The eustachian tube is a small passageway that connects the upper part of the throat to the middle ear. Its main purpose is to equalize pressure between the middle ear and the outside world. When this tube gets blocked, usually due to inflammation from allergies, colds, or other respiratory infections, fluid can build up in the middle ear causing discomfort. This is referred to as eustachian tube dysfunction or ETD. Some common symptoms of ETD include muffled hearing, ear fullness, popping and clicking noises, dizziness, and ear pain. Fortunately, there are several methods you can try at home to help force the eustachian tubes to drain and relieve discomfort caused by ETD.
How Do the Eustachian Tubes Normally Function?
Under normal conditions, the eustachian tube opens periodically to ventilate the middle ear space and equalize pressure. This happens unconsciously when we swallow, yawn, or chew. When the tubes are functioning properly, air is able to flow freely between the middle ear and the nasopharynx (the upper part of the throat connected to the nasal cavity).
The muscles responsible for opening the eustachian tubes are activated during these acts. As the muscles contract, the tubal lumen widens and allows air to enter and exit the middle ear space. This pressure equalization is essential for normal middle ear function.
What Causes Eustachian Tube Dysfunction?
ETD occurs when the eustachian tubes become blocked or impaired, preventing normal ventilation of the middle ear. Common causes include:
- Inflammation from colds, flu, sinus infections, or allergies
- Enlarged adenoids
- Growths or tumors in the nasal cavity or throat
- Cleft palate
- Barotrauma from air pressure changes
- Smoking
When the ET is dysfunctional, it cannot open and close properly to allow air flow. The middle ear then becomes isolated, causing a pressure build-up and fluid accumulation. This leads to the bothersome symptoms associated with ETD.
Methods to Help Force and Drain Eustachian Tubes
Here are some of the most effective techniques for forcing eustachian tubes to drain:
1. The Valsalva Maneuver
This is one of the simplest ways to pop open the eustachian tubes. To perform the Valsalva maneuver:
- Close your mouth and pinch your nostrils shut with your fingers.
- Blow gently like you are trying to exhale out of your nose.
- You should feel pressure building up inside your head, followed by a popping sensation as the tubes open up.
This technique forces air into the tubes and equalizes pressure in the middle ear. Repeating this several times per day helps keep the tubes open and draining.
2. Swallowing and Yawning
Since the muscles that open the eustachian tubes are activated when we swallow or yawn, exaggerating these actions can help push air through the tubes.
Try taking big gulps of water repeatedly to get more vigorous contraction of your swallowing muscles. You can also try fake yawning with your mouth closed. These repetitive motions encourage the tubes to open more frequently.
3. Chewing Gum
Chewing gum is another way to work those eustachian tube muscles and get them to open up. The motion of chewing gum mimics what happens naturally when we chew food.
Aim to chew sugar-free gum for at least 30 minutes two to three times per day. You should feel popping sensations in your ears as the gum stimulates the tube muscles.
4. Nasal Decongestants
Nasal sprays or oral decongestants like pseudoephedrine shrink swollen nasal tissues. This helps open the entrance to the eustachian tube in the nose, allowing air to pass through more freely.
Use a decongestant spray or pill for a few days at the first signs of ETD to reduce inflammation before it gets worse. Just make sure to follow dosage guidelines.
5. Nasal Irrigation with Saline
Washing out the nasal passages helps clear out mucus and reduces inflammation. This can aid eustachian tube drainage.
Use a bulb syringe, nasal irrigation bottle, or neti pot to regularly flush the nasal cavity with sterile saline. The saline will thin out mucus buildup and promote drainage.
6. Stay Hydrated
Drinking plenty of water keeps nasal secretions thin and flowing. Thick mucus can clog the eustachian tube openings.
Aim for 8-10 glasses of water per day to keep yourself well hydrated, especially if you are experiencing ETD symptoms.
7. Use a Humidifier
Dry air causes membranes to swell and mucus to become sticky. Running a humidifier adds moisture to the air and can improve ETD symptoms.
Use a cool mist humidifier in your bedroom when sleeping and in rooms where you spend a lot of time. The hydrating mist keeps nasal tissues from drying out.
8. OTC Medicated Nasal Sprays
Some over-the-counter nasal sprays contain medications that help shrink tissues and stimulate drainage. These include options like oxymetazoline (Afrin) and phenylephrine (Neo-Synephrine).
Use medicated sprays for no more than 3 days at a time. They provide quick relief but shouldn’t be used long term due to rebound congestion.
9. Oral Antihistamines
For ETD caused by allergies and hay fever, oral antihistamines like Claritin (loratadine), Zyrtec (cetirizine), and Allegra (fexofenadine) can help reduce swelling of nasal tissues that block the tubes.
Take antihistamines as directed during allergy season to keep eustachian tube inflammation under control.
10. Decongestant Pills
Oral decongestants like pseudoephedrine also work well to relieve ETD caused by nasal and respiratory allergies. These medications available over the counter shrink swollen tissues in the nose and throat.
Follow dosage limits when using oral decongestants. Do not take them if you have high blood pressure or heart disease.
11. Steroid Nasal Sprays
Prescription nasal sprays containing steroids help resolve chronic inflammation affecting the eustachian tubes. Brand names include Flonase, Rhinocort, Nasonex and Nasacort.
It may take several days of use for steroid sprays to take effect. Use them daily as prescribed for the best results.
12. Salt Water Gargling
Gargling with warm salt water pulls excess fluid from swollen tissues in the throat, reducing inflammation at the openings of the eustachian tubes.
Stir 1⁄2 teaspoon of salt into an 8 oz glass of warm water. Gargle for 30 seconds, 3 to 4 times per day to reduce irritation in the throat.
13. Over-the-Counter Ear Drops
Ear drops that contain alcohol and acetic acid help dissolve earwax blockages. This allows for better ventilation through the eustachian tubes.
Place 2-3 drops in each ear 1-2 times per day. Use no longer than 2-3 days. See a doctor if excessive wax persists.
14. Manual Lymphatic Drainage
This specialized massage technique promotes lymphatic flow and drainage. A trained therapist uses light pressure to stimulate lymphatic vessels and nodes around the face, neck and head. This coaxes fluid buildup through the lymphatic system to drain.
See a lymphatic drainage therapist once or twice per week for optimal results if you have chronic ETD.
15. Prescription Medicated Nasal Rinses
For severe ETD that doesn’t respond to other methods, your doctor may prescribe medicated nasal rinses. These require a prescription and contain medications that work directly inside the nasal cavity to reduce swelling and promote drainage. An example is Xlear. Use daily as instructed.
16. Oral Antibiotics or Anti-Inflammatories
If an acute sinus infection or severe inflammation is the cause of ETD, oral antibiotics or prescription anti-inflammatory drugs may be needed to clear it up. Follow dosage guidelines if prescribed antibiotics or medications like prednisone. Take the full course as directed.
17. Ventilation Tubes
If conservative treatments fail, surgery to insert small ventilation tubes in the eardrums could be warranted. These tubes bypass the blocked eustachian tubes and provide an alternate airway. Tubes will either fall out on their own or may require removal after the ETD resolves.
18. Balloon Sinuplasty
This outpatient procedure uses a tiny balloon catheter to dilate sinus openings and ducts. This allows for better ventilation and drainage through the sinuses and eustachian tubes. It is an option for chronic sufferers without improvement from medications.
Home Remedies to Avoid
Some home remedies are not recommended and could potentially cause harm:
- Trying to forcefully blow air through the tubes by holding your nose and blowing hard. This risks ear damage.
- Using a cotton swab inside the ear canal. This could push earwax deeper into the tube.
- Putting 1-2 drops of rubbing alcohol into the ear. This dries out tissues and worsens swelling.
- Lighting a hollow candle near the affected ear. The heat and low pressure could scald the ear.
- Laying with the affected ear down. This may increase pressure in the tube.
When to See a Doctor
You should make an appointment with your doctor if:
- Symptoms last more than one week
- Pain in the ear becomes severe
- Hearing loss occurs
- You get acute dizziness, ringing in the ears, or vertigo
- Ear pressure and pain persists after trying home treatments
- ETD disrupts sleep or daily activities
- You have recurrent ETD
The doctor can check for infection and obstruction in the ear canal and nasopharynx. Treatment options may include prescription steroid therapy, antibiotics, nasal irrigation, or surgery if warranted. Chronic, recurrent cases may require referral to an ear, nose and throat specialist.
Conclusion
ETD develops when the eustachian tubes cannot open properly to equalize pressure and drain fluid from the middle ear space. This leads to uncomfortable symptoms like ear fullness, muffled hearing, and popping sensations. There are many techniques that can be done at home to get the eustachian tubes to open up and provide relief, such as the Valsalva maneuver, gum chewing, nasal irrigation, decongestants, antihistamines, and salt water gargling. Persistent or severe cases should be evaluated by a doctor for additional treatment. Promptly addressing eustachian tube dysfunction helps prevent short-term hearing problems and other complications like ear infection or perforated eardrum. With a multifaceted approach, most people can successfully manage their bothersome ETD symptoms.