Eustachian Tubes: Anatomy, Dysfunction & Treatment

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Eustachian tubes connect your middle ears to the back of your throat. The tubes help drain fluid from your middle ear and balance air pressure inside your ears. Allergies, colds or infections can cause eustachian tube dysfunction. This is a broad term for issues that keep your eustachian tubes from working like they should.

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Overview

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What are eustachian tubes?

Your eustachian (you-STAY-shee-un) tubes are tubes made of bone and cartilage that run from your middle ears to the back of your nose and throat. Healthcare providers may call them auditory (hearing) tubes or pharyngotympanic (throat to eardrum) tubes. Eustachian tubes are named for Bartolomeo Eustachi, the doctor who discovered how the tubes connect middle ears to noses and throats.

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Eustachian tubes protect your middle ear from issues that can affect your hearing. Allergies, colds or infections can cause eustachian tube dysfunction (ETD), a broad term for when your eustachian tubes don’t open or close normally.

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Function

What do eustachian tubes do?

Your eustachian tubes have three primary functions. They:

• Drain fluid from your middle ear: This reduces your risk of an ear infection.
• Equalize air pressure in your middle ear: Your eustachian tubes do this by opening when you swallow or yawn. This lets in small amounts of air so that the air pressure in your middle ear and the environment match, and your eardrum can work like it should.
• Protect your middle ear: Your tubes close when you’re not swallowing or yawning, which protects your middle ear from intruders like viruses and bacteria.

Anatomy

Where are eustachian tubes located?

You have two eustachian tubes, one on each side of your face, measuring 12 millimeters (mm, half an inch) long and 2 to 3 mm (one-eighth inch) wide.

Your eustachian tube has two sections. One is near your middle ear, measures 12 mm long and is made of bone. The second section is closer to your nose and throat, measures 24 mm (just under an inch) and is made of cartilage.

Conditions and Disorders

What conditions affect my eustachian tubes?

The most common issue is eustachian tube dysfunction, which may develop if your eustachian tubes swell. This can happen if you have:

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• Allergies.
• Barotrauma.
• Colds.
• Ear tumors.
• GERD.
• Sinusitis.

These conditions may cause the following symptoms:

• A feeling of fullness in your ears.
• Muffled sounds or distorted hearing.
• Popping or clicking sensations.
• Ear pain on one or both sides that may feel like an ear infection.
• Ringing in your ears (tinnitus).
• Balance problems.
• Dizziness.
• Vertigo.
• A “tickling” sensation in your ears.

These symptoms may go away on their own. But you should contact a healthcare provider if you have symptoms that last for more than two weeks.

How are eustachian tube conditions diagnosed?

A healthcare provider will examine your eardrum for disease or damage. They may ask you to do a Valsalva maneuver, or to follow these steps to open your clogged eustachian tubes:

• Close your mouth.
• Pinch your nostrils closed.
• Breathe out as hard as you can.

They may do tests to see if your eustachian tubes open and close normally. Your eustachian tubes should only open when you do things like yawn, chew or swallow.

What home remedies open clogged eustachian tubes?

Eustachian tube massage is one home remedy. To do this, you:

1. Use your finger to find a bony bump behind your ear lobe.
2. Slide your finger down until you feel a groove between your earlobe and jaw.
3. Using firm, steady pressure, trace the groove all the way down your neck to the collarbone.
4. Repeat this process three times on each side of your head, three times a day.

Other home remedies are:

Chewing gum.

• Clearing clogged nasal passages with saline spray.
• Taking antihistamines or decongestants.
• Yawning.
• Swallowing.
• Valsalva maneuver.

If home remedies don’t work, your provider may refer you to an otolaryngologist (ear, nose and throat specialist or ENT) for more tests and treatment. Procedures to treat your eustachian tubes include:

• Tympanostomy (ear tubes): Your surgeon places ear tubes into your eardrums and does a myringotomy.
• Eustachian tuboplasty (eustachian tube balloon dilation): This treatment involves expanding your eustachian tubes with a balloon.

A note from Cleveland Clinic

Your ears aren’t always the reason why you have symptoms like ringing or fullness in your ears. Sometimes, your eustachian tubes are to blame. Your eustachian tubes help keep your middle ear healthy. Allergies, colds or infections can affect your eustachian tube and how they function.

Most of the time, eustachian tube issues go away on their own or by using home remedies like chewing gum or yawning. But you should schedule a visit with a healthcare provider if your symptoms last more than two weeks.

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Medically Reviewed.Last updated on 04/02/2024.

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References

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

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Medically Reviewed.Last updated on 04/02/2024.

References

Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.

• American Academy of Family Physicians. Eustachian Tube Dysfunction (https://familydoctor.org/condition/eustachian-tube-dysfunction/). Updated 11/2023. Accessed 4/2/2024.
• Llewellyn A, Norman G, Harden M, et al. Interventions for adult Eustachian tube dysfunction: a systematic review (https://www.ncbi.nlm.nih.gov/books/NBK262265/). Southampton (UK): NIHR Journals Library; 2014 Jul. (Health Technology Assessment, No. 18.46.) Chapter 1, Background. Accessed 4/2/2024.
• Szymanski A, Agarwal A. Anatomy, Head and Neck, Ear Eustachian Tube. (https://www.ncbi.nlm.nih.gov/books/NBK482338/) 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Accessed 11/26/2021.

Care at Cleveland Clinic

Fluid behind your eardrum can cause constant earaches and fullness. Ear tube surgery, or tympanostomy, at Cleveland Clinic can help you feel — and hear — better.

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