Eustachian Tubes

Overview

What are eustachian tubes?

Eustachian (pronounced “you-stay-shee-un”) tubes run from the middle ears to the back of your nose and throat. They’re located on each side of your face. Most of the time, your eustachian tubes stay closed. But when you yawn, chew or swallow, they open. The eustachian tube is named after Bartolomeo Eustachi, the Italian physician who discovered that the tube connected the middle ear to the nose and throat.

Function

What do eustachian tubes do?

Your eustachian tubes have three primary functions. They:

  1. Drain excess fluids and secretions from your middle ear.
  2. Ventilate your middle ear and equalize air pressure on either side of your eardrum.
  3. Protect your middle ear from pathogens (microorganisms that cause disease).

Proper eustachian tube function helps maintain overall ear health, including your sense of hearing.

What is actually happening when my ears “pop”?

If your ears “pop” when you yawn, you’re actually hearing the eustachian tubes open. They do this to equalize the pressure in your middle ear with the outside air pressure.

Anatomy

Where are the eustachian tubes located?

Your eustachian tubes extend from your middle ear to the upper part of your throat, just behind your nose.

What does the eustachian tube look like?

Your eustachian tube is a hollow canal that runs about 36 millimeters (mm) in length. The first 12 mm, nearest to your middle ear, is made of bone. The remaining 24 mm, closest to your nose and throat, is made of elastic fibrocartilage (tough, flexible cartilage).

Conditions and Disorders

What are the common disorders affecting the eustachian tubes?

If your eustachian tubes don’t function properly, it can result in fluid buildup, ear pressure or ear pain. Eustachian tube dysfunction (ETD) may be associated with ear infections. The most common ETDs include:

  • Patulous ETD.
  • Obstructive ETD.
  • Baro-challenge-induced ETD.

Patulous eustachian tube dysfunction

This condition occurs when your eustachian tubes stay open. When this happens, sound may travel from your nasal cavity to your ears, causing you to hear your own breathing or your own voice too loudly. You might even hear your own blood pumping.

Caused by chronic nasal allergies, weight loss, GERD (chronic acid reflux) or neuromuscular diseases, patulous eustachian tube dysfunction is often resolved with nasal drops. Or your symptoms may improve if you drink more water or limit caffeine and decongestants. In severe cases, surgery may be necessary to correct the issue.

Obstructive eustachian tube dysfunction

This condition occurs when your eustachian tubes don’t open properly. As a result, fluid may build up in your ears and you may experience pain or pressure. Many people with obstructive eustachian tube dysfunction experience muffled hearing as well.

Obstructive eustachian tube dysfunction can be caused by environmental allergies, acid reflux, sinusitis or abnormal tissue growth, such as ear tumors. You may be able to ease your symptoms by taking medication and avoiding triggers. Some people might need surgery, which may include balloon dilation of their eustachian tube, adenoid removal, placement of ear tubes or tissue mass removal. Appropriate treatment depends on the cause of the dysfunction.

Baro-challenge-induced eustachian tube dysfunction

This condition is similar to obstructive ETD — it occurs when your eustachian tubes don’t open properly. However, people with baro-challenge-induced ETD only develop symptoms when traveling by airplane, scuba diving, driving through the mountains or engaging in other activities that involve atmospheric pressure changes.

Like obstructive ETD, treatment for baro-challenge-induced ETD depends on the cause. However, research has indicated that balloon dilation of the eustachian tube is highly effective for military pilots and divers with the condition.

What are some common eustachian tube dysfunction symptoms?

If you have eustachian tube dysfunction, you may develop a range of uncomfortable symptoms, including:

  • A feeling of fullness in your ears.
  • Muffled sounds or distorted hearing.
  • Popping or clicking sensations.
  • Ear pain on one or both sides.
  • Ringing in your ears (tinnitus).
  • Balance problems or dizziness.

What are some common tests to check the health of the eustachian tubes?

If you’re showing signs of eustachian tube dysfunction, your healthcare provider will examine your ear drum to see if it’s functioning properly. They may also run tests to measure the pressure inside of your ear.

What are some common treatments for the eustachian tubes?

In many cases, eustachian tube dysfunction goes away on its own. Conservative treatments, such as taking medication and avoiding triggers, are often helpful. Severe or chronic eustachian tube dysfunction may require surgery.

Keep in mind that even though antihistamines and decongestants may work for some people, they can actually make eustachian tube dysfunction worse in some cases. If you’ve had symptoms for longer than a week, call your healthcare provider. They can help you determine the appropriate course of action.

Care

How can I encourage a clogged eustachian tube to drain?

If you have minor symptoms of a clogged eustachian tube, you may be able to clear it with some simple exercises:

Eustachian tube massage

Use your finger to find a bony bump behind your ear lobe. Using firm, steady pressure, slide your finger down until you feel a groove between your ear lobe and jaw. Trace that groove all the way down your neck to your collarbone using the same firm pressure. Repeat this process three times on each side, three times a day.

Valsalva maneuver

Pinch your nostrils, close your mouth and push air out, like you’re blowing up a balloon. Don’t blow too forcefully, however, as you could rupture your eardrum. People with high blood pressure or those at risk for stroke or heart attack should not attempt the Valsalva maneuver.

A note from Cleveland Clinic

Your eustachian tubes help keep your middle ear healthy. Allergies, colds or infections can cause eustachian tube dysfunction, which can lead to pain, dizziness, hearing problems and other issues. Most of the time, eustachian tube dysfunction (ETD) goes away on its own. But if you have symptoms that last longer than two weeks, schedule a visit with your healthcare provider. They can determine the cause of the problem and design a personalized treatment plan.

Last reviewed by a Cleveland Clinic medical professional on 11/15/2021.

References

  • American Academy of Family Physicians. Eustachian Tube Dysfunction. (https://familydoctor.org/condition/eustachian-tube-dysfunction/) Accessed 11/26/2021.
  • Llewellyn A, Norman G, Harden M, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. (https://www.ncbi.nlm.nih.gov/books/NBK262265/) Southampton (UK): NIHR Journals Library; 2014 Jul. (Health Technology Assessment, No. 18.46.) Chapter 1, Background. Accessed 11/26/2021.
  • Szymanski A, Agarwal A. Anatomy, Head and Neck, Ear Eustachian Tube. (https://www.ncbi.nlm.nih.gov/books/NBK482338/) [Updated 2021 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Accessed 11/26/2021.
  • Utz, ER, LaBanc AJ, Nelson MJ, Gaudreau P A, Wise S R. (2020). Balloon Dilation of the Eustachian Tube for Baro-Challenge-Induced Otologic Symptoms in Military Divers and Aviators: A Retrospective Analysis. (https://journals.sagepub.com/doi/10.1177/0145561320938156) Ear, Nose & Throat Journal. Accessed 11/26/2021.

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