Eustachian Tubes: How They Function and Common Issues

The nasopharynx is the area in the back of the nasal passages that extends down into the throat. The ears are connected to the nasopharynx through the pharyngotympanic tubes. The scientific name for these tubes describes where they are found in the body, between the pharynx, or the throat, and the tympanic membrane, or eardrum. Pharyngotympanic tubes are more commonly known as Eustachian tubes, deriving this name from Eustachius, an Italian anatomist from the 16th century.

You may not be aware of the pharyngotympanic tubes until you experience a problem with them. Certain conditions may cause dysfunction of the tubes that can contribute to hearing loss.

What Do the Eustachian Tubes Do?

The Eustachian tube is a space leading from the middle ear at an angle down into the throat. It has two main functions:

• Allow fluid to drain out of the middle ear
• Regulate air pressure in the ear

Without the Eustachian tube, the middle ear would be vulnerable to changes in air pressure caused by ordinary reflexive actions, such as swallowing or yawning. It could fill up with fluid, providing an environment for bacteria to grow, leading to infection.

The end of the Eustachian tube that connects to the nasopharynx usually remains closed. This is to prevent secretions from the nose from entering the Eustachian tube and contaminating it with fluid and pathogens. When you take actions that change the air pressure inside your head, such as swallowing or yawning, muscles in the back of the throat contract, causing the Eustachian tube on each side of your head to open.

What Causes Eustachian Tube Dysfunction?

Sometimes the pharyngotympanic tubes fail to adequately regulate air pressure or allow fluid to drain properly, causing Eustachian tube dysfunction. Most people experience mild symptoms of this from time to time. It can occur due to changes in air pressure or altitude, especially if these come on suddenly. For example, some people report mild symptoms from riding in an elevator or taking off in an airplane. This mild type of Eustachian tube dysfunction usually resolves itself within a few minutes, although it may also take several hours.

Sometimes something causes a blockage of the Eustachian tube, preventing it from opening properly. The passages are very narrow, meaning that it doesn’t take much to block them. When this occurs, it can cause a buildup of fluid that causes Eustachian tube dysfunction. Inflammation of tissues can cause them to swell, blocking the openings of the pharyngotympanic tubes. Common causes of inflammation include the following:

• Upper respiratory illnesses (e.g., cold or flu)
• Seasonal allergies
• Sinus infections

Another issue that can affect the Eustachian tube is a “patulous” tube, or one that is always open. This is a rare condition, and the cause is not always known, but it allows secretions from the nasal cavities to get into the middle ear, which may cause frequent ear infections.

Who Is at Risk for Eustachian Tube Dysfunction?

Most people experience mild Eustachian tube dysfunction at some point in their lives, but some people are at risk for recurrent episodes that may be more severe or more prolonged. Here are some common risk factors:

1. Young Age

The pharyngotympanic tubes of children are still developing. In childhood, the tubes are straighter and shorter, making it easier for fluid to become trapped in the middle ear. As a result, children tend to be more susceptible to Eustachian tube dysfunction and ear infections than adults.

2. Obesity

Fatty tissue deposits that form around the pharyngotympanic tubes can block them off, causing Eustachian tube dysfunction. People who are obese are more likely to have these deposits form.

3. Smoking

The middle ear is lined with tiny hairs called cilia that sweep mucus down the Eustachian tube into the throat. Smoking can damage the cilia, preventing mucus from moving down the tube.

Certain activities that put you at risk for changes in air pressure can also cause recurrent Eustachian tube dysfunction. Examples include scuba diving, rock climbing, and snowboarding or skiing.

How Does Eustachian Tube Dysfunction Affect Hearing?

Eustachian tube dysfunction can make your ears feel as though they are full of water or plugged up. This can cause an attenuation of sound, which is a type of mild hearing loss. Eustachian tube dysfunction also has the potential to cause tinnitus or ringing in the ears, which can also have a negative effect on your hearing.

In addition to hearing loss and tinnitus, Eustachian tube dysfunction can produce other symptoms, such as ear pain, a clicking or popping sensation, or difficulty with balance.

What Can You Do About a Eustachian Tube Issue?

Dysfunction of the Eustachian tubes often requires no treatment at all. If it is secondary to another medical problem, treating the underlying condition will resolve the symptoms. However, you should seek treatment if symptoms of Eustachian tube dysfunction last more than two weeks, are severe, or keep coming back.

Sources:

Eustachian Tube Dysfunction – FamilyDoctor.Org

Pharyngotympanic Tube – Healthline.com

What Is Eustachian Tube Dysfunction? – MedicineNet

What’s to Know About Eustachian Tube Dysfunction? – Medical News Today

Patulous Eustachian Tube – National Center for Advancing Translational Sciences