Eustachian Tubes: What to Know

Medically Reviewed by Poonam Sachdev on October 03, 2022
4 min read

Your eustachian tubes are located on the inside of each ear on the sides of your head. These tubes connect your middle ear to the back of your nose and throat.

The eustachian tubes have a few different functions. First, they drain fluid from your middle ear. They also help to protect your middle ear from viruses and bacteria. Additionally, eustachian tubes equalize the pressure around your ear drums. When you hear your ears pop after you swallow or yawn, that is actually your eustachian tubes at work.

The eustachian tubes are hollow, consisting of a combination of bone and cartilage. They are about 36 millimeters long, just under 1.5 inches. The third of the tube that is closest to your middle ear is made of bone. The rest is made of cartilage.

The eustachian tubes play an important role in maintaining ear health. Eustachian tube dysfunction can cause muffled hearing, ear pain, balance issues, and dizziness. 

How do these tubes work, though?

Your eustachian tubes are closed most of the time. However, when you yawn or swallow, they open to equalize the pressure and release any excess fluid and mucus.

The position of the eustachian tube is different in children and adults. In children younger than 6, it is oriented more horizontally. As you get older, the tube slants down from the middle ear into the back of the nose and throat. This is why young children are more prone to ear infections than adults. When the tube is horizontal, it gets blocked more easily.

When your eustachian tube is blocked, air becomes trapped in the middle ear. The air pressure inside the middle ear then becomes lower than the air pressure outside the middle ear. This negative pressure pulls the ear drum inward, causing tension and pain. If the tube is blocked for a long enough period, fluids and bacteria are trapped in the middle ear, leading to an ear infection.

Your eustachian tubes are located in the middle ear. 

The external ear consists of the pinna (the part of the ear that you can see), as well as the ear canal. The middle ear contains the ossicles, which are three small bones that help you hear, as well as some air and the eustachian tubes.

It's normal to feel like your ears are blocked for a few days if you have a cold. However, if you experience these issues for longer than that, you may want to consult your doctor. Other signs something may be wrong with your eustachian tubes include:

  • Ear pain
  • Muffled hearing
  • Popping sounds
  • Tinnitus
  • Balance issues
  • Dizziness
  • Your own voice sounds uncomfortably loud to you
  • The sound of your own blood pumping loudly

Chronic eustachian tube issues are called eustachian tube dysfunction. This can occur for many reasons:

  • Viruses like a cold or flu 
  • Allergies
  • Obesity 
  • Nasal polyps 
  • Cleft palate 
  • Tumors 
  • GERD 
  • Weight loss 
  • Neuromuscular disease 
  • Changes in altitude, like flying in a plane or scuba diving 
  • Exposure to pollution  
  • Secondhand cigarette smoke 
  • Smoking

There are three main types of eustachian tube dysfunction:

Patulous eustachian tube dysfunction. This occurs when your eustachian tubes stay open for too long, causing you to hear everything happening inside of your head much louder than usual. Your doctor may prescribe nasal drops or spray. Your symptoms may also improve if you drink more water and cut out caffeine.

Obstructive eustachian tube dysfunction. This occurs when your tubes become blocked, causing pain, pressure, and hearing loss. Such chronic obstruction can lead to ear infections. Treatments include allergy medication or decongestants. Your doctor may also recommend surgery to dilate the tubes with a balloon, remove the adenoids, or insert a tube into the eardrum to equalize pressure.

Baro-Challenge-Induced Eustachian Tube Dysfunction. This is similar to obstructive eustachian tube dysfunction, but it only occurs when you experience changes in altitude. For people who must do so often, like pilots, this condition can be a significant issue. The most successful treatment for this condition is surgery to dilate the eustachian tubes with a balloon.

Follow these tips to keep eustachian tubes healthy and prevent ear infections.

  • Feed infants with their heads elevated to stop milk from entering the middle ear.
  • Give babies pacifiers to encourage swallowing or feed them if you suspect their eustachian tubes are blocked.
  • If you have blocked eustachian tubes for longer than two weeks, visit your doctor.
  • Perform a eustachian tube massage by running your finger from the bony bump behind your ear down the groove between your earlobe and your jaw, all the way down to your collarbone.
  • If your eustachian tubes are blocked, try the valsalva maneuver: hold your nose shut and close your mouth. Then, blow out without expelling any air. This can equalize the pressure in your ears and cause them to "pop." Do not do this, though, if you have high blood pressure or are at risk for a heart attack or stroke.
  • If your eustachian tubes are blocked, try chewing gum, yawning, or swallowing to relieve the pressure.