Eustachian Tube Dysfunction

Overview

What is eustachian tube dysfunction?

Your eustachian (you-\_stay___-shee-un) tubes connect your middle ears to the back of your throat. (Your middle ear is the air-filled chamber just behind your eardrum.) Your eustachian tubes equalize air pressure and help drain fluid from your ears. When they become clogged, it’s called eustachian tube dysfunction (ETD).

Who does eustachian tube dysfunction affect?

Eustachian tube dysfunction can affect people of all ages, but it’s much more common in children. To put it in perspective, about 1% of the adult population is diagnosed with the condition. Meanwhile, approximately 70% of children develop eustachian tube dysfunction before the age of 7.

What are the types of eustachian tube dysfunction?

There are different types of eustachian tube dysfunction. The most common include patulous ETD, obstructive ETD and baro-challenge-induced ETD.

  • Patulous ETD: Your eustachian tubes stay open all of the time. This can cause sound to travel from your nasal cavity to your ears and distort the sound of your voice.
  • Obstructive ETD: Your eustachian tubes don’t open as they should. As a result, fluid accumulates and causes ear pain or pressure.
  • Baro-challenge-induced ETD: Like obstructive ETD, baro-challenge-induced ETD occurs when your eustachian tubes don’t open properly. The difference is that symptoms of baro-challenge-induced ETD only occur when you experience altitude changes.

Symptoms and Causes

What are the signs and symptoms of eustachian tube dysfunction?

People with ETD may experience a number of warning signs. Common eustachian tube dysfunction symptoms include:

Eustachian tube dysfunction symptoms may get worse in higher altitudes. This is called barotrauma, and it can happen while scuba diving, flying in an airplane or driving in the mountains.

What causes eustachian tube dysfunction?

Allergies and infections (like the common cold and the flu) are the most common causes of eustachian tube dysfunction. These conditions can cause inflammation and mucus buildup, leading to blockage. GERD, or chronic acid reflux, can also cause ETD. This is because stomach acid can back up into your throat and result in inflammation. As mentioned above, altitude changes can also cause ETD.

Diagnosis and Tests

How is eustachian tube dysfunction diagnosed?

Your healthcare provider will ask about your symptoms and examine your ears. They’ll check your ear canals, nasal passages and the back of your throat.

Management and Treatment

What are some common eustachian tube dysfunction treatments?

In most cases, treatment isn’t necessary because ETD often resolves on its own. However, you might need treatment if your symptoms linger for more than two weeks.

Eustachian tube dysfunction treatment depends on the cause and the severity of your condition. Treatments may include home remedies, medications or, in severe cases, surgery.

Home remedies

Sometimes simple home remedies can help with mild cases of eustachian tube dysfunction. To try and clear the blockage, you can:

  • Chew gum.
  • Yawn.
  • Swallow.
  • Try the Valsalva maneuver (breathing out forcefully while closing your mouth and pinching your nostrils).
  • Use a saline spray to clear out nasal passages.

If you think your baby has ETD, give them a pacifier or a bottle. The sucking motion may help clear the blockage.

Medications

Over-the-counter medications can help if allergies are causing eustachian tube dysfunction. Try antihistamines (like cetirizine or diphenhydramine) to ease your symptoms. If you have discomfort, pain relievers — such as acetaminophen or ibuprofen — can help.

When an infection causes ETD, your healthcare provider may prescribe antibiotics. They may also give you corticosteroids to help with inflammation.

Surgery

Chronic eustachian tube dysfunction may require surgery. The goal of this treatment is to bypass your eustachian tubes and address ventilation problems in your middle ears. This restores hearing issues and other symptoms. There are a few different surgical options, including:

  • Myringotomy. During this procedure, your surgeon makes a small incision in your eardrum to drain the fluid from your middle ear. In adults, the incisions usually stay open long enough for the swelling in your eustachian tubes to resolve.
  • Pressure equalization tubes. Sometimes surgeons place ear tubes into the eardrums once they make the incisions. These tubes provide proper middle ear ventilation for up to one year. Some surgeons recommend earplugs while swimming or bathing while ear tubes are in place. Typically, over time the tubes are pushed out and the drum heals. However, the tubes don’t always stay in place as long as they should and repeat placement may be necessary.
  • Eustachian tuboplasty (eustachian tube balloon dilation). This newer procedure involves expanding your eustachian tubes with a balloon. Your surgeon uses endoscopic instruments to thread the balloon through your nasal passages into your eustachian tube. The balloon is inflated for two minutes, then the balloon is deflated and removed.

How long does it take to recover from eustachian tube dysfunction treatment?

If you’ve had surgery for eustachian tube dysfunction, your recovery time can vary depending on which type of treatment you received. People who’ve had myringotomy usually recover in about three to four weeks. If you had tubes placed, they should remain in place for about 12 to 18 months. People who receive eustachian tuboplasty generally recover in about 24 hours.

Prevention

Can I prevent eustachian tube dysfunction?

While you can’t prevent ETD altogether, there are things you can do to reduce your risk. For example:

  • Wear specialized ear plugs before you fly to reduce your risk of airplane ear.
  • Avoid extreme temperatures, which can make ear-related issues worse.
  • Drink plenty of water to keep your mucus thin.

Outlook / Prognosis

What can I expect if I have eustachian tube dysfunction?

The good news is that ETD usually isn’t serious. But the associated symptoms can be annoying and inconvenient. Talk to your healthcare provider to learn how to manage the condition and improve your quality of life.

How long does eustachian tube dysfunction last?

Eustachian tube dysfunction usually goes away in one to two weeks. People with chronic eustachian tube dysfunction may have lingering symptoms for weeks, months or even years.

What happens if eustachian tube dysfunction is left untreated?

Chronic eustachian tube dysfunction has been linked to ear injuries and trauma. In rare cases, untreated ETD can cause hearing loss and permanent damage to your eardrum and middle ear. That’s why prompt treatment is necessary.

Living With

When should I see my healthcare provider?

If eustachian tube dysfunction causes severe pain, or if symptoms last longer than a couple of weeks, make an appointment with your healthcare provider.

A note from Cleveland Clinic

Eustachian tube dysfunction usually isn’t serious. But if symptoms linger for several weeks and are left untreated, it could lead to serious health problems, such as hearing loss, tinnitus or damage to your eardrum and middle ear. If you notice that symptoms don’t go away on their own in a week or two, it’s important to schedule a visit with your healthcare provider. They can help determine the cause of your condition and recommend the appropriate treatment.

Last reviewed by a Cleveland Clinic medical professional on 03/17/2022.

References

  • American Academy of Family Physicians. Eustachian Tube Dysfunction. (https://familydoctor.org/condition/eustachian-tube-dysfunction/) Accessed 12/14/21.
  • Hamrang-Yousefi S, Ng J, Andaloro C. Eustachian Tube Dysfunction. (https://www.ncbi.nlm.nih.gov/books/NBK555908/) [Updated 2021 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Accessed 12/14/21.
  • Huisman JML, Verdam FJ, Stegeman I, de Ru JA. Treatment of Eustachian tube dysfunction with balloon dilation: A systematic review. (https://pubmed.ncbi.nlm.nih.gov/28799657/) Laryngoscope. 2018 Jan;128(1):237-247. Accessed 12/15/21.
  • 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. Accessed 12/14/21.

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