Eustachian Tube Dysfunction: What Causes Blocked Ears and How to Fix It

Blocked, popping, or muffled ears are annoying and common. Eustachian tube dysfunction (ETD) happens when the small tube that connects your middle ear to the back of your nose won’t open or close properly. That tube equalizes pressure and drains fluid — when it fails, you feel pressure, hearing changes, or pain.

Most people get ETD after a cold, an allergy flare, a sinus infection, or when flying. Kids get it more often because their tubes are shorter and more horizontal. Smoking, acid reflux, and nasal polyps can make ETD worse. Sometimes a chronic problem develops and symptoms last for weeks or months.

What you’ll notice:

ear fullness, popping or clicking when you swallow, muffled sounds, mild ear pain, ringing, or a sense that your ear is “under water.” If fluid sits behind the eardrum, hearing may drop and infections can recur. Sudden severe pain, fever, dizziness, or bleeding from the ear mean you should seek urgent care.

Simple steps that help right away include swallowing, yawning, chewing gum, or using the Valsalva maneuver (pinch your nose, close your mouth, and blow gently).

Those actions open the tube and equalize pressure. A warm compress over the ear eases discomfort. For short-term relief, oral decongestants or short courses of nasal decongestant sprays can reduce swelling, but avoid prolonged use of nasal decongestants because of rebound congestion.

If allergies are the trigger, daily nasal steroid sprays and antihistamines reduce inflammation over time and lower recurrences. Saline nasal rinses clear mucus and help the tube drain. For kids, giving fluids, offering a pacifier, or encouraging swallowing during airplane climbs and descents reduces pressure problems.

When symptoms don’t improve in two to three weeks or hearing loss persists, see an ENT specialist. They’ll inspect your eardrum, check hearing, and may use tympanometry to measure middle ear pressure. Treatment options include prescription nasal steroids, antibiotics if there’s an infection, or a short-term oral steroid for severe inflammation. For persistent fluid or chronic ETD, an ear tube (myringotomy with tube) can ventilate the middle ear and prevent repeated infections. Balloon Eustachian tuboplasty is another option for adults with obstructive ETD; it gently widens the tube, but not everyone is a candidate.

Preventing future episodes means controlling allergies, avoiding smoke, treating reflux, and using saline sprays when you’re sick. Don’t poke inside ears with cotton swabs; that can push wax deeper and raise infection risk. If flying often causes major problems, see an ENT before long trips — they may suggest pressure-regulating ear plugs or a preflight plan.

Want help deciding if your symptoms need a doctor? Describe what you feel, how long it’s lasted, and whether hearing is clearly worse. I can point to reliable guides or explain tests and treatments in plain terms.

If you have ongoing pressure or hearing loss, ask about hearing tests, tympanostomy tubes, or allergy shots. Early care often prevents long-term damage and improves quality of life and sleep.