This topic is a bit related to the ear tubes topic, and I think it’s worth covering because I get all kinds of weird depictions of how Eustachian tubes work from patients. I’ve gotten everything from a mysterious “channel that goes from the ears down into the chest” to a description (with hand motions) of what sounded like two plungers on either side of the brain pulling back and forth on each other. It’s not like I expect a patient to know what they are. I just like hearing them describe it.
So Eustachian tubes (ET) are the normal way for the “middle ear,” or the space behind the eardrum where the little ear bones are, to ventilate. If you think about it, there’s got to be some way for this to happen or that space would just be a little blind pouch filled with fluid—not great for receiving sound energy in an air environment. The ETs are soft tubes made of soft tissue and muscle, suspended by attachments to muscle from the skull base. They go from the front or anterior part of the middle ear space, to just below the base of the skull on either side, to the very back of the nasal cavity. If you were to take a chopstick and put it straight back into the nostril about 9cm or so, you would look a little like a walrus. And you would probably be spearing your Eustachian tubes. Don’t do that.
ET tubes are the reason your ears “pop” on airplanes and in elevators. That feeling comes from when there’s a buildup of pressure in your middle ear, causing your Eustachian tubes to suddenly open. When they open, the pressure equalizes, and your ear drums move—exactly what you’re feeling. If you have ear tubes or PETs in, then these artificial tubes provide a more constant equalization of middle ear pressure. That works, but with the tradeoff that your middle ear can now get water into it through those PETs and can (rarely) get infected.
If we can get your Eustachian tubes working, then that’s preferable to artificial PETs. One way of doing that is Eustachian tube dilation, which has shown some promise with initial studies. That’s a procedure done in the OR under sedation, but it’s an outpatient procedure without a lot of downtime. Another way to do it is to get you to “pop” your ears on a more regular basis, about 20 times per day, often by closing your nostrils with your hand and blowing gently against that pressure. The pressure should help force the Eustachian tube to open a bit, draining pressure and any fluid that’s in that space. No, you don’t have to listen to your mom or your boyfriend or whoever who said that you’re going to burst your eardrum by doing that. Just do it gently, and don’t sneeze while you do it, and you’ll be fine.
There are some people that can pop their ears by flexing the muscles behind their jaw, actually flexing open the Eustachian tube. There is an old-school method called the “Politzer maneuver” by which ENTs would force pressurized air into the nose while covering the other nostril, and this works well at ENT parties with a few drinks.
FAQs
ET tubes are the reason your ears “pop” on airplanes and in elevators. That feeling comes from when there's a buildup of pressure in your middle ear, causing your Eustachian tubes to suddenly open. When they open, the pressure equalizes, and your ear drums move—exactly what you're feeling.
How long does it take for Eustachian tube to unblock? ›
Eustachian tube dysfunction usually goes away in one to two weeks. People with chronic eustachian tube dysfunction may have lingering symptoms for weeks, months or even years.
How do doctors unblock Eustachian tubes? ›
In some cases, people need surgery for a blocked eustachian tube. The doctor makes a small cut in the eardrum to drain fluid and to make the pressure the same inside and outside the ear. Sometimes the doctor will put a small tube in the eardrum. The tube usually will fall out over time.
How do you force Eustachian tubes to drain? ›
Close your mouth, hold your nose, and gently blow as if you are blowing your nose. Yawning and chewing gum also may help. You may hear or feel a "pop" when the tubes open.
Does popping ear help Eustachian tube dysfunction? ›
If there's a difference in pressure, your eardrum may bulge inward or outward in response. The pressure difference can cause that familiar feeling of fullness in the ear. Popping your ears involves opening both eustachian tubes to relieve the imbalance of pressure, ending or reducing your discomfort.
What happens if my eustachian tube has been blocked for months? ›
Long-term blockage of the Eustachian tube leads to the accumulation of fluid in the middle ear space that further increases the pressure and hearing loss. This is called serous otitis media. Should bacteria contaminate this fluid, a middle ear infection may result, called acute otitis media.
How long does it take for Eustachian tubes to unblock with nasal spray? ›
NASAL STEROID SPRAYS. These sprays decrease swelling in your nose and your Eustachian tubes to help them pop open. Nasal steroid sprays must be used everyday to be effective and often take 5-7 days before you will notice their benefit.
What is the best position to sleep to drain an eustachian tube? ›
If your ear pain is limited to one ear, try to sleep on your other side. Try propping up your head on two or more pillows, so your affected ear is higher than the rest of your body. That will help encourage fluid to drain.
How painful is a blocked eustachian tube? ›
Blocked eustachian tubes can cause several symptoms. For example, your ears may hurt or feel full. You may have ringing or popping noises in your ears. Or you may have hearing problems or feel a little dizzy.
Does Flonase help eustachian tube dysfunction? ›
The treatment for ETD is aimed at opening up the eustachian tube in the back of the nose. The main treatment is using a steroid nasal spray to help shrink the tissue where the ear drains. Nasal steroid (Flonase, Nasonex, Nasacort) - 2 sprays into each nostril twice daily.
Sudden sensorineural hearing loss (SSNHL) can be misdiagnosed as ETD. A simple 512-Hz tuning fork test lateralizes to the opposite ear in SSNHL and to the affected ear in ETD with conductive hearing loss.
What is the best decongestant for eustachian tube dysfunction? ›
Afrin (oxymetazoline) and 4-Way (phenylephrine nasal) are among the most common and effective topical decongestants.
Can a doctor see a blocked Eustachian tube? ›
How does a doctor test for Eustachian tube dysfunction? Your doctor will ask about your symptoms, examine your ear canals and ear drums, and check your nasal passages and the back of your throat for signs of inflammation and mucus buildup.
What aggravates Eustachian tubes? ›
The most common cause of Eustachian tube dysfunction is when the tube become swollen (inflamed) and mucus or fluid builds up. This can be caused by a cold, the flu, a sinus infection, or allergies.
Can hydrogen peroxide unclog an Eustachian tube? ›
You Can Try Putting Hydrogen Peroxide Drops into Your Ear
You might need to repeat this several times a day for a couple of days, but ultimately, the blockage should clear.
What can be mistaken for Eustachian tube dysfunction? ›
Sudden sensorineural hearing loss (SSNHL) can be misdiagnosed as ETD. A simple 512-Hz tuning fork test lateralizes to the opposite ear in SSNHL and to the affected ear in ETD with conductive hearing loss.
What is the best decongestant for Eustachian tube dysfunction? ›
Afrin (oxymetazoline) and 4-Way (phenylephrine nasal) are among the most common and effective topical decongestants.
What will an ENT do for clogged ears? ›
The surgeon makes a tiny incision in the ear drum using a small scalpel or laser, then suctions the fluid out of the middle ear. The doctor inserts a small tube in the incision in the eardrum to allow fluid to drain.
How long does a blocked inner ear last? ›
How long does a blocked ear last for? It all depends on the cause of the blockage, but generally, if it's caused by something as simple as water or air pressure, it should clear quickly. For more serious problems, such as infections, it can take a few weeks to return to normal.
