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Patient education: Eustachian tube problems (The Basics)

Patient education: Eustachian tube problems (The Basics)

What is the Eustachian tube? — 

This tube connects the middle ear (the part of the ear behind the eardrum) to the back of the nose and throat (figure 1).

Normally, the Eustachian tube opens and closes. This helps keep the air pressure inside the middle ear the same as the air pressure outside the middle ear. If there is a problem with the tube opening, the 2 air pressures won't be the same. This can cause ear pain, hearing loss, and other symptoms. When people have symptoms or damage in the middle ear because of air pressure differences, it is called "ear barotrauma."

In some people, the Eustachian tube does not close normally, but stays open all the time. This can also cause symptoms like hearing the sound of your own voice and breathing.

Most Eustachian tube problems last only a short time and get better on their own. But they can sometimes lead to more serious conditions, such as:

A middle ear infection

A torn eardrum

Hearing loss

In children, long-term hearing loss from Eustachian tube problems can also lead to language or speech problems.

What causes Eustachian tube problems? — 

Common causes are:

Illnesses or conditions that make the Eustachian tubes swollen or inflamed – These include colds, allergies, ear infections, or sinus infections. (The sinuses are hollow areas in the bones of the face.)

Sudden air pressure changes – These can happen when flying in an airplane, scuba diving, or driving up to the mountains.

Growths that block the Eustachian tube

Being born with an abnormal Eustachian tube

What are the symptoms of a Eustachian tube problem? — 

Common symptoms include:

Ear pain

Feeling pressure or fullness in the ear

Trouble hearing

Ringing in the ear

Feeling dizzy

Loud sounds of your own voice or your own breathing

Will I need tests? — 

Probably not. Your doctor or nurse should be able to tell if you have a Eustachian tube problem by learning about your symptoms and doing an exam.

If your symptoms are severe, last for a long time, or only affect 1 ear, your doctor or nurse might:

Have you see an ear, nose, and throat ("ENT") doctor

Do tests to check your hearing

Do an imaging test – These create pictures of the inside of the body.

How are Eustachian tube problems treated? — 

Treatment depends on what's causing the problem. Depending on your situation, your doctor might suggest 1 or more of these:

Nose sprays

Antihistamines – These medicines are usually used to treat allergies. They help stop itching, sneezing, and runny nose symptoms.

Decongestants – These medicines can help with stuffy nose symptoms.

Avoiding dehydration – Drink a lot of fluids, especially before doing physical activity or being in the heat.

Surgery – Most people do not need surgery for Eustachian tube problems. But people might need surgery if their symptoms don't get better with medicines or if they have severe or long-term symptoms.

Antibiotics are not needed to treat Eustachian tube problems. But they might be needed if a person has an ear infection.

What can I do on my own? — 

It might help to:

Chew gum.

Swallow or yawn.

Breathe in, close your mouth, pinch your nose shut, and then blow.

Give a baby a bottle or pacifier.

You can also help prevent Eustachian tube problems by:

Avoiding airplane travel and scuba diving if you have a cold, ear infection, or sinus infection

Avoiding smoking and places where other people are smoking

When should I call the doctor? — 

Call your doctor or nurse for advice if your symptoms:

Are severe or get worse

Don't go away after a few days

More on this topic

Patient education: Ear infections in children (The Basics)
Patient education: Ear infections in adults (The Basics)
Patient education: Otitis media with effusion (The Basics)
Patient education: Hearing loss in adults (The Basics)
Patient education: Cough, runny nose, and colds (The Basics)
Patient education: Environmental allergies in adults (The Basics)
Patient education: Environmental allergies in children (The Basics)
Patient education: Sinusitis in adults (The Basics)
Patient education: Sinusitis in children (The Basics)

Patient education: Ear infections (otitis media) in children (Beyond the Basics)
Patient education: The common cold in adults (Beyond the Basics)
Patient education: The common cold in children (Beyond the Basics)
Patient education: Acute sinusitis (sinus infection) (Beyond the Basics)

This topic retrieved from UpToDate on: May 11, 2025.
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