Do your ears ever feel full, like they’re stuffed with cotton? Maybe your hearing fades in and out or you hear popping sounds when you swallow. These might seem like minor annoyances, but for someone with Eustachian tube dysfunction (ETD) they can be a part of life.
ETD is more common in children due to the size and shape of their tubes, but it can also affect adults. While it can go away on its own, ETD can be frustrating and affect daily life.
We spoke with Chris Adams, PA, a physician assistant in otolaryngology, to learn more about this disorder, how it can impact your hearing and tips for living well with it.
What is Eustachian tube dysfunction?
Your ears, nose and throat are all connected. The Eustachian tube is a hollow tunnel that links your middle ear to the back of your throat. It helps keep air pressure equal on both sides of your eardrum, makes sounds clear to hear and drains fluid from your ear.
Normally, the Eustachian tube is closed. It opens when you yawn, chew or swallow. “However, if the muscles that should pull the tube open fail to do so, the tube becomes blocked or the tube itself is anatomically too narrow, you can develop Eustachian tube dysfunction,” Adams explained.
What causes Eustachian tube dysfunction?
ETD is most often caused by differences in air pressure due to:
- Allergies: Swelling in your nose and throat can block the Eustachian tube.
- Colds or sinus infections: These illnesses can cause mucus and fluid buildup, which can block the tube.
- Chronic rhinitis: Ongoing inflammation (swelling) of the nasal passages can affect how the Eustachian tube works.
- Changes in altitude: Flying, scuba diving or driving in the mountains can lead to sudden pressure changes.
- Structural problems: Narrow or unusually shaped tubes may not function well.
- Smoking: Exposure to smoke can irritate the lining of the Eustachian tube, making it more likely to become blocked.
“A less common cause of ETD is a side effect of treatment for nasopharyngeal cancer,” Adams said. “This can scar shut the opening of the tube in the sinus.”
People with chronic nasal disease or chronic sinusitis may also be at risk.
What are the symptoms of Eustachian tube dysfunction?
ETD can show up in different ways. Here are the most common symptoms:
- A feeling of fullness or pressure in the ear
- Muffled hearing
- Ear pain or discomfort
- Popping or crackling sounds when swallowing or yawning
- Dizziness or balance problems
Symptoms may come and go. Sometimes they last for days or weeks, depending on the cause.
Living with ETD can be frustrating. It may be more difficult to talk on the phone or socialize. Physical pressure and pain can make focusing on work or school more challenging. In severe cases, dizziness or balance issues can make driving and walking difficult.
Tips for managing mild to moderate ETD
The good news is that you can take steps to manage mild to moderate ETD and feel more comfortable. Here are some tips:
1. Stay hydrated
Drinking fluids helps thin mucus and reduce congestion, making it easier for the Eustachian tube to work properly. Hydration is especially important if colds or allergies trigger your ETD.
2. Keep allergies under control
“Managing your allergies is important for preventing and treating ETD,” Adams said. “Start allergy medications at least one month before allergy season begins to help reduce inflammation and congestion around the Eustachian tube.”
Medications such as antihistamines or nasal steroid sprays containing fluticasone or azelastine can help minimize swelling and congestion in the nasal passages. Ask your health care provider which medication is the best fit for your needs.
3. Use saline rinses
Saline nasal rinses and sprays can help keep the sinuses moist and clear, preventing mucus buildup that can block the Eustachian tube.
4. Relieve ear pressure
To help open the eustachian tube, you can swallow, yawn or chew gum. You can also try the Valsalva maneuver.
“The Valsalva maneuver is a quick way to relieve that clogged feeling by popping your ears,” Adams said. “Try gently (not forcefully) blowing your nose with your mouth closed and your nose pinched shut.”
If you think your baby has ETD, give them a pacifier or a bottle to help relieve pressure or clear the blockage.
You can also use a device called the EarPopper to regulate air pressure. Talk to your health care provider about whether this product may be helpful to you.
When to see your health care provider
ETD can lead to hearing loss, especially if left untreated for a long period of time.
If your symptoms last longer than two weeks or you experience a lot of pain, hearing loss or other discomfort, it’s important to see your health care provider. Obstructive ETD, which occurs when the Eustachian tube is physically blocked or severely inflamed, can cause chronic symptoms and may require more intensive treatment.
If you have a history of recurring ear infections or frequent ETD symptoms, you may also benefit from seeing an ear, nose and throat (ENT) specialist.
Your provider may suggest other treatments, such as:
- Prescription medications: Stronger decongestants or steroids to reduce inflammation.
- Pressure equalization tubes: “This is a small tube that is placed through a small incision in the eardrum,” Adams said. “It allows for pressure to ventilate through the tube and helps to augment the function of the Eustachian tube.” It is a temporary fix, not a long-term solution. As the incision heals, the tube is slowly pushed out.
- Balloon dilation: “This newer technique involves placing a catheter into the Eustachian tube and inflating a small balloon to stretch the tube open gently,” Adams said. “This procedure can be effective for people with chronic ETD who haven't responded to other treatments.”
Tips for air travel
Flying can be especially difficult for people with ETD due to the rapid changes in air pressure. To manage symptoms during flights:
- Use nasal spray: A nasal decongestant like Afrin can be helpful before flying. "We recommend using one to two puffs of Afrin in each nostril about one hour before takeoff and reapply after six hours," Adams said. “However, Afrin should only be used for up to three consecutive days to avoid rebound congestion.”
- EarPopper: Another great way to pressurize your ears without medication is to bring an EarPopper with you on flights.
Takeaway
Living with ETD can be challenging but with proper treatment and lifestyle changes, most people can manage their symptoms effectively.
Staying on top of your allergies, using saline rinses and trying ear pressure-relieving techniques can make a big difference. If your symptoms don’t improve, talk to your health care provider or a Banner Health specialist to explore further treatment options.
Related articles:
- Nasal Rinse or Neti Pots: Are They Safe?
- Got an Ear Full? When and How to Properly Use Ear Drops
- Your Partner Says You Have Trouble Hearing – Now What?
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