How to Treat Inner Ear Infections or Eustachian Tube Blockage

The Eustachian tube is a small passage located inside the head that connects the middle ear to the throat. It can become blocked due to a cold or allergies. In more severe cases, seeing an ENT specialist is necessary. However, for mild to moderate cases, you can treat it at home with home remedies, over-the-counter medications, and prescribed methods.

Recognize the Symptoms. Regardless of whether the cause is a cold, allergies, or an infection, the Eustachian tube can become swollen, blocking air passage. This leads to pressure changes and sometimes fluid buildup inside the ear. If this happens, you may experience the following signs:

• Ear pain or a sensation of "fullness" in the ear.
• Ringing or popping noises in the ear that are not from the external environment.
• Children may describe this noise as a "tickling" sensation.
• Difficulty hearing clearly.
• Dizziness and difficulty maintaining balance.
• Symptoms may worsen when there is a sudden change in altitude—such as during air travel, riding in an elevator, or driving up mountains.

Jaw Movement. This simple technique is known as the first step in the Edmonds maneuver. Simply move your jaw forward, then rotate it back and forth from side to side. If the Eustachian tube is only mildly blocked, this movement will help clear the passage and restore normal airflow.

Perform the Valsalva Maneuver. This method involves attempting to push air through the blockage to re-establish proper airflow. When you try to exhale through the blocked areas, the air pressure inside your body is affected. The sudden exhalation can rapidly alter heart rate and blood pressure, so it's important to do this gently.

• Take a deep breath, hold it, and pinch your nose shut.
• Try to blow air out through your nose, which is pinched shut.
• If the technique works, you will hear a popping sound in your ear, and your symptoms will improve.

Perform the Toynbee Maneuver. Similar to the Valsalva maneuver, the Toynbee maneuver also helps clear a blocked Eustachian tube. However, instead of controlling the air pressure by breathing, the doctor will ask you to swallow. The steps are as follows:

• Pinch your nose shut.
• Take a sip of water.
• Swallow.
• Repeat this process until you hear a popping sound, indicating that your ear is clear again.

Blow Bubbles Through Your Nose. This may sound silly, but it’s actually the Otovent maneuver, which is very effective at balancing the air pressure in your ear. You can buy an "Otovent balloon" online or in large pharmacies. Essentially, this device is just a regular balloon with a nozzle that fits your nostrils. If you find a nozzle or tube that fits both the balloon and your nostrils, you can create your own Otovent balloon at home.

• Insert the nozzle into one nostril, then pinch the other nostril shut with your finger.
• Blow air through your nose to inflate the balloon until it’s about the size of a fist.
• Repeat this process with the other nostril. Alternate back and forth until you hear a “pop,” which indicates that the airflow has cleared in the Eustachian tube.

Swallow While Pinching Your Nose. This is called the Lowery maneuver, and it’s not as easy as you might think. Before swallowing, you need to build up air pressure inside your body, much like when you’re having a bowel movement. While holding your breath and pinching your nose shut, it will feel like you’re pushing air through the blocked tubes. Some people find it difficult to swallow under these conditions because of the high internal pressure. Be patient and keep trying. With enough practice, this maneuver will help clear your Eustachian tube.

Apply a warm compress to your ear. This method helps alleviate pain while also treating the blockage. The gentle heat from a warm cloth can help break up the obstruction and clear the Eustachian tube. If you are using a heating pad, be sure to place a cloth between the pad and your skin to avoid burns.

Use a nasal decongestant. Ear drops won’t be effective for clearing a blockage, as the ear canal is currently sealed. Since the ear and nose are connected through tubes, using a nasal spray is a more effective way to treat the Eustachian tube blockage. Insert the nasal spray nozzle into your nostril, aiming towards the back of the throat, and hold the bottle at a right angle to your face. When spraying, inhale gently so the medication travels to the back of your throat—don’t inhale too forcefully, or the spray may go down your throat or be expelled from your mouth.

• After using the nasal spray, perform one of the maneuvers described earlier. This is the optimal time to try these techniques.

Take antihistamines if your issue is caused by allergies. While allergy medications are not the primary treatment for Eustachian tube blockage, they can help alleviate congestion caused by allergies. Ask your doctor if this treatment is right for you.

• Note that antihistamines are generally not recommended for people with ear infections.

Request a prescription for a nasal spray. While over-the-counter nasal sprays can help with congestion, you will likely see better results with prescription-strength decongestants. If your symptoms are allergy-related, ask your doctor if they can prescribe a steroid nasal spray and/or an antihistamine nasal spray to address the issue.

Use antibiotics if you have an ear infection. While Eustachian tube blockage is usually harmless and temporary, it can lead to an ear infection, which can cause pain and disorientation. If your blockage progresses to this stage, visit your doctor for a prescription. You may not be prescribed antibiotics unless your fever reaches 39°C (102.2°F) or higher for 48 hours.

• Follow the prescribed dosage carefully. Even if your symptoms improve before finishing the antibiotics, complete the entire course as directed.

Discuss ear drum incision surgery with your doctor. In some cases of blockage, your doctor may suggest surgery to restore airflow to the middle ear. There are two types of surgery, with ear drum incision being the faster option. The doctor will make a small incision in the eardrum and then drain any fluid buildup from the middle ear. Ideally, the incision should heal slowly. While it may seem counterintuitive, if the incision stays open longer, the swollen Eustachian tube may deflate naturally. If the incision heals too quickly (within three days), fluid may build up again and symptoms may recur.

Consider pressure equalization tube placement. This surgery has a higher success rate but is a longer process. Like the ear drum incision procedure, your doctor will make a small incision in the eardrum to drain the fluid. Then, a tiny tube will be inserted into the eardrum to allow air to circulate in the middle ear. The tube will naturally fall out as the eardrum heals, which typically takes six months to a year. This method is recommended for those with chronic Eustachian tube blockage, so it’s important to discuss it thoroughly with your doctor before deciding.

• Make sure to keep water out of your ear while the pressure equalization tube is in place. Use earplugs or cotton balls when showering, and wear earplugs when swimming.
• If water passes through the tube and enters the middle ear, you may develop an ear infection.

Treat underlying causes. Eustachian tube blockage is often the result of conditions that cause mucus buildup and swelling in the tissues, obstructing normal airflow. Common causes of tissue swelling and mucus accumulation in this area include colds, flu, sinus infections, and allergies. Don’t ignore these conditions, as they can lead to inner ear issues. See your doctor for a cold or flu as soon as symptoms appear. Discuss self-care strategies to prevent recurring issues such as sinus infections and allergies.

• If you know there’s fluid in your ear, avoid using ear cleaning products. These solutions may cause infection and are unnecessary since it’s fluid, not earwax, inside your ear.
• When you have ear pain, do not lie with your head level to your shoulder.
• Add an extra pillow when lying down. This can help drain the fluid and make you more comfortable while sleeping.
• Drink warm beverages like tea instead of cold water.
• Try sucking on a few chewable papaya tablets. The papain enzyme in green papaya is great for breaking down fluid. You can also use fenugreek for similar benefits.
• If the pain is due to ear congestion, ask your doctor for pain-relieving ear drops. You may also use over-the-counter pain relievers like ibuprofen, acetaminophen, or naproxen sodium to reduce discomfort.
• Wear a hat with ear covers to keep your ears and head warm. This can help break down the fluid buildup.
• Consider using Vicks vapor drops to help clear the congestion in your ear. This product can aid in relieving blockage.

• If you’ve been using over-the-counter nasal spray for a few days without any improvement, stop and consult your doctor. Continuing to use it without results could make the blockage worse.
• Avoid using nasal irrigation tools or ear candles. These products are not approved by the U.S. Food and Drug Administration for safe use with ear congestion.
• Do not go scuba diving if you have pressure imbalance in your Eustachian tube! The pressure difference will cause “ear pressure,” which can be extremely painful.