Eustachian tube: anatomy, location and function


The Eustachian tube runs from the middle ear to the top of the pharynx behind the nose. Also known as an auditory tube, it helps maintain the health of the middle ear by equalizing pressure, clearing secretions, and protecting against pathogens that could otherwise cause infection.

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Your Eustachian tube is in an area known as the parapharyngeal space. It runs from the anterior wall of the middle ear to the lateral wall of the nasopharynx. In adults, the Eustachian tube is tilted downward about 35 degrees; In children, the Eustachian tube is tilted downward about 10 degrees .

The Eustachian tube is made up of bone, cartilage, and fibrous tissue. The hollow tube is lined with cilia, hair-like projections that drain mucus from the middle ear to the nasopharynx .

Six muscles facilitate the opening and closing of the Eustachian tube. They are found in the ear, head, neck, soft palate, and jaw .


The Eustachian tube has three functions to maintain the health of the middle ear. That:

  • Maintains the same air pressure on both sides of the eardrum
  • Drains the discharge from the middle ear
  • Protects the middle ear from bacteria and viruses.

The Eustachian tube is usually closed, but it opens periodically when the muscles contract during activities such as yawning and swallowing. When the outside air pressure changes, the Eustachian tube opens, allowing air to move from the ear canal to the middle ear so that the pressure can equalize on both sides of the eardrum.

For the middle ear to function properly, there must be no fluid or other debris in the Eustachian tube space. The cilia and folds of the lining of the Eustachian tube are believed to work together to actively drain mucus that forms in the middle of the ear .

Most of the time, the Eustachian tubes remain closed to protect the middle ear, effectively acting as a barrier to protect this area from nasopharyngeal secretions and pathogens .

Related conditions

Eustachian tube dysfunction (ETD) can occur when the tubes do not open or close properly. A blockage in the Eustachian tube causes uneven pressure in the ear canal and middle ear. This can cause symptoms such as stuffy ears, hearing loss, and earache . Pressure can also cause tinnitus , buzzing, or buzzing in the ears.

The Eustachian tubes are often blocked due to a runny nose from upper respiratory infections, allergies, or sinusitis. This discharge can also contain bacteria or viruses that can cause a middle ear infection, also known as otitis media .

In children, the Eustachian tube is located more horizontally than in adults, making it difficult for the nasal discharge to drain. This can cause children to get ear infections more often than adults .

Some people have no problem opening the Eustachian tube when air pressure changes, such as when flying in an airplane or diving underwater. Others may find it more difficult, making pressure equalization difficult and causing temporary earache .

A less common patular Eustachian tube occurs when the Eustachian tube remains open longer than usual. Patients may complain of a feeling of pressure in the ears or distortion of their own voice or breathing. In many cases, the cause of Eustachian tube tumor formation is unknown, but some of the risk factors include weight loss, pregnancy, neurological disorders such as multiple sclerosis, anxiety, and wasting .

Watch out

Most of the symptoms of ETD are mild and resolve within a few days. If your Eustachian tubes are blocked, you can try some simple methods to clear them, such as swallowing, chewing gum, or yawning.

If symptoms persist or if you have pain, see your doctor to determine what is causing the blockage and if treatment is necessary.

To relieve nasal congestion and remove drainage from the middle ear, your healthcare professional may recommend one or more of the following treatments:

  • Nasal saline spray
  • Decongestants
  • Antihistamines
  • Corticosteroids

If the blockage is caused by an infection, your doctor may prescribe antibiotics.

For severe NTD symptoms that do not go away, surgical options are available. Tympanostomy tubes, also known as ear tubes , can be inserted to help with permanent drainage and blockages in the middle ear.

Some patients may benefit from balloon expansion of the Eustachian tube. In this procedure, a balloon catheter is inserted into the Eustachian tube through the nose, filled with saline, emptied, and removed.

For the patular Eustachian tube

Patients with an abnormal Eustachian tube can control symptoms in several ways.

Your healthcare provider may recommend that you place your head between your knees when symptoms appear.

For patients with severe cases, surgery may also be an option.

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