• Eustachian Tube Dysfunction

    (ETD; Barotitis Media; Barotrauma; Ear Popping; Pressure-related Ear Pain)

    Definition

    The eustachian tube is a small canal that connects the middle ear to the back of the nose and upper throat (nasopharynx). Its purpose is to equalize the air pressure in the middle ear with the pressure outside it.
    Eustachian tube dysfunction (ETD) occurs when the tube fails to open during swallowing or yawning. This results in a difference between the air pressure inside and outside the middle ear. It causes discomfort in the ear and temporary hearing problems.
    Eustachian Tube
    si55550605 96472 1
    Copyright © Nucleus Medical Media, Inc.

    Causes

    The ear may feel blocked if the pressure outside the ear changes, but the pressure inside the ear does not change. When this happens, the eardrum cannot vibrate normally. It often occurs during altitude changes, like flying in an airplane, driving on steep hills, or scuba diving. Swallowing, yawning, or chewing usually make the symptoms go away.
    ETD occurs if the tube is blocked or swollen, trapping air and fluids in the middle ear. This causes symptoms to continue beyond a few hours. Sometimes it can lead to ear damage.
    Causes include:
    • Nasal congestion from an allergy
    • Cold other upper respiratory infection
    • Ear or sinus infections
    • Narrow eustachian tube
    • Adenoid tissue blocking eustachian tube (in children)
    • Tumors (in adults)

    Risk Factors

    A risk factor is something that increases your chance of getting ETD. Tell your doctor if you have any of these factors:
    • Activities with large, rapid altitude changes, such as flying in an airplane or scuba diving
    • Allergy, cold, or other upper respiratory infection
    • Ear or sinus infection
    • Narrow eustachian tube
    • Presence of obstructing tumors in the nasopharynx
    • Children with large adenoids
    • Age: Children (Their eustachian tubes are narrower.)
    • Environmental allergies

    Symptoms

    Symptoms can include:
    • Feeling of fullness or clogging in the ear
    • Discomfort or pain in the ear
    • Hearing loss
    • Ringing in the ear (tinnitus)
    • Dizziness
    • Symptoms cannot be relieved by swallowing, yawning, or chewing
    • Pain if the blockage results in an infection

    Diagnosis

    Your doctor will ask about your symptoms and medical history, and perform a physical exam. A lighted instrument, called an otoscope, will be used to look inside your ear. The doctor will check for a slight bulge around the eardrum, fluid, and swelling. If your case is severe, your may need to see an otolaryngologist, a doctor who specializes in ear disorders.
    Other possible tests include:
    • Tympanogram—to measure pressure in the ear canal and movement of the eardrum
    • Audiogram—to measure hearing
    • Examination of the nose and the back of the nose

    Treatment

    To deal with ear clogging, discomfort, or pain, you can try:
    • Swallowing, yawning, or chewing gum to relieve the pressure
    • Clearing your ears by breathing in and then gently breathing out while holding your nostrils and mouth closed
    If the symptoms do not go away within a few hours or are severe, your doctor may recommend the following medications:
    • Nasal or oral decongestants
    • Oral antihistamines
    • Nasal steroids to relieve nasal congestion and enable the eustachian tube to open
    • Pain medications (eg, acetaminophen or ibuprofen)
    In rare cases, a myringotomy may be necessary. The doctor makes an incision in the eardrum to allow the pressure to equalize and the fluid to drain.

    Prevention

    To help reduce your chances of getting ETD, take the following steps:
    • Avoid flying in an airplane or going scuba diving if you have allergies or a cold.
    • When flying:
      • Use decongestants or antihistamines if you have an allergy or a cold.
      • Yawn or chew gum. Encourage swallowing by sucking on hard candy or drinking water.
      • When taking off and landing, clear your ears by breathing in and then gently breathing out while holding your nostrils and mouth closed.
      • Try special earplugs that slowly equalize the pressure in your ear. These earplugs can be found at drugstores and airports.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    American Hearing Research Foundation http://www.american-hearing.org/

    CANADIAN RESOURCES

    Canadian Academy of Audiology http://www.canadianaudiology.ca/

    The Canadian Hearing Society http://www.chs.ca/

    References

    American Hearing Research Foundation. Barotrauma. American Hearing Research Foundation website. Available at: http://www.american-hearing.org/disease/barotrauma.html . Updated April 2002. Accessed June 18, 2008.

    Mayo Clinic. Airplane ear. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00472 . Updated October 2006. Accessed June 18, 2008.

    McKinley Health Center. Eustachian tube dysfunction. McKinley Health Center, University of Illinois at Urbana-Champaign website. Available at: http://www.mckinley.uiuc.edu/handouts/eustachian%5Ftube%5Fdysfunction/eustachian%5Ftube%5Fdysfunction.html . Updated March 2007. Accessed June 18, 2008.

    National Cancer Institute. General information about nasopharyngeal cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancerinfo/pdq/treatment/nasopharyngeal/patient/#Keypoint3 .

    Patient UK. Eustachian tube dysfunction. Patient UK website. Available at: http://www.patient.co.uk/health/Eustachian-Tube-Dysfunction.htm . Updated July 13, 2010. Accessed November 4, 2010.

    University Health Services. Eustachian tube dysfunction. University Health Services, University of Wisconsin-Madison website. Available at: http://www.uhs.wisc.edu/display%5Fstory.jsp?id=652&cat%5Fid=38 . Updated May 2007. Accessed June 18, 2008.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.