Eustachian tubes are small tubes that run between your middle ears and the upper throat. They are responsible for equalizing ear pressure and draining fluid from the middle ear, the part of the ear behind the eardrum. The eustachian tubes are usually closed except for when you chew, swallow, or yawn.

These passageways are small in size and can get plugged for a variety of reasons. Blocked eustachian tubes can cause pain, hearing difficulties, and a feeling of fullness in the ears. Such a phenomenon is referred to as eustachian tube dysfunction (ETD).

ETD is a relatively common condition. Depending on the cause, it may resolve on its own or through simple at-home treatment measures. Severe or recurring cases may require a visit to the doctor.

Symptoms of ETD may include:

  • fullness in the ears
  • feeling like your ears are “plugged”
  • changes to your hearing
  • ringing in the ear, also known as tinnitus
  • clicking or popping sounds
  • ticklish feelings in the ears
  • pain

The length of time that ETD symptoms last depends on the initial cause. Symptoms from altitude changes, for example, may resolve once you get back to the altitude you’re used to. Illnesses and other causes of ETD may result in longer-lasting symptoms.

Allergies and illnesses like the common cold are the most common causes of ETD. These conditions may cause your eustachian tubes to become inflamed or clogged with mucus. People with sinus infections are more likely to develop plugged eustachian tubes.

Altitude changes can also cause problems with your ears. You may experience the effects of altitude change from:

  • hiking
  • traveling through mountains
  • flying on a plane
  • riding an elevator

Anyone can experience ETD from time to time, but some people are more prone to this condition.

  • Obesity can increase your risk because fatty deposits may accumulate around the eustachian tubes.
  • Smoking can damage protective hairs in the middle ear, called cilia, and increase the chances of mucus getting stuck.
  • People with allergies may experience more mucus and congestion, leading to increased risk.

Children are at a greater risk of ETD. This is because their eustachian tubes are smaller, which increases the chance that mucus and germs will become trapped. They also have more frequent colds and are more prone to infections because their immune systems are still developing.

See your doctor if your symptoms are severe or last more than two weeks.

Children are more likely to see a doctor for eustachian tube dysfunction. This is because they are at an overall higher risk of getting ear infections. The pain from ETD can mimic the pain from an ear infection.

ETD is diagnosed through a physical exam. First, your doctor will ask you about pain, hearing changes, or other symptoms you are experiencing. Then your doctor will look inside your ear, carefully checking your ear canal and passages into the nose and throat.

Sometimes ETD may be mistaken for other conditions involving the ears. One example is abnormal patency of the eustachian tubes. This is a condition in which the tubes frequently open on their own.

ETD usually resolves without treatment. But if your symptoms are severe or persist for more than two weeks, talk to your doctor about treatment options.

Treatment for ETD depends on both the severity and cause of the condition, and may include home remedies, over-the-counter (OTC) medications, and prescription drugs. Check with your doctor before using any medications or supplements.

Home remedies

Minor symptoms may be resolved with home remedies, especially if they aren’t caused by an illness. You can try:

  • chewing gum
  • swallowing
  • yawning
  • breathing out with your nostrils and mouth closed
  • using a saline nasal spray to help clean out passageways

To resolve minor ETD symptoms in babies, give your baby a bottle or pacifier to suck.

Read more: How to clear a stuffy nose »

OTC options

If allergies are causing eustachian tube discomfort, you may consider over-the-counter allergy medications. Antihistamines, such as diphenhydramine (Benadryl) or cetirizine (Zyrtec, Aller-Tec, Alleroff) can reduce allergy symptoms and related ear problems.

OTC pain relievers, such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can alleviate pain in your ears. Make sure to read the dosage instructions carefully.

Ask your doctor before using these medications to see if they interact with other drugs you might be taking.

Conventional methods

In the case of an infection, your doctor may prescribe an antibiotic. This can come in the form of ear drops, oral tablets, or both. Oral corticosteroids may be used in cases of severe inflammation.

Severe cases of ETD may require more invasive treatments. Pressure equalization tubes (PETs) are implanted in some people to equalize ear pressure and to help with frequent or chronic middle ear infections. Built-up fluids may also need to be drained if the eustachian tube is not functioning properly. This is done by making a small cut in the eardrum to help fluid drain.

Can I use ear candles?

Ear candles are not considered safe options by the Food and Drug Administration (FDA). The FDA has not found any evidence that ear candles are effective.

The most common complication of ETD is the risk for recurring symptoms. Symptoms are more likely to come back if you don’t treat the underlying causes of ETD.

In severe cases, ETD may also cause:

  • Chronic otitis media, also known as a middle ear infection.
  • Otitis media with effusion, often called glue ear. This refers to fluid buildup in the middle ear. It may last for a few weeks, but more severe cases can cause permanent hearing damage.
  • Eardrum retraction, which is when the eardrum is seemingly sucked back further into the canal.

Most cases of ETD resolve within a few days without causing long-term complications. ETD caused by infections may fully resolve within a week or two.

Treating the underlying causes can help prevent recurring cases. Managing your allergies and staying well can prevent ETD from occurring in the first place.

Since ETD is more common in children, you may consider talking to your doctor if your child gets frequent ear infections or illnesses that cause ear pain.

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