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Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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In this Article

• What is the Eustachian tube?
• What are the functions of the Eustachian tube
• What can cause Eustachian tube blockage?
• How do altitude changes or air travel affect Eustachian tube problems?
• How is Eustachian tube blockage treated?
• Eustachian Tube Problems At A Glance
• Ear Infection (Otitis Media) FAQs
• Patient Comments: Eustachian Tube Problems - Altitude and Air Travel
• Patient Comments: Eustachian Tube Problems - Treatments
• Patient Comments: Eustachian Tube Problems - Experience
• Find a local Ear, Nose, & Throat Doctor in your town
• Eustachian Tube Problems Index

A rapid change in altitude, and thus air pressure is equalized across the eardrum by a normally functioning Eustachian tube. A healthy tube opens frequently and widely enough to equalize these changes in air pressure. With altitude changes during the descent of an airplane, air pressure increases as the plane lowers. The air pressure change pushes the eardrum inward (retraction). Persons with Eustachian tube blockage can develop fullness of the ear, dulled hearing, and possibly pain when this occurs. Those with poorly functioning Eustachian tubes may experience similar symptoms when riding in elevators, driving through the mountains, or diving to the bottom of a swimming pool. Scuba divers learn tricks to equalize their ear pressures.

Several maneuvers may be done to improve Eustachian tube function and thus aid in equalization of air pressure.

• The simple act of swallowing activates the muscles in the back of the throat that help open the Eustachian tube. Any activity that promotes swallowing can help open the Eustachian tube, for example, chewing gum, drinking, or eating.
• Yawning is even more effective because it is a stronger muscle activator.
• If the ears still feel full, the person can try to forcibly open the Eustachian tube by taking a deep breath and blowing while pinching your nostrils and closing the mouth. When a "pop" is felt, you know you have succeeded. If problems persist despite trying to forcibly open the tubes you may need to seek medical attention. If you feel dizzy performing this maneuver, then stop and discuss this with your doctor.
• If you have a cold, sinus infection, ear infection, or suffering from allergies, it may be advisable to postpone air travel.
• Similarly, individuals with Eustachian tube problems may find such sports as scuba diving painful, and in some situations quite dangerous.
• Babies traveling on airplanes cannot intentionally pop their ears, but may do so if they are sucking on a bottle or pacifier. Crying, similar in function to yawning, will also enable equalization of air pressure.

Many individuals who travel with Eustachian tube problems use a decongestant pill or nasal spray an hour prior to takeoff, and if necessary, prior to descent. The decongestant acts to shrink the membranes lining the nose and throat, allowing the ears to equalize more easily. Similarly, patients experiencing chronic daily problems with Eustachian tube dysfunction can benefit by aggressive control of allergies (with antihistamines, decongestants, and prescription nasal sprays). Allergy evaluation can be helpful. In severe situations, a "pressure equalization tube" (PET) can be surgically placed in the eardrum, replacing the role of a functioning Eustachian tube, and thus guaranteeing equalization of middle ear pressure.