Eustachian tube dysfunction (ETD)

About the Eustachian tube

The Eustachian tube is a small passage that connects your middle ear to the back of your  nose and throat. Its role is to:

• equalise pressure in your middle ear
• drain fluid from your ear to your throat
• protect your ear from infections and changes in air pressure.

When the eustachian tube doesn’t work properly, it’s known as Eustachian Tube Dysfunction (ETD).

ETD causes and symptoms

Causes

ETD can occur for a variety of reasons, including the following.

• Colds or respiratory infections: Swelling in the nasal passages can block the Eustachian tube. This is common in children under the age of 7, due to the size and positioning of their Eustachian tubes compared to an adult ear.
• Allergies: Inflammation caused by allergies can disrupt normal function.
• Frequent ear infections: Children prone to ear infections may experience ETD more often.
• Growth of the adenoids (glands found in the upper airway). Enlarged adenoids can press on the Eustachian tube, blocking it.

Symptoms

Children with ETD may experience:

• ear pain or discomfort
• sensation of fullness or pressure in the ear
• muffled hearing or temporary hearing loss
• popping or clicking sounds in the ear
• balance issues (rare).

Management of ETD

Treat the cause

If symptoms are related to colds or allergies, treating the underlying cause can help. Following a cold, it can take longer for a child's middle ear pressure to normalise, because their Eustachian tubes tend to be less angled and narrower compared to an adult ear.

Your child’s GP may recommend antihistamines or nasal sprays for allergies.

Encourage auto-inflation

You can encourage your child to do blowing exercises such as blowing bubbles through a straw into water or blowing balloons.

If your child is old enough, encourage them to equalise their ears in the following way:

• Instruct your child to take a deep breath and close their mouth.
• Ask them to pinch their nose shut with their fingers.
• While keeping their nose pinched and mouth closed, ask them to gently blow as if trying to blow their nose.

You can also consider using Otovent. An Otovent kit consists of a nosepiece attached to a latex balloon. Using this device helps to open the Eustachian tube to equalise middle ear air pressure.

Prevention of ETD

While ETD cannot always be prevented, the following tips can make it less likely to happen.

• Keep your child’s allergies well managed
• Teach your child to blow their nose gently to avoid forcing mucus into the ear
• Avoid exposing your child to second-hand smoke, which can increase the risk of ear problems.