Advice and treatment for Eustachian tube dysfunction

The Eustachian tube is a narrow tube (approximately 3mm in diameter) that connects the space behind the eardrum (the middle ear) with the back of the nose. In adults it is about 3 to 4 cm long. 

The Eustachian tube is normally closed but opens 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 to either side of the eardrum. Having equal air pressure on each side of the eardrum and the middle ear free of mucus helps the eardrum to vibrate. This vibration is needed for us to hear properly.

Eustachian tube dysfunction means that the Eustachian tube is blocked or does not open properly. Air cannot then get into the middle ear. This means that 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.

• Ears feel full or blocked
• Sound appears muffled or like you are underwater
• Experiencing a popping or clicking sensation
• Pain or discomfort
• You may experience buzzing or ringing in your ears (tinnitus)
• Mild dizziness

Colds and nasal, sinus, ear or throat infections

These are common causes of Eustachian tube dysfunction:

• blocked nose, or thick mucus that develops during a cold or other infections
• infection may also cause the lining of the Eustachian tube to become inflamed and swollen

Allergies

Allergies that affect the nose and cause symptoms, such as a persistent runny nose can cause extra mucus and inflammation in the Eustachian tube and lead to Eustachian tube dysfunction.

Blockages

Anything that causes a blockage to the Eustachian tube can cause Eustachian tube dysfunction, such as enlarged adenoids (small lumps of tissue at the back of your throat behind your nose).

Air travel

A change in air pressure during flying can cause unequal pressure to either side of the eardrum and cause Eustachian tube dysfunction.

Treatment options depend on the cause and severity of the condition. Often no treatment is needed and in many cases the Eustachian tube dysfunction is mild and gets better itself in 6 to 8 weeks.

There are techniques that can be used to encourage air flow through the Eustachian tube and improve symptoms. These include:

• regular nose blowing
• good nasal hygiene
• auto inflation – cover one nostril and blow gently through the other

Medical treatments can include: 

• oral and nasal decongestants
• antihistamines
• corticosteroids

If Eustachian tube dysfunction affects you for a long amount of time, other treatment may be needed. A referral to the Ear, Nose and Throat department will be needed so that they can assess you. Treatments they can recommend include:

• a ventilation tube or grommet may be inserted through a small incision in your ear drum. These usually fall out on their own after 6 to 12 months. If, by the time it falls out your problem has not got better, you may need another procedure to put it back in place.
• Some tubes are designed to stay in place more permanently and these are called T tubes. 

If you have any further problems or concerns following your appointment please contact the Ear Care and Audiology Service.