Eustachian Tube Dysfunction

The Eustachian tubes are anatomical structures that establish a connection between the middle ear and the upper throat, with a critical role in pressure regulation and fluid drainage from the middle ear (area behind the ear drum). Ordinarily, these narrow tubes remain closed, and their patency can be established by physiological manoeuvres such as chewing, swallowing or yawning.

Eustachian Tube Dysfunction: An Overview

The Eustachian tube is a narrow tube connecting the throat and the middle ear. The Eustachian tube regulates the pressure in the ear and drains fluid from the middle ear. This occurs through the natural process of the tube opening in response to physiological activities. Eustachian Tube Dysfunction can cause ear pain, pressure and hearing problems when this channel is blocked or infected. Although Eustachian Tube Dysfunction frequently resolves independently without treatment, medical assessment is advised when severe symptoms last longer than a few weeks. An experienced healthcare professional should be consulted to determine the underlying cause and develop an appropriate treatment plan to manage the condition.

Eustachian Tubes: The Functions

The Eustachian tubes serve three primary functions:

  • Ventilating the middle ear
  • Safeguarding it from infections
  • Facilitating the drainage of secretions away from the middle ear

These narrow passages remain sealed in their natural state but open reflexively in response to activities such as chewing, swallowing or yawning. This phenomenon permits the entry of fresh air into the middle ear. It facilitates the outflow of mucus, equalising air pressure on either side of the eardrum and ensuring its vibratory capacity. When the Eustachian tubes function correctly, they usually do not cause noticeable symptoms.

Symptoms of Eustachian Tube Dysfunction

Eustachian Tube Dysfunction manifests when the Eustachian tube experiences an obstruction or faulty opening, leading to a disparity in air pressure on either side of the eardrum. The resultant disparity creates an increased external pressure on the eardrum compared to the internal pressure, causing tension and hindering its ability to vibrate in response to sound waves.

The symptoms of Eustachian Tube Dysfunction may persist for hours, weeks or more and commonly include:

Ear Pain

  • Feeling pressure or congestion in the ears, such as ears popping, or experiencing a sense of ear blockage
  • Tension and stretching of the eardrum can occur in certain ear conditions
  • Continuous ear pain is an uncommon symptom of Eustachian Tube Dysfunction. If you are experiencing persistent ear pain, it is advisable to seek medical attention to explore alternative underlying causes


  • A sensation of ringing or buzzing in the ear can be a symptom of tinnitus
  • Muffled hearing is a symptom that may accompany the tension and stretching of the eardrum
  • Continuous ear pain is an uncommon symptom of Eustachian Tube Dysfunction. If you are experiencing persistent ear pain, seeking medical attention to explore alternative underlying causes is advisable


  • Ears popping, clicking or crackling sounds when chewing or swallowing
  • Intermittent pain
  • Vertigo or mild dizziness

Flying and Diving - Eustachian Tube Dysfunction

Eustachian Tube Dysfunction can cause significant problems when the ears are challenged with changes in pressure such as during a flight or when diving under water. This typically causes pain and pressure which is not alleviated by trying to pop the ears. Simple measures such as chewing gum or sucking sweets may help but if the is a significant underlying issue with the eustachian tube then even these measures may not help. Thankfully there are a number of options available to treat these pressure related symptoms.

Causes of Eustachian Tube Dysfunction

Upper Respiratory Infections: Respiratory infections such as the common cold, along with other ear, nose and throat infections, can cause the accumulation of thick mucus and blockage of nasal passages, leading to obstruction of the Eustachian tube. Additionally, infections can induce inflammation and swelling of the Eustachian tube lining, resulting in the persistence of ETD symptoms after treatment.

Glue Ear: A common condition in children, glue ear occurs when the middle ear fills with a viscous fluid that impairs airflow through the Eustachian tube, resulting in a difference in air pressure that can cause pain and muffled hearing. The fluid can also interfere with the eardrum's vibrations, further affecting hearing.

Allergies: The production of excess mucus in and around the Eustachian tubes due to diseases like allergic rhinitis or hay fever, which cause nasal inflammation, sneezing and blocked ears or runny nose, can result in ETD.


Obstruction of the Eustachian Tube: Blockages of the Eustachian tube can result from enlarged adenoids or other conditions, including rare cases where tumours develop in the back of the nose.

ETD: Diagnosis and Treatment

With the help of an ENT specialist, the ear canals and tubes leading to the nose and throat will be examined to determine the underlying cause of the ETD. This thorough medical evaluation will occur during the consultation with our experienced ENT expert.


Our ENT specialist will review your treatment choices with you based on the diagnosis, which may entail surgical or non-surgical interventions to address the condition's underlying cause.

Non-surgical treatment options that can be used to treat ETD symptoms include:

  • Simple Exercises: Swallowing, yawning, chewing gum and forceful exhalation through a closed mouth and nose are techniques that can be recommended to help open up the Eustachian tubes and equalise pressure in the middle ear.
  • Allergy Medication: Antihistamines can be prescribed to help manage allergy symptoms and associated ear problems.
  • Over-the-Counter Pain Medication: Our ENT specialist may recommend taking ibuprofen or other pain relievers to help alleviate discomfort associated with ear pain.
  • Nasal or Oral Corticosteroids: Prescription nasal or oral corticosteroids may be recommended to reduce inflammation of the lining of the Eustachian tubes.
  • Antibiotics: If a bacterial ear infection causes the symptoms of ETD, our specialist may prescribe antibiotics to treat the condition.

Various treatment options for Eustachian Tube Dysfunction are available, which vary depending on the underlying cause. Some of these options include:

  • Myringotomy: A small incision is made in the eardrum to extract the fluid using suction.


  • Pressure Equalisation Tubes (PETs) Implantation: The tubes are inserted to balance ear pressure and drain fluid.


  • Balloon Eustachian Tuboplasty: To facilitate airflow and stabilise pressure, a balloon is inserted through the nose.

Mr Lakhani is an ENT surgeon with a significant experience base in treating Eustachian Tube Dysfunction using the latest surgical techniques. He is committed to tailoring treatment to each patient's unique needs for optimal results. Surgical treatment options for Eustachian Tube Dysfunction include procedures on the nose, sinuses and eustachian tubes, which are often combined to improve the effectiveness of the treatment. Mr Lakhani will carefully evaluate each patient and determine the most appropriate surgical approach to address their specific condition and improve their symptoms.

With Mr Lakhani's expertise and state-of-the-art surgical techniques, patients can significantly relieve the discomfort and inconvenience of Eustachian Tube Dysfunction. Patients can expect compassionate care, clear communication and customised treatment plan to ensure the best possible outcomes.

ENT LDN: Improving Lives Through Advanced ENT Solutions

At ENT LDN, we offer specialised treatment for Eustachian Tube Dysfunction (ETD), which affects the middle ear and can cause symptoms such as ear pressure, pain and hearing loss. Our ENT specialists have extensive experience diagnosing and treating ETD using advanced techniques, including balloon dilation and other minimally invasive procedures.


We understand how ETD can impact your daily life and are committed to providing personalised care that addresses your needs. No matter what ENT-related condition you may be dealing with, whether it's Eustachian Tube Dysfunction treatment, hearing loss, sinus problems or anything else, we are here to provide the care and support you need. Contact us today to schedule an appointment and take the first step towards optimal health and well-being.

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Julia Brighton

9 Harley Street
London W1G 9QY


020 7760 7561
020 7760 7222