Eustachian tube dysfunction

Timothy C. Hain, MD, Please read our disclaimer. Most recent update: 12/22/00.

The eustachian tube connects the middle ear to the throat. It is labeled #10 on the diagram above. Its purpose is to equalize middle ear pressure with environmental pressure. When your ear "pops" on a high-speed elevator or in an airplane, the reason is that the eustachian tube has opened and equalized pressure.

Occasionally people develop symptoms when the eustachian tube does not equalize pressure. This may involve pain or fullness. Disturbances of eustachian tube function are generally called "ET" dysfunction.


Treatment of ET dysfunction is not very sophisticated. Medications for allergy such as antihistamines or topical steroids are commonly tried. Recently a method of directly treating ET dysfunction by instilling steroids into the middle ear through a "microwick" has been described.(Silverstein et al, 2003). As this method involves putting a hole in the tympanic membrane, it is possible that the good results are related to better ventilation rather than the effect of medication. It is too soon to say if this method will become standard.

Occasionally, people with severe symptoms due to ET dysfunction may have a ventilation tube placed in their ear drum. This relieves the symptoms of ET dysfunction but creates a perforation in the eardrum which reduces hearing to a small extent as well as provides a potential entry point for infection.

A ventilation tube being placed in the ear drum.


Graphics are courtesy of Northwestern University, and are used with permission.