Eustachian Tube Dysfunction (ETD): Causes, Symptoms, and Treatment
A Hampshire ENT Clinics patient guide
A feeling of blocked ears, pressure, popping, muffled hearing, or discomfort when flying or driving through hills is often due to Eustachian tube dysfunction (ETD). This is a common ENT condition and can significantly affect comfort, hearing, and quality of life.
At Hampshire ENT Clinics, we regularly assess and treat patients with ETD using a structured, evidence-based approach, from medical therapy to modern procedural options.
What Is the Eustachian Tube?
The Eustachian tube is a narrow passage that connects the middle ear to the back of the nose (nasopharynx). Its role is to:
Equalise pressure between the middle ear and the outside world
Drain fluid from the middle ear
Protect the ear from infection
It opens briefly when you swallow, yawn, or chew.
What Is Eustachian Tube Dysfunction?
ETD occurs when the tube fails to open properly or becomes blocked. This leads to negative pressure in the middle ear and the sensation of fullness or pressure.
ETD may be:
Intermittent (e.g. during colds or flights)
Chronic (persistent symptoms lasting months)
Common Causes of ETD
ETD is often related to inflammation around the tube opening and may be caused by:
Colds and upper respiratory infections
Allergic rhinitis
Chronic rhinosinusitis
Nasal blockage or turbinate swelling
Acid reflux affecting the back of the nose
Structural narrowing of the Eustachian tube
Typical Symptoms
Patients with ETD may experience:
Ear fullness or pressure
Popping or crackling sensations
Muffled hearing
Discomfort during flying or altitude change
Intermittent ear pain
A feeling that the ear “won’t clear”
Some patients also develop fluid behind the eardrum (otitis media with effusion).
How Is ETD Assessed?
Assessment at Hampshire ENT Clinics typically includes:
Detailed history of symptoms and triggers
Ear examination (otoscopy)
Hearing tests (audiometry)
Tympanometry to measure middle-ear pressure
Nasal endoscopy to assess the Eustachian tube opening
This helps distinguish ETD from inner-ear conditions or jaw-related symptoms.
Treatment Options for ETD
1. Medical Treatment
Often the first step, including:
Steroid nasal sprays
Saline rinses
Allergy management
Treating reflux if relevant
These aim to reduce inflammation around the tube opening.
2. Autoinflation Techniques
Some patients benefit from pressure-equalising exercises or devices to help open the tube.
3. Grommets (Ventilation Tubes)
In selected cases, small tubes can be placed in the eardrum to equalise pressure, particularly if fluid is present.
4. Balloon Eustachian Tuboplasty
For persistent ETD, balloon dilation of the Eustachian tube may be considered. This minimally invasive procedure widens the tube opening and can provide long-term symptom relief in selected patients.
When to Seek ENT Review
You should seek specialist assessment if:
Symptoms persist for more than 6–8 weeks
Ear pressure or hearing problems keep recurring
Symptoms are affecting flying, work, or sleep
You have recurrent middle-ear fluid or infections
Frequently Asked Questions (FAQs)
Is Eustachian tube dysfunction serious?
ETD is usually not dangerous, but chronic symptoms can affect hearing and quality of life and may lead to middle-ear problems if untreated.
Can ETD cause hearing loss?
Yes. ETD can cause temporary conductive hearing loss due to pressure changes or fluid behind the eardrum.
Why is ETD worse when flying?
Rapid pressure changes require the Eustachian tube to open frequently. If it cannot, pressure builds up, causing pain or blockage.
Do decongestant sprays help ETD?
Short-term use may help during colds or flights, but regular or prolonged use can worsen nasal inflammation and is not recommended.
Is ETD linked to nasal problems?
Very commonly. Allergic rhinitis, sinus disease, and nasal blockage are frequent contributors and should be treated as part of management.
What is balloon Eustachian tuboplasty?
It is a minimally invasive procedure where a small balloon is used to widen the Eustachian tube opening, improving ventilation and pressure equalisation.
Will ETD go away on its own?
Acute ETD often resolves. Chronic ETD may persist without targeted treatment and should be assessed by an ENT specialist.
Do I need scans for ETD?
Usually not. Diagnosis is primarily clinical, supported by hearing tests and tympanometry. Imaging is reserved for atypical cases.
Where can I be assessed?
Assessment and treatment are available at Hampshire ENT Clinics, with consultant-led care across Portsmouth, Winchester, Salisbury, and the wider Hampshire region.
Expert Care for Ear Pressure and Blocked Ears
Eustachian tube dysfunction is common, treatable, and often linked to nasal inflammation. A structured ENT assessment helps identify the cause and the most effective treatment.
📞 If you are struggling with blocked ears or pressure, contact Hampshire ENT Clinics to arrange an expert assessment.