middle ear. Any swelling in the Eustachian tube usually decreases to normal. This procedure is called myringotomy.
Pressure equalisation tubes can be inserted, if needed. The operation follows the same process, but a tiny hollow tube of plastic or metal is also inserted into the incision. This is slowly expelled as the eardrum heals and provides relief for up to a year.
Patient outlook for Eustachian tube dysfunction
ETD is common and most times will resolve itself without the need for medical treatment. The best way to avoid repeated ETD symptoms is to treat the underlying cause. If you are experiencing repeated, chronic or severe ETD symptoms, however, please consult your doctor.
FAQs
- Muffled hearing or hearing loss
- Your ears may feel blocked or ‘full of water’
- A clicking, popping or tickling sensation in your ears
- Ringing in your ears, known as tinnitus
- Pain or tenderness in one or both ears
- Trouble keeping your balance, or dizziness
It varies from person to person and depending on the cause. Symptoms may last from only a few hours to several days or longer. If symptoms last more than two weeks, consult your doctor, and sooner if it is a child or baby with symptoms.
It is more likely to be successfully created with medical help, so please consult your doctor. Weight loss, dehydration, caffeine and pregnancy can all contribute towards PET.
Yes, in most cases. If it’s caused by a cold or flu, the symptoms will diminish as you recover. If it’s caused by a change in altitude, you will feel better when you land again (in the meantime, try sucking a sweet).
Simple actions such as yawning, chewing gum, sucking a sweet, swallowing or pinching your nose and blowing out with your mouth closed will help. For more persistent symptoms, you can take over-the-counter pain relief, as suggested by your pharmacist. Nasal sprays also help alleviate the symptoms.
