If your ears have ever "popped", you have experienced
the Eustachian tube doing its job. The Eustachian tube is a narrow canal that connects
the middle ear to the throat, right behind the nasal cavity. The middle ear
is the air-filled space
behind the eardrum that contains the three middle ear bones (the ossicles) that
are involved in hearing. The main functions of the Eustachian tube are to act as
a pressure-equalizing valve for the middle ear and to drain the mucus produced by
the lining of the middle ear. Swallowing or yawning opens the Eustachian tube and
allows air to flow into or out of the middle ear, equalizing the air pressure on
both sides of the eardrum. When this happens, the characteristic "pop" may be felt.
What is Eustachian tube dysfunction? Eustachian tube dysfunction
occurs when the Eustachian tube is unable to function properly. The most common
causes for this are infections such as the common cold, sinusitis and throat infections.
Other causes include nasal allergies (e.g. allergic rhinitis) and exposure to pollutants
or cigarette smoke. All of these can cause inflammation and swelling of the Eustachian
tube. Should the tube become swollen to the point of becoming blocked, the lining
of the middle ear absorbs the air that is trapped there. This creates a partial
vacuum in the middle ear which pulls the eardrum inward. Ear drum retraction along
with the negative air pressure are responsible for causing the predominant symptoms
of Eustachian tube dysfunction----pain, a sensation of pressure or fullness in the
ears, and hearing loss. Dizziness, unsteadiness and ringing in the ears can occur
also. Young children (especially ages 1 to 6 years) are at particular risk for Eustachian
tube dysfunction because they have very narrow Eustachian tubes. Also, they may
have adenoid enlargement that can block the opening of the Eustachian tube.
Self care for Eustachian tube dysfunction: It is not uncommon for
the symptoms associated with Eustachian tube dysfunction to persist even after the
symptoms of an acute upper respiratory tract infection have subsided. Given enough
time, usually on the order of a week or so, the inflammation and swelling gradually
go away, and the Eustachian tube starts to resume its normal function. During the
time that the pressure in the middle ear is equalizing to the outside air, popping
may be felt. This is a sign that the Eustachian tube is starting to function normally.
Once the pressure becomes equal, symptoms resolve. Measures that can help open the
Eustachian tube include:
- Sucking on candy, chewing gum, or yawning.
the ears" -exhaling while holding the nostrils closed and the mouth shut. A safer
way to do this, since there is a risk of rupturing the ear drum if exhaling too
forcefully, is to blow up a balloon.
- Eating, drinking or just swallowing activates
the muscles in the back of the throat which helps open the Eustachian tube.
swelling in the nasal passages can contribute to blocking the opening of the Eustachian
tube, another helpful "home remedy" involves use of nasal irrigation. This can be
done with a bulb syringe or Neti pot and saline solution.
Medical treatment of Eustachian tube dysfunction: A number of medications
can help Eustachian tube dysfunction by relieving nasal congestion and swelling
near the opening to the Eustachian tube. These include decongestants that are taken
by mouth (pseudoephedrine) or by a nose spray (phenylephrine), oral antihistamines,
and intranasal steroids. The specific medication that is used hinges on the underlying
cause for the dysfunction. For example, antihistamines would be helpful when allergies
are responsible, whereas an intranasal steroid might be used following an upper
respiratory tract infection. Identifying the particular allergen a patient is sensitive
to and eliminating it from the environment may reduce the patient's symptoms also.
Surgical Treatment: Surgery is usually reserved for cases of chronic Eustachian
dysfunction that persist despite self care measures and medical treatment. The primary
goal of surgical treatment is to bypass the Eustachian tube and re-establish ventilation
of the middle ear. This is done to restore hearing, relieve pressure sensation in
the ear, and reduce the tendency for middle ear infections. The most common procedure
used for chronic Eustachian tube dysfunction is the placement of pressure equalization
Prevention of Middle Ear Problems with Flying: One of the most
common situations leading
to Eustachian tube problems
is flying. During airplane travel the ears are subject to large swings in barometric
pressure. For most people, this pressure easily escapes out through the Eustachian
tube without causing problems. Those with a tendency to Eustachian tube dysfunction,
colds or nasal allergies, however, can have severe symptoms when flying. Yawning,
swallowing, chewing gum, or trying to "pop" ones ears usually will help with Eustachian
tube function. Use of decongestant medications or nasal sprays, taken so that their
peak activity is during the last hour of flight can to equalize pressure in the
middle ear and reduce symptoms.