Dysfunction of Eustachian Tube

The eustachian tube is a narrow passageway that connects the upper part of the throat to the middle ear. It controls the pressure behind the eardrum and middle ear space and helps keep the middle ear free of fluid. The eustachian tube is normally flat or closed, but opens on occasion with swallowing or yawning.

Eustachian tube dysfunction (when the ear tube does not work properly) occurs when the tube experiences chronic blockage. Blockage of the eustachian tube can also be present before birth (meaning it's congenital).

Eustachian tube dysfunction and inner ear problems with effusion (non-infected fluid in the middle ear space) affect 70% of children by the age of 7.

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology).

Causes & Risk Factors

Children are particularly at risk of eustachian tube problems because their tubes are narrower than those of an adult. Eustachian tubes in children are more horizontally oriented and more prone to inflammation when a child has a cold.

A blocked eustachian tube causes air pressure in the middle ear to change from the pressure on the outside of the eardrum. This can damage the ear and cause pain for the child.

Causes include:

  • Nasal congestion from an allergy
  • Cold or other upper respiratory infection
  • Ear or sinus infections 
  • Environmental allergies
  • Large adenoids
  • Activities with rapid altitude changes, such as flying in an airplane or traveling in the mountains
  • Rarely, a tumor in the nasopharynx (the upper part of the throat behind the nose)

Risk factors:

  • A blocked eustachian tube increases the chance that your child may get an ear infection (otitis media).
  • Eustachian tubes are smaller and more level in children than they are in adults. This makes it harder for fluid to drain out of the ear, even under normal conditions.

Symptoms & Types

Symptoms are similar to those of an ear infection.

Symptoms may include:

  • Ears that hurt and feel full
  • Ringing or popping noises in the ears
  • Hearing problems
  • Feeling dizzy

Diagnosis & Tests

The doctor will use an instrument (otoscope) with a light attached to look into the ear canal. The doctor may also recommend you have your child’s hearing checked.

Treatment & Care

Treatment may include:

  • Prescription for a nasal spray
  • Acetaminophen (Tylenol)
  • A mucus thinner
  • Warm compress against the ear to relieve pain
  • Over-the-Counter (OTC) nasal saline spray or mist daily

Children who get infections often may need surgery to place small tubes inside their ears. The tubes relieve pressure in the ears.

Living & Managing

If your child needs tubes in the ears, it is important to follow your doctor's advice for recovery.

When you fly or travel in the mountains, encourage your child to frequently yawn, swallow or chew gum if your child is old enough.  This helps the ears to equalize pressure through popping.

Related Topics

Because problems with eustachian tubes are closely related to ear infections, you may want to read information on ear infections. Call our Ear, Nose and Throat Department (Otolaryngology) for an appointment.