What is Eustachian Tube Dysfunction?
The Eustachian tube connects the space behind the eardrum (middle ear) with the back of the throat (nasopharynx). It equalises air pressure on both sides of the eardrum and allows drainage of normal secretions. When the tube doesn’t open properly – often after a cold, sinus infection, or allergy – you may experience Eustachian Tube Dysfunction (ETD).
Common Symptoms
- Fullness, blockage or pressure in one or both ears
- Popping or crackling sounds
- Muffled or reduced hearing ('underwater' sensation)
- Occasional discomfort or pain
- Ringing in the ears (tinnitus)
Non-urgent advice: Mainstay Treatment - Valsalva Manoevre
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This helps open the Eustachain tube and equalise air pressure in the middle ear.
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This is the most important daily exercise for blocked ears.
How to perform:
- Sit or stand upright.
- Take a normal breath in.
- Close your mouth and pinch your nostrils closed.
- Gently blow out through your nose (while keeping it pinched) – do not blow hard.
- You may feel or hear a light 'pop' in the ears. Stop if there is pain or dizziness.
- Breathe normally and repeat gently.
Frequency: Perform the manoeuvre 25 times in the morning and 25 times in the evening every day for at least one month before saying conservative treatment has failed.
Consistency is key — this exercise retrains the Eustachian tube to open properly.
ETD can take up to three months to fully resolve.
Demonstration Videos – How to Perform the Valsalva Manoeuvre
Watch these short UK-based demonstration videos to learn how to safely perform the Valsalva manoeuvre and use an auto-inflation device.
Valsalva Manoeuvre Demonstration (Audiology & ENT UK)
Otovent Balloon Demonstration (NHS Recommended)
Other Helpful Measures
- Chew gum, swallow, or yawn regularly to help equalise pressure.
- Try saline nasal rinses or sprays to clear mucus.
- Short course of nasal decongestant (max 7 days).
- Consider antihistamines or nasal steroid sprays if you have allergy or sinus symptoms.
- Steam inhalation with menthol or eucalyptus can ease congestion.
Prevention Tips
- Use 'Earplanes' earplugs on flights to reduce pressure changes.
- Use a nasal decongestant spray 30 minutes before flying.
- Avoid diving if your ears feel blocked.
- Keep allergies and nasal problems well controlled.
When to See Your GP or ENT Specialist
- Symptoms persist longer than 12 weeks despite regular self-treatment.
- Significant or worsening ear pain, discharge, or hearing loss.
- Recurrent infections or chronic symptoms.
- Children with hearing or speech problems.
References & Useful Links
Chelsea & Westminster NHS – ETD
MyHealth Devon – ETD (Blocked Ears)
NICE Guidance – Balloon Dilation for ETD