4 Causes of Eustachian Tube Neck Pain
September 10, 2022

Eustachian tube neck pain is a condition where the tubes that connect your middle ears to your upper throat become blocked. This can lead to discomfort, hearing problems, and a feeling of fullness in the ear. Eustachian tube dysfunction usually corrects itself within a few days. But if not, it’s important to seek treatment.

What are Eustachian tubes?

The Eustachian tubes are channels that run from the back of the nose and upper throat to the middle ear and help keep the air pressure behind the eardrum the same as the pressure outside. They stay closed most of the time but open when a person swallows, chews, or yawns.

Some people may have a condition that health professionals refer to as a patulous eustachian tube, where the tubes remain open when they should be closed. This causes a person to experience autophony, which is when they hear their breath and voice in their head. In addition, these channels are so small that blockages can occur for many reasons. Clogged Eustachian tubes can cause discomfort and lead to hearing problems. Any of these symptoms could be considered ETD.

List some Symptoms

Symptoms of ETD can vary from mild to severe and may be different for each person. Common symptoms include:

  • A plugged feeling in the ears

  • The ears feel as if they are filled with water

  • Tinnitus, or ringing in the ear

  • Muffled hearing or partial hearing loss

  • Ticking or popping sounds

  • Pain and tenderness around the ear

  • A tickling or tingling sensation

  • Trouble with balance

The duration and severity of ETD symptoms depend on their cause. For example, if ETD results from a change in altitude, these symptoms often disappear when the body adjusts to the pressure or reaches a lower altitude.

In contrast, ETD, which is caused by an illness or infection, can last much longer. Anyone with ETD symptoms that last longer than 2 weeks should seek medical advice.

Children with symptoms of ETD should get medical help sooner because the symptoms of ETD are similar to an ear infection. When people experience dysfunction from a non-viral cause, they are more likely to experience symptoms that last longer.

What causes Eustachian tube dysfunction?

The most common cause of Eustachian tube dysfunction is when the tube becomes swollen (inflamed) and mucus or fluid builds up. This can be caused by a cold, flu, sinus infection, or allergies. Some people are at greater risk of Eustachian tube dysfunction

  1. Sinusitis

Sinusitis is a common infection that occurs in the sinuses. An estimated 31 million Americans have the condition. It causes inflammation of the sinuses and their blockage with fluid.

There are four different types of sinusitis: acute bacterial, chronic, subacute, and recurrent acute sinusitis. Although eustachian tube pain can develop with any type of sinusitis, the one most commonly associated with eustachian ear pain is chronic sinusitis.

Common symptoms of sinusitis include:

  • Mucus that drips down the throat

  • A thick nasal discharge that is yellow or green

  • Pressure around the nose, eyes, and forehead

  • Bad breath

  • Cough

  • Tiredness

  • Fever

  1. Temporomandibular Disorder

The TMJ allows a person to open and close the jaw. When the joints don’t work as they should, or when the joint and the muscles around it hurt, it’s referred to as TMD. It is estimated that up to 25% of the population will experience TMD at some point in their lives. The cause of this type of disease varies from person to person, but one cause is osteoarthritis. Other common causes of TMD include:

  • Putting pressure on the joint consistently through teeth grinding or clenching

  • Stress that causes facial and jaw muscles to tighten

  • A dislocated disc or soft cushion between the ball and socket of the joint

Aside from pain in the eustachian tube, can neck pain cause dizziness, keep in mind that yes it can. More than that people with TMD will often experience other symptoms, including:

  • Pain and tenderness in the face, jaw joint area, neck, and shoulders

  • Limited mouth opening

  • A locked or stuck jaw when the mouth is in either an open or closed position

  • Grating, popping, or clicking sounds in the jaw joint when the mouth is opened or closed

  • Face tiredness

  • Trouble chewing or a sudden uncomfortable bite

  • Swelling on the side of the face in the affected joint

  • Toothaches

  • Headaches

  • Neck aches

  • Dizziness

  • Tinnitus

Eustachian tube pain has been reported in many people with TMD

  1. Middle ear infection

A middle ear infection occurs behind the eardrum. They are most common in children, although they can develop at any age. Ear infection and neck pain are caused by either bacteria or viruses that travel through the Eustachian tube and into the middle ear. They usually develop after a cold or respiratory infection.

Symptoms that occur with an ear infection include:

  • Difficulty hearing

  • Ear ache

  • Yellow, brown, or white fluid coming out of the ears

  • Fever

  • Bad sleep

  • Irritability

  • Loss of appetite

If an ear infection develops with effusion (the fluid that has leaked into a body cavity), the fluid can get trapped in the ear and cause mild hearing loss. A blocked Eustachian tube can also lead to an ear infection with an effusion. Middle ear infections are one of the most common causes of Eustachian tube pain.

  1. Nasal obstruction

Nasal obstruction occurs when there is a blockage or obstruction in the nasal passage. This type of disease is most often a symptom of other underlying health problems, such as allergies, polyps, tumors, or malformations of the nose. Symptoms associated with nasal obstruction include:

  • Nasal voice

  • Drainage from the nasal passage

  • Mouth breathing

  • Recurrent sinus infections

Nasal obstruction can also lead to symptoms of eustachian tube dysfunction, which include eustachian tube pain.

List some medical treatments of Eustachian tube neck pain

  • Allergy treatment and nasal decongestion

Identifying and treating nasal allergies can also help reduce swelling in the lining of the Eustachian tube. Identifying the specific allergen to which the patient is sensitive and removing it from the environment can alleviate the patient’s symptoms. Allergy shots can also provide some help, although it may take a while before you notice the beneficial effects. Intranasal steroids work by reducing inflammation of the nasal mucosa and may provide some benefit to patients with Eustachian tube dysfunction. In my experience, it helps about 50% of patients with Eustachian tube dysfunction due to allergies. It is recommended to try 2 weeks of daily use to see if the drug is useful. Nasal steroids take that long to work. The onset of their effects is gradual, so patients must take it every day. A person usually does not notice an immediate improvement after a nasal spray.

  • Self-inflating ears

It is possible to force air through the Eustachian tube into the middle ear by pinching the nose and popping the ear. Another way to do this is to blow up balloons. The pressure required to expand the balloon is usually sufficient to force air through the Eustachian tube. This is a very useful maneuver and can be repeated as often as needed whenever a feeling of pressure or fullness develops in the ear. This should not be done when a cold or runny nose is present, as this can drive infected mucus into the middle ear and cause an ear infection.

Some surgical treatment

The primary goal of surgical treatment is to bypass the Eustachian tube and restore middle ear ventilation. This will restore hearing, relieve the feeling of pressure in the ear and reduce the tendency to middle ear infections.

  • Myringotomy

A small incision can be made in the eardrum and any fluid from the middle ear can be aspirated. In adults, the incision often remains open long enough to allow the swelling in the lining of the Eustachian tube to resolve. After the eardrum heals (usually within 1 to 3 days), middle ear fluid can build up again if the lining of the Eustachian tube does not recover.

  • Pipes for equalizing pressure

After an incision is made in the eardrum and all the middle ear fluid is sucked out, a small hollow tube made of plastic or metal is inserted into the eardrum. Over time, the tube is pushed out as the eardrum heals. A pressure equalization tube usually provides middle ear ventilation for 6 to 12 months. Often by this time, the Eustachian tube has recovered and the pressure equalization tube does not need to be replaced.

Another risk of a myringotomy or pressure equalization tube is that the incision may not heal. This may eventually require surgery (tympanoplasty) to seal the hole.