Medical News Today: Eustachian tube dysfunction: Causes, symptoms, and treatment

The eustachian tube runs from the middle ear to the back of the nose and throat. If this tube becomes plugged or infected, it can cause eustachian tube dysfunction.

There are a few different causes of eustachian tube dysfunction (ETD), and certain factors may make a person more at risk. Eustachian tube dysfunction is often easily treated at home, although persistent symptoms may require a trip to the doctor for treatment.

What are the eustachian tubes?

eustachian tubes
The eustachian tubes (red tube at the back of the ear in diagram) drain excess fluid and regulate ear pressure.

The eustachian tubes are canals on each side of the face that run from the back of the nose and upper throat to the middle ear. They remain closed most of the time but will open as a person swallows, chews, or yawns.

The eustachian tubes help regulate ear pressure and drain excess fluid from the middle ear, moving it to the throat to be eliminated.

The canals in these tubes are tiny so blockages can happen for many reasons. Blocked eustachian tubes can cause discomfort and hearing problems, and any of these symptoms can be referred to as ETD.

What causes ETD?

ETD covers a broad range of symptoms and has a range of potential causes. Season allergies and illnesses that create inflammation in the area, such as the flu or cold, are common causes of ETD.

Sinus infections can also trigger ETD, as a sinus infection causes the eustachian tubes to become inflamed or filled with mucus. More serious infections can cause ETD as well.

Simple changes in altitude or air pressure may also trigger ETD. Driving up a mountain or sitting in a plane can cause ETD, and even just riding the elevator in a tall building may be enough for some people to develop unpleasant symptoms.

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Risk factors

scuba diving
ETD symptoms may be triggered by scuba diving and high altitude hiking.

It is common to experience ETD occasionally, but some people get symptoms more regularly than others. People who smoke may be more at risk for experiencing ETD, as smoking damages the delicate hairs in the throat and middle ear.

People who are obese may also be more likely to experience ETD symptoms. This is because fatty tissue deposits can form around the eustachian tubes, making it more likely that they will become closed off.

People with allergies may also experience ETD more often, as allergies can cause increased mucus and congestion.

Engaging in certain activities may also put a person more at risk for pressure changes, which could trigger ETD symptoms. These activities include things like:

  • hiking at a high altitude

  • rock climbing

  • skiing or snowboarding

  • scuba diving

Children are also more at risk for ETD, as their eustachian tubes are much smaller and so more likely to become clogged by mucus or germs. A child’s immune system is also less able to fight off infections, as it is not fully developed. Children have more frequent colds and sinus infections, which are direct causes of ETD.


Symptoms of ETD can vary from mild to severe and may be different for each person. Common symptoms include:

  • a plugged feeling in the ears

  • ears feeling like they are filled with water

  • tinnitus, or ringing in the ear

  • muffled hearing or partial hearing loss

  • ticking or popping sounds

  • pain and tenderness around the ear

  • a tickling or tingling sensation

  • trouble with balance

The length and severity of ETD symptoms depend on their cause. For instance, if ETD is caused by a change in altitude, these symptoms will often go away as the body adjusts to the pressure or reaches a lower altitude.

On the other hand, ETD caused by an illness or infection can last much longer. Anyone with symptoms of ETD that last more than 2 weeks should see a doctor. Children with symptoms of ETD should see a doctor sooner, as the symptoms of ETD are similar to an ear infection.


ETD is often easily diagnosed during a visit to a doctor. The doctor may ask questions about hearing changes, pain in the ears, or feelings of pressure. They will also look inside the ear using an otoscope, checking for any signs of infection or blockages.

If ETD is being caused by another illness or disorder, the doctor may ask questions about that as well in order to determine the correct treatment.

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The symptoms of ETD will usually clear up on their own. If another illness is causing the symptoms, they will resolve once the underlying illness is treated.

Home remedies

lady putting a piece of chewing gum in her mouth
Minor ETD symptoms may be treated by forcing a yawn or chewing gum.

If the symptoms of ETD are bothersome, some simple home remedies may help. Minor ETD symptoms, such as those caused by a change in altitude or air pressure, can be treated by chewing gum or forcing a yawn.

Many people also find that the symptoms of minor ETD can go away as they swallow, so drinking or having a snack may help. These remedies help open and close the eustachian tube and relieve the pressure.

Children experiencing minor or temporary ETD symptoms can eat a snack or chew a piece of gum. Giving an infant a bottle or pacifier may help relieve the symptoms.

Minor to moderate symptoms may be relieved using a saline nasal spray or irrigation system. Sometimes dried mucus or other particles can get stuck in or near the eustachian tube and cause symptoms. Clearing the passageways can help eliminate anything clogged in the passage.

Ear candles

Despite what many ear candle manufacturers say, the U.S. Food and Drug Administration (FDA) has found no valid evidence that ear candles will help clear symptoms of ETD. Ear candles are not a recommended treatment for any ear-related symptoms.

Over-the-counter medication

Depending on the cause, some over-the-counter drugs may help with ETD symptoms. Someone who experiences ETD caused by allergies may find relief using antihistamines such as cetirizine (Zyrtec), diphenhydramine (Benadryl), or loratadine (Alavert, Claritin).

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help with pain and swelling.

Medical intervention

If the symptoms of ETD are caused by a bacterial infection, a doctor will likely prescribe antibiotics. This may be a topical treatment or an oral antibiotic. In severe cases of ETD, a doctor may prescribe oral steroids as well.

Long lasting, severe cases of ETD are not common but can require extensive and sometimes invasive treatments. In some cases, fluids build up behind the eardrum and cannot escape through the dysfunctional eustachian tubes. In these cases, doctors may make a small cut in the eardrum to help with fluid drainage.

People who experience frequent severe ETD may be treated using pressure equalization tubes. These are implants that balance the pressure in the ears and help reduce the chances of middle ear infections. New treatment methods, such as eustachian tube balloon dilation, are also being studied.


ETD is common, but most cases resolve with little or no help. Treating the underlying cause is the best way to treat and prevent recurring symptoms of ETD.

Children or adults who get frequent ear infections should talk to a doctor to consider more thorough treatments.

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