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November 25, 2009
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Eustachian Tube Problems (cont.)

How do altitude changes or air travel affect Eustachian tube problems?

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 elevators, driving through the mountains, or diving to the bottom of a swimming pool. Scuba divers learn tricks to equalize their ear pressures.

How is Eustachian tube blockage treated?

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. Chewing gum, drinking, or eating promotes swallowing.

  • Yawning is even more effective because it is a stronger muscle activator.

  • If the ears still feel full, you can try to forcibly open the Eustachian tube by taking a deep breath and blowing while pinching your nostrils and closing your mouth. When you feel a "pop" 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 or ear infection or are having an allergy attack, it may be advisable to postpone a trip by airplane.

  • 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 plane travelers with Eustachian tube problems use a decongestant pill or nasal spray an hour before 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.

Eustachian Tube Problems At A Glance

  • The Eustachian tube connects the middle ear space to the back of the nose.

  • Normally, the Eustachian tube is closed.

  • Partial or complete blockage of the Eustachian tube can cause sensations of popping, clicking, and ear fullness.

  • The Eustachian tube can become blocked from common colds or allergies.

  • Altitude changes can cause symptoms in persons with Eustachian tube problems.

  • Several maneuvers can be done to improve Eustachian tube function.

Last Editorial Review: 11/24/2008


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