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Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.
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John Carew, MD, is board-certified in otolaryngology and is an adjunct assistant professor at New York University Medical Center.
The e ustachian tubes keep the middle ear healthy by equalizing pressure, clearing secretions, and protecting it from pathogens that could cause infections.
The eustachian tube is also called the auditory tube. It extends from the middle ear to the upper part of the throat behind the nose.
This article will go over the anatomy and function of the eustachian tube. You will also learn about conditions that can affect the auditory tube.
The eustachian tube is located in a part of the head and neck called the parapharyngeal space. It runs from the front wall of the middle ear to the side wall of the top part of the throat ( nasopharynx ).
In adults, the eustachian tube slopes down about 35 degrees. In children, the eustachian tube only slopes about 10 degrees down. 1
The eustachian tube is made of bone, cartilage, and fibrous tissue. It is a hollow tube that is lined with hair-like projections ( cilia ) that sweep mucus away from the middle ear toward the nasopharynx. 1
There are six muscles that help the eustachian tube open and close. The muscles are located in the ear, head, neck, soft palate, and jaw. 1
The eustachian tubes help make sure the middle ear stays healthy by:
Each eustachian tube usually stays closed to act as a barrier to protect the ear. 3 However, they will open when the muscles contract—for example, when a person is yawning and swallowing.
When the air pressure changes outside, the eustachian tube opens to allow air to move from the ear canal to the middle ear. This ensures the pressure can equalize on both sides of the eardrum.
To keep the middle ear working right, the space around the tubes needs to be free of fluid and other debris. The cilia and mucosal folds in the eustachian tube work together to drain the mucus that is made in the middle of the ear. 4
Eustachian tube dysfunction (ETD) is when the tubes do not open or close properly. There are a few conditions that can be caused by an auditory tube that isn't working right.
If a eustachian tube is blocked, it makes the pressure in the ear canal and middle ear unequal. This can cause symptoms such as fullness in the ears, reduced hearing, and ear pain . The pressure can also cause a ringing or buzzing in the ears ( tinnitus ). 2
The eustachian tubes commonly get blocked by nasal secretions from upper respiratory tract infections, allergies, or sinusitis. The secretions can have bacteria or viruses in them, which can cause a middle ear infection ( otitis media ). 5
In children, the eustachian tubes are more horizontal than they are in adults. This makes it harder for nasal secretions to drain and is one reason why kids tend to get more ear infections than adults do. 1
In most people, the eustachian tubes open without a problem whenever the air pressure changes, such as when flying in an airplane or diving underwater. However, in some people, the tubes have a harder time equalizing the pressure. As a result, people may have temporary ear pain when they are in these situations.
Patulous eustachian tube is when a eustachian tube stays open longer than usual. It can cause a feeling of pressure in the ears. People can also experience a distortion in the sound of their own voice or breathing.
Often, the cause of patulous eustachian tube is not known. However, there are some known risk factors for patulous eustachian tubes including weight loss, pregnancy, neurologic disorders like multiple sclerosis, anxiety, and exhaustion. 6
Most symptoms of eustachian tube dysfunction are mild and get better on their own within a few days. If your eustachian tubes are blocked, swallowing, chewing gum, or yawning can help clear them.
If your symptoms persist or if you’re having pain, make an appointment with your healthcare provider. They can figure out why your ears are blocked and recommend the best treatment.
They might suggest you try a few treatments to reduce nasal congestion and clear the middle ear of drainage, such as:
Alternative medicine practitioners often recommend using eustachian tube massage as a natural way to help ear congestion drain. 7 You press your fingers behind and below your ear lobe and gently massage the area by pulling your fingers down.
Some people might find eustachian tube massage helpful for symptoms, but there has not been a lot of research to prove that it works to clear up a blockage or treat eustachian tube dysfunction. 8
For severe eustachian tube dysfunction symptoms that don't go away, you might need to have surgery. There are a few ways that providers can clear the eustachian tubes if they are blocked:
Most people with patulous eustachian tubes can manage their symptoms without surgery because they only happen once in a while (e.g., while they're in an airplane). For example, putting your head down between your knees can quickly relieve symptoms.
If these strategies do not work, patulous eustachian tubes can be treated with surgery similar to eustachian tube dysfunction. 9
The eustachian tubes run from the top of your throat to your middle ear. Their job is to help protect your ear and keep it healthy. Sometimes, there are problems with the eustachian tube and they don't open or close correctly.
Eustachian tube dysfunction can often be treated without surgery, but sometimes people need to have special tubes put in their ears to help prevent them from getting blocked up or infected.
Szymanski A, Agarwal A. Anatomy, Head and Neck, Ear Eustachian Tube . National Center for Biotechnology Information.
Llewellyn A, Norman G, Harden M, et al. Interventions for adult Eustachian tube dysfunction: a systematic review. Health Technol Assess. 2014;18(46):1-180, v-vi. doi:10.3310/hta18460.
Smith ME, Takwoingi Y, Deeks J, et al. Eustachian tube dysfunction: A diagnostic accuracy study and proposed diagnostic pathway. PLoS ONE. 2018;13(11):e0206946. doi:10.1371/journal.pone.0206946.
Casale J. Physiology Eustachian Tube Function. National Center for Biotechnology Information.
Genetic and Rare Disease Information Center. Patulous Eustachian Tube .
Florida Naturopathic Medicine Association. Eustachian Tube Massage for Congestion .
Feldmann H. Die Trommelfellmassage, Aufstieg und Niedergang eines vielversprechenden therapeutischen Konzeptes [Tympanic membrane massage, origin and decline of a promising therapeutic concept] . Laryngorhinootologie . 1996;75(8):491-498. doi:10.1055/s-2007-997621
Hussein AA, Adams AS, Turner JH. Surgical management of Patulous Eustachian tube: A systematic review . Laryngoscope . 2015;125(9):2193-2198. doi:10.1002/lary.25168 doi:10.1002/lary.25168
By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.
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Example of a Surgical Site Closure Process
Step 3: Gauze covering the incision the day after surgery
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In most cases, when a G-tube is no longer needed, it can simply be removed. The site will slowly close on its own over a period of about two weeks. Usually all that is needed is a bit of gauze to catch any initial leakage. Barrier cream can be used around the site to protect the skin from any leakage.
Sometimes, the stoma or site does not close easily on its own. This may be more likely to occur when a child has a G-tube for a long period of time, if the child has had lots of problems with the site, or if the child has certain medical conditions that make healing more difficult. In this case, a surgeon may surgically close the site in a short outpatient surgery.
Typically, doctors will wait for a period of 2 to 8 weeks before performing surgery to try to allow the site to close on its own. If leakage is substantial or the child’s skin is becoming severely irritated, call the doctor right away since surgery may need to be performed earlier. It may be wise to have a surgical consult at the time of removal to make sure a plan is in place.
G-tube button prior to removal. Clean and no granulation tissue.
In this instance, a Pediatric Surgery nurse used a silver nitrate stick inside the stoma immediately after removal. The family continued to silver nitrate at home with silver nitrate sticks given with permission from the pediatric surgery nurse. The stoma was covered with barrier cream, gauze, and tape. The stoma seemed to be closing, but after 4 weeks there was still a pinhole that was leaking when eating/drinking. Surgery was scheduled to close the hole and inner lining of stomach.
3 strips of gauze soaked in betadine to prevent infection. The incision was covered with gauze until 3 days after surgery.
The betadine gauze was removed. It was simple to remove, just pull gently and the strips come right out.
The incision already started to close on its own 8 hours after pulling the strips. The incision was kept clean and dry and covered with gauze for one more day, but after that there was no need to cover the incision.
Please note that this site should not replace medical information from health care professionals.
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