Eustachian Tubes: What to Know

Written by Dayva Segal, Shawna Seed
Medically Reviewed by Shruthi N, MD on December 18, 2024
6 min read

Your Eustachian tubes are located inside each ear , on the sides of your head. These tubes connect your middle ear to the back of your nose and throat. When you hear your ears pop after swallowing or yawning, that is actually your Eustachian tubes at work.

The Eustachian tubes are hollow and made of a combination of bone and cartilage. They are about 36 millimeters long, just under 1.5 inches. The third of the tube that is closest to your middle ear is made of bone; the rest is made of cartilage.

Eustachian tubes play an important role in maintaining ear health. They have three key roles.

Draining fluid. Your Eustachian tubes usually are closed. However, when they open — for instance, when you yawn or swallow — they release excess fluid and mucus from your ears.

Controlling air pressure. When your Eustachian tubes open, they let in a small amount of air. This equalizes the pressure between your middle ear and the outside environment. This is crucial for your eardrum to work correctly.

Protecting your middle ear. Because the tubes stay closed most of the time, they help keep out bacteria and viruses that can cause illness.

Your Eustachian tubes are located in the middle ear. 

The external ear consists of the pinna (the part of the ear that you can see), as well as the ear canal. The middle ear contains the ossicles, which are three small bones that help you hear, as well as some air and the Eustachian tubes.

The position of the Eustachian tube is different in children and adults. In children younger than 6, it is oriented more horizontally. As you get older, the tube slants down from the middle ear into the back of the nose and throat. When the tube is horizontal, it gets blocked more easily. This is why young children are more prone to ear infections than adults.

If your Eustachian tubes don't open and close properly, you have Eustachian tube dysfunction (ETD). Eustachian tube blockage is caused by inflammation in your ears.

 

It's normal to feel like your ears are blocked for a few days if you have a cold. However, if you experience these issues for longer than that, you may want to consult your doctor. Other signs that indicate a problem with your Eustachian tubes include:

  • Ear pain
  • Muffled hearing
  • Popping sounds
  • Tinnitus
  • Balance issues
  • Dizziness
  • Your own voice sounds uncomfortably loud to you
  • You hear your blood pumping loudly

The most common causes of Eustachian tube dysfunction are:

  • Viral infections, such as cold or flu 
  • Allergies
  • Obesity 
  • Gastroesophageal reflux disease (GERD)
  • Weight loss
  • Changes in altitude, for instance, flying in a plane or scuba diving 
  • Exposure to pollution
  • Secondhand cigarette smoke
  • Smoking

These conditions — though less common — also can lead to Eustachian tube dysfunction:

There are three main types of Eustachian tube dysfunction:

Patulous Eustachian tube dysfunction. This occurs when your Eustachian tubes stay open for too long, causing you to hear everything happening inside of your head much louder than usual. Your doctor may prescribe nasal drops or spray. Your symptoms may also improve if you drink more water and cut out caffeine.

Obstructive Eustachian tube dysfunction. This occurs when your tubes become blocked, causing pain, pressure, and hearing loss. Such chronic obstruction can lead to ear infections. Treatments include allergy medication or decongestants. Your doctor may recommend surgery to dilate the tubes with a balloon, remove the adenoids, or insert a tube into the eardrum to equalize pressure.

Baro-challenge-induced Eustachian tube dysfunction. This is similar to obstructive Eustachian tube dysfunction, but it happens only when you experience changes in altitude. For people who must do so often, such as pilots, this condition can be a significant issue. The most successful treatment for this is surgery to dilate the Eustachian tubes with a balloon.

You might be able to clear Eustachian tube blockage using simple home remedies. Things to try include:

  • Yawning
  • Chewing gum
  • Swallowing
  • Breathing out forcefully while pinching your nostrils shut and keeping your mouth closed (Valsalva maneuver)
  • Using saline spray to clear your nose
  • Holding a warm washcloth to your ear

You can buy a device called an Otovent, which is designed to unclog your ears. It's basically a small balloon that you blow up using your nose.

You can also try massaging the area. Here are the steps for Eustachian tube massage:

  • Place your finger on the bony bump behind your earlobe.
  • Move your finger down to the groove between your earlobe and your jaw.
  • Follow the groove all the way down to your collarbone, maintaining firm pressure.

You can do three repetitions of this massage three times a day.

If you think your baby's ears are blocked, feed them to encourage swallowing or give them a pacifier.

Over-the-counter pain relievers such as acetaminophen or ibuprofen might make you feel better. If your ears stay blocked for two weeks or longer, see your doctor.

If your ear problems continue, you may need to see a specialist who can perform a procedure on your Eustachian tubes. Surgery options include:

Myringotomy. A surgeon makes a small cut in your eardrum, which allows fluid to drain. For adults, the cuts generally stay open long enough for all the fluid to drain.

Ear tubes. Your surgeon might place tubes in your ear during myringotomy. The tubes allow the correct airflow in your ears. The tubes may stay in place for up to a year. They fall out on their own, and the cut in your eardrum heals.

Tuboplasty. This technique uses a balloon to expand and open your Eustachian tubes. Using a special tool, the surgeon goes in through your nose and places the balloon in your Eustachian tube. They will inflate the balloon for a couple of minutes, then take it out.

Follow these tips to keep your Eustachian tubes healthy and prevent ear infections.

  • Feed infants with their heads elevated to stop milk from entering the middle ear.
  • Wear earplugs when you fly.
  • Drink plenty of water, which will thin out mucus and make it drain more easily.
  • Avoid temperature extremes, which can make ear problems worse.
  • Don't smoke.

Taking medicines for underlying health issues such as allergies can help keep your Eustachian tubes healthy. They include:

  • Antihistamines
  • Nasal sprays

Your Eustachian tubes help drain fluid from your ears, equalize pressure between your ears and your environment, and protect you against viruses and bacteria. When they don't open and close the way they should, your ears might feel plugged and uncomfortable. If the problem continues, you may get Eustachian tube dysfunction. You can try home remedies such as yawning, swallowing, or chewing gum to unblock your ears. In some cases, you might need a procedure to resolve your Eustachian tube issues.

How do you know if you have Eustachian tube problems?

Signs of Eustachian tube issues include:

  • Ear pain
  • Muffled hearing 
  • Feeling of fullness
  • Popping or clicking sounds 
  • Ringing in your ears
  • Feeling dizzy or having balance problems

How do you get Eustachian tubes to drain? 

Chewing gum, yawning, or swallowing may be enough to open your Eustachian tubes. If that doesn't work, you can massage the area or try the Valsalva maneuver. To do that, you breathe out forcefully while keeping your mouth closed and your nostrils pinched shut.

How do you sleep to drain Eustachian tubes?

Traditionally, elevating your head while you sleep is touted as a way to clear your Eustachian tubes. Research suggests that changing your sleep position makes no difference, but it's unlikely to cause any harm if you want to try it.

 

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