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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. A doctor can assess Eustachian tube dysfunction by video and treat it; symptoms that last more than 3 weeks, or hearing that gets worse, need an ear examination in person.
- What it is: the narrow tube, about 3 to 4 cm long in adults, that links the middle ear to the back of the nose is blocked or does not open properly.
- Main symptoms: muffled hearing, a feeling of fullness or pressure, and popping or crackling. It rarely causes constant or severe pain.
- How long it lasts: after a cold, it usually clears within about a week; some cases last several weeks or longer.
- Emergency: call 112 for hearing loss or dizziness with facial drooping, weakness, numbness or slurred speech. Sudden hearing loss needs urgent assessment.
Do not book a video appointment if hearing loss or spinning dizziness comes with facial drooping, weakness, numbness, slurred speech or double vision, or follows a head injury: call 112 or go to an emergency department. Hearing that drops suddenly, rather than muffling gradually with a cold, needs urgent assessment: get medical advice the same day.
Can an online doctor treat Eustachian tube dysfunction?
Yes, usually. Eustachian tube dysfunction is recognised from the story: muffled hearing, fullness and popping that started with a cold, an allergy or a flight. Most cases clear with self-care and treatment of the cause, and a doctor can assess them by video, check the warning signs, and recommend or prescribe sprays when they help. A video call cannot see the eardrum, so symptoms that last more than 3 weeks, and hearing that gets worse, especially on one side, need an ear examination in person.
How an online consultation helps with Eustachian tube dysfunction
- The tube, or something else?: Earwax, an ear infection and sudden hearing loss can feel the same, and the way it started tells them apart.
- The cause treated: A cold, sinusitis, hay fever or smoking keeps the tube swollen, and treating the cause is what opens it.
- Sprays used the right way: Which spray suits you, and why decongestant sprays must stop after a few days.
- Ready to fly or dive: How to equalise your ears, and when to postpone a flight or a dive.
What the doctor checks in an online Eustachian tube consultation
The doctor checks the warning signs first, then the pattern of your symptoms. The doctor asks about:
- Warning signs: hearing that dropped suddenly, spinning dizziness, facial weakness, severe pain, discharge or a high temperature.
- How it started: with a cold, hay fever, sinus trouble, a flight or a dive, and how long it has lasted.
- Your ears: muffled hearing, fullness, popping or crackling, ringing, mild dizziness, and whether one ear or both are affected.
- Your nose: a blocked or runny nose, sinus pain, allergies, and smoking.
- Your plans: an upcoming flight or dive.
- Your health: high blood pressure, heart or circulation problems, diabetes, an overactive thyroid, glaucoma, pregnancy, and the sprays and medicines you already use.
Before the call, note when it started, which ear is affected, what makes it pop, and which sprays you have tried and for how long.
What is the Eustachian tube, and what goes wrong?
The Eustachian tube is a narrow tube, about 3 to 4 cm long in adults, that links the middle ear to the back of the nose. The middle ear is normally full of air. The tube stays closed most of the time and opens when you swallow, yawn or chew, letting air in so that the pressure on both sides of the eardrum stays equal.
In Eustachian tube dysfunction (ETD), the tube is blocked or does not open properly. Air cannot reach the middle ear, so the eardrum is pulled inwards, becomes tense and cannot vibrate normally, which is why sounds are muffled. It can affect one ear or both. There are three types:
Swipe sideways to compare →
| Type | What happens | When it shows |
|---|---|---|
| Obstructive | The tube stays closed or opens poorly | Most of the time, often after a cold or with a blocked nose |
| Baro-challenge | The tube cannot keep up with fast changes in pressure | Mainly when flying, diving or driving in the mountains |
| Patulous | The tube stays open when it should be closed | The least common type |
What are the symptoms of Eustachian tube dysfunction?
The main symptom is dull or muffled hearing, often described as being underwater or having cotton wool in the ears. Other symptoms are:
- a feeling of fullness or pressure in the ear
- popping, clicking or crackling sounds
- mild pain or discomfort, from the pressure difference stretching the eardrum
- ringing or buzzing in the ear (tinnitus)
- mild dizziness
Eustachian tube dysfunction rarely causes constant or severe ear pain. Severe pain, a high temperature or discharge points to an ear infection, and a sudden drop in hearing needs urgent assessment.
Why do my ears crackle and pop?
Popping and crackling are the sound of the tube trying to open and air moving into the middle ear. Popping is common as the tube recovers, and hearing may come back for a moment before it dulls again. That pattern is usually a sign of getting better, not worse.
Is it the Eustachian tube, or something else?
Swipe sideways to compare →
| What it could be | What points to it | Read more |
|---|---|---|
| Eustachian tube dysfunction | Muffling, fullness and popping during or after a cold, hay fever or a flight | This page |
| Earwax build-up | Muffling that builds up over days or weeks, sometimes itchy, often after cotton bud use | Earwax build-up |
| Ear barotrauma | Pain and blocked ears that started on a flight or a dive | Ear barotrauma |
| Ear infection | Earache, a high temperature, sometimes discharge | Ear infection |
| Sudden hearing loss | Hearing that drops all at once or over a few days, sometimes noticed on waking | Hearing loss: urgent |
The blocked ear guide covers every cause of a blocked ear in one place.
What causes Eustachian tube dysfunction?
Anything that makes the lining of the nose and throat swell can block the tube. A cold is the most common cause:
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| Short-term | Long-term |
|---|---|
| Colds, the most common cause | Long-term sinusitis, involved in up to half of long-term cases |
| Ear, nose, throat and sinus infections | Rhinitis that does not settle |
| Allergies, including hay fever | Allergies, including hay fever |
| Changes in altitude, such as flying | Fluid behind the eardrum (glue ear) |
| Smoking | Changes in the lining caused by smoking |
No cause is found in about 1 in 5 long-term cases. There is no evidence that Eustachian tube dysfunction itself is inherited, although some conditions behind it, such as glue ear, can run in families.
Fluid behind the eardrum (glue ear) in adults
When the tube stays blocked, fluid can collect in the middle ear, a condition known as glue ear or otitis media with effusion. It is one of the causes of long-term Eustachian tube dysfunction, and it can also follow ear barotrauma. Fluid that does not clear may need a grommet, a tiny tube placed in the eardrum. Hearing that keeps getting worse, especially on one side, needs a doctor to look at the ear.
How do you unblock a Eustachian tube at home?
The aim is to let air into the middle ear and to calm the swelling that keeps the tube shut. These help:
- Swallow, yawn or chew: all three open the tube. Sucking a boiled sweet or chewing gum makes swallowing easier.
- The Valsalva manoeuvre: breathe in, then breathe out gently with your mouth closed and your nose pinched, until your ears pop. Sit down first, as it can make you dizzy, and never force it.
- An autoinflation device: a balloon you inflate with your nose, sold in pharmacies and online, which pushes air up the tube.
- Steam: breathing in steam from a bowl of hot water, with a towel over your head, can ease a blocked nose.
- Fluids: drink plenty of water.
- No smoking: smoke irritates the lining of the nose and the tube.
Is there a cure for Eustachian tube dysfunction?
Most Eustachian tube dysfunction clears by itself once the cold, the sinus infection or the allergy settles, so the real cure is treating the cause. Stories of a single trick that cured it usually describe a tube that was about to recover anyway. For symptoms that last, the options with evidence behind them are autoinflation, steroid sprays for a swollen nasal lining and, for long-term dysfunction, grommets or balloon dilation by an ENT specialist.
How long does Eustachian tube dysfunction last?
From a few hours to several weeks or more, depending on the cause. After a cold, it usually clears within about a week. Long-term sinusitis, rhinitis or glue ear can keep it going until the cause is treated.
Swipe sideways to compare →
| Situation | Usual course | See a doctor |
|---|---|---|
| During or after a cold | Clears within about a week | If it has not cleared after 3 weeks |
| After a flight | Usually settles with swallowing, yawning and equalising | If it has not eased after a few hours of self-care |
| With hay fever or long-term sinusitis | Comes and goes with the nose | For treatment of the nose |
| Hearing getting worse, especially on one side | Needs checking | Promptly |
| Hearing that drops suddenly | An emergency for the ear | Urgently: get medical advice the same day |
Flying and diving with Eustachian tube dysfunction
A tube that cannot open properly struggles with fast changes in pressure, most of all during the descent to land. If your ears are already blocked by a cold or an allergy, consider postponing the flight. If you fly:
- stay awake during the descent, and keep swallowing, yawning or chewing
- use the Valsalva manoeuvre gently and often on the way down
- consider earplugs designed for flying
- a decongestant before the flight can help if it suits you; check with a pharmacist or the doctor first
Diving with a blocked nose or an allergy is dangerous and can cause severe ear barotrauma. Divers should descend and ascend slowly, and talk to a doctor about decongestants before diving. The ear barotrauma page covers ear pain during and after flights and dives.
Which Eustachian tube dysfunction treatment might the doctor recommend?
Treatment depends on the cause and how long the tube has been blocked. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Muffled, popping ears with a cold | Swallowing, yawning, Valsalva, and a decongestant spray for a few days if it suits you | Yes | If it has not cleared after 3 weeks |
| Symptoms with hay fever or a long-term blocked nose | An antihistamine, and a steroid nasal spray | Yes | If symptoms continue despite treatment |
| Symptoms lasting more than 3 weeks | An ear examination and hearing tests | Partly | For otoscopy, a hearing test and pressure test of the eardrum, and an ENT opinion |
| An upcoming flight or dive | A plan to equalise, and a decongestant if it suits you | Yes | If symptoms are severe or the ear is painful |
| Long-term dysfunction that treatment has not helped | ENT referral | Partly | For grommets or balloon dilation |
| Earache with a high temperature or discharge | Assessment for an ear infection | Yes, to assess | If the eardrum needs to be seen |
| Hearing that dropped suddenly | Urgent assessment | Only to assess | Urgently: get medical advice the same day |
Ears still blocked after a cold? A doctor can tell you in one consultation what will open them.
See available times →Treatment options for Eustachian tube dysfunction
What you can do yourself
- Swallow, yawn and chew often, and use the Valsalva manoeuvre gently.
- Try an autoinflation balloon if popping your ears does not work.
- Treat the blocked nose: steam, plenty of water, and a decongestant spray for no more than 5 days at a time.
- If hay fever is the cause, keep taking your allergy treatment.
- Stop smoking.
- Do not put anything into your ear.
Prescription treatment
A prescription is never issued without a consultation. If the lining of the nose stays swollen, the doctor may prescribe a steroid nasal spray or steroid nose drops, used for the length of time prescribed, and may suggest an antihistamine if an allergy is behind it. Decongestants are bought without a prescription and are not suitable for everyone, so the doctor checks your blood pressure history, heart and other conditions, and your other medicines first. If the doctor prescribes, use the prescription at a pharmacy near you.
Grommets and balloon dilation
If Eustachian tube dysfunction lasts despite treatment, an ENT specialist may offer a grommet: a tiny tube placed through a small cut in the eardrum to let air into the middle ear. Grommets usually fall out after several months, so they may need replacing, and longer-lasting tubes can crust, get infected or leave a small hole in the eardrum. Balloon dilation is another option: under a local or general anaesthetic, a small balloon is passed through the nose into the tube, filled with salt water for about 2 minutes to widen it, and then removed.
What does not help
Decongestant sprays used for more than 5 days, which make a blocked nose worse. Forcing air into the ears hard. Cotton buds or anything else in the ear, which cannot reach the tube.
Special situations
High blood pressure, heart problems and other conditions
Decongestants are not suitable for everyone, and taken with some antidepressants they can cause a dangerous rise in blood pressure. Ask a pharmacist or the doctor before using one if you have high blood pressure, heart or circulation problems, diabetes, an overactive thyroid, glaucoma or an enlarged prostate, or take other medicines.
Pregnancy and breastfeeding
It is not clear whether any decongestant is safe in pregnancy, so use one only if a doctor or pharmacist advises it. When breastfeeding, decongestants you swallow are not recommended; ask before using a spray.
Hay fever and long-term sinus problems
An allergy or long-term sinusitis keeps the lining of the nose swollen. Treating the nose is what helps the ear, and the hay fever and sinusitis pages cover both.
Eustachian tube dysfunction while travelling in Europe
Pack your usual allergy treatment and a decongestant that suits you, and plan to equalise on every descent. Driving on mountain roads can trigger the same pressure problem as flying.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When Eustachian tube dysfunction is treated online, and when you need in-person care
Treated online: muffled, full or popping ears with a cold, an allergy or after a flight, self-care and autoinflation, the right sprays and how long to use them, and plans for the next flight or dive.
In-person care: symptoms that last more than 3 weeks, hearing that gets worse, an ear that needs examining or a hearing test, grommets and balloon dilation, and any sudden loss of hearing.
When to get in-person care
Call 112 or go to an emergency department now for:
- hearing loss or spinning dizziness with facial drooping, weakness, numbness or tingling in an arm or leg
- slurred speech, double vision or sudden loss of vision with dizziness
- bleeding or clear fluid from the ear after a head injury
- numbness, weakness or breathing problems after a dive
Get medical advice the same day for:
- sudden hearing loss in one or both ears
- severe ear pain, a high temperature, or discharge from the ear
- spinning dizziness or ringing that starts after a flight or a dive
- swelling or redness behind the ear
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your ears: say when the muffling started, whether it followed a cold, an allergy or a flight, and which sprays you have tried and for how long.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s eustachian tube dysfunction? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Similar symptoms, different condition? Ear barotrauma can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about Eustachian tube dysfunction
What is Eustachian tube dysfunction?
A blockage or poor opening of the Eustachian tube, the narrow tube that links the middle ear to the back of the nose. Air cannot reach the middle ear, so the eardrum is pulled in and sounds are muffled.
How can I clear my Eustachian tube at home?
To clear a blocked Eustachian tube, swallow, yawn or chew, try the Valsalva manoeuvre by breathing out gently with your mouth closed and nose pinched, or use an autoinflation balloon. Treat a blocked nose with steam, plenty of water and, if it suits you, a decongestant spray for no more than 5 days.
How long can Eustachian tube problems last?
Eustachian tube dysfunction lasts from a few hours to several weeks or more. After a cold, it usually clears within about a week. See a doctor if it lasts more than 3 weeks, or straight away if your hearing gets worse, especially on one side.
What is the most effective nasal spray for a blocked Eustachian tube?
For a blocked Eustachian tube, it depends on the cause. A decongestant spray opens a blocked nose quickly but must be stopped after 5 days. A steroid nasal spray calms a swollen lining from hay fever or long-term sinusitis, and is used for the prescribed length of time.
How do people cure Eustachian tube dysfunction?
Most cases of Eustachian tube dysfunction clear by themselves once the cold, sinus infection or allergy settles, so treating the cause is the real cure. For symptoms that last, autoinflation, steroid sprays and, from an ENT specialist, grommets or balloon dilation can help.
Why do my ears crackle?
Crackling and popping are the sound of the Eustachian tube opening and air moving into the middle ear. They are common as the tube recovers after a cold or a flight.
Can Eustachian tube dysfunction cause dizziness or tinnitus?
Yes. Eustachian tube dysfunction can cause mild dizziness and ringing or buzzing in the ear, because the pressure difference affects the eardrum and the middle ear. Severe spinning, or dizziness with sudden hearing loss, needs urgent assessment, because those point to the inner ear rather than the tube.
Is Eustachian tube dysfunction serious?
Usually not. Most cases clear by themselves. Long-term dysfunction can damage the eardrum and the middle ear, which is why symptoms that last more than 3 weeks need an ear examination.
How can I prevent Eustachian tube dysfunction?
Treat the things that swell the lining of the nose: manage hay fever and other allergies with antihistamines or a steroid nasal spray, treat sinusitis, and do not smoke, because smoke irritates the tube. Before a flight, avoid flying with a heavy cold if you can, stay awake for the descent and keep swallowing, and use a decongestant spray beforehand if it suits you. Eustachian tube dysfunction that keeps returning is worth a check for long-term rhinitis or sinusitis.
Can I fly with Eustachian tube dysfunction?
You can fly with Eustachian tube dysfunction, but a blocked tube makes ear barotrauma more likely. Consider postponing the flight if a cold or an allergy has blocked your ears, stay awake during the descent, keep swallowing and equalising, and ask about a decongestant before you fly.
What is balloon dilation of the Eustachian tube?
A procedure for long-term dysfunction: a small balloon is passed through the nose into the tube, filled with salt water for about 2 minutes to widen it, and removed. It is done by an ENT specialist under a local or general anaesthetic.
When should I see a doctor about a blocked Eustachian tube?
See a doctor about a blocked Eustachian tube if symptoms last more than 3 weeks, if your hearing gets worse, especially on one side, or if you have severe pain, a high temperature or discharge. Sudden hearing loss needs urgent assessment.
Can an online doctor treat Eustachian tube dysfunction?
Yes, usually. A doctor can assess Eustachian tube dysfunction by video, advise on self-care and autoinflation, and recommend or prescribe sprays. Symptoms that last, worsening hearing, grommets and balloon dilation need in-person care.
- Eustachian tube dysfunction, Patient.info, updated 30 March 2026.
- Eustachian tube dysfunction, Chelsea and Westminster Hospital NHS Foundation Trust, patient leaflet, accessed 15 October 2026.
- Balloon dilation for chronic Eustachian tube dysfunction: the condition, current treatments and procedure (HTG534, formerly IPG665), NICE, National Institute for Health and Care Excellence, reviewed 18 December 2019.
- Ear barotrauma, MedlinePlus, US National Library of Medicine, reviewed 29 April 2026.
- Decongestants, NHS, National Health Service (UK), reviewed 3 November 2022.
- Ear infections, NHS, National Health Service (UK), reviewed 16 January 2025.
- Sudden deafness, NIDCD, US National Institute on Deafness and Other Communication Disorders, updated September 2018.
- Earwax build-up, NHS, National Health Service (UK), reviewed 5 January 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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