From the Guidelines
The leading causes of ear pressure include Eustachian tube dysfunction, ear infections, sinus congestion from colds or allergies, and changes in altitude during air travel or diving, as these conditions can create pressure differentials between the middle ear and outside environment or block the Eustachian tubes that normally equalize pressure. According to 1, the Eustachian tube plays a crucial role in maintaining the pressure inside the middle ear similar to the pressure in the ear canal, and its dysfunction can lead to negative pressure and ear infections. Ear infections, such as otitis media, can cause fluid buildup and inflammation in the middle ear, creating pressure sensations 1. Sinus congestion from colds or allergies can block the Eustachian tubes, leading to ear pressure. Changes in altitude during air travel or diving can also create pressure differentials between the middle ear and outside environment, causing ear pressure.
Some key points to consider:
- Eustachian tube dysfunction is a common cause of ear pressure, especially in young children, as their Eustachian tubes are not fully developed 1
- Ear infections, such as otitis media, can cause fluid buildup and inflammation in the middle ear, creating pressure sensations 1
- Sinus congestion from colds or allergies can block the Eustachian tubes, leading to ear pressure
- Changes in altitude during air travel or diving can create pressure differentials between the middle ear and outside environment, causing ear pressure
To relieve ear pressure, try:
- Yawning, swallowing, or performing the Valsalva maneuver (gently blowing with closed mouth and pinched nose) to open the Eustachian tubes
- Over-the-counter decongestants like pseudoephedrine (30-60mg every 4-6 hours) or nasal sprays like oxymetazoline to help with congestion-related pressure
- Antihistamines like loratadine (10mg daily) for allergies
- If pressure persists beyond a week, worsens, or is accompanied by severe pain, hearing loss, or fever, seek medical attention as prescription antibiotics or other treatments may be needed, especially for infections 1.
From the Research
Leading Causes of Ear Pressure
The leading causes of ear pressure are often related to Eustachian tube dysfunction, which can be caused by various factors. Some of the key causes include:
- Obstruction of the Eustachian tube, which can lead to reduced ventilation of the middle ear space and the development of high negative pressure in the middle ear 2
- Abnormal patencies of the Eustachian tube, which can include blockage or abnormal opening and closing of the tube 3
- Adenoid hypertrophy, which is a frequent cause of obstructive tube dysfunction in children 4
- Eustachian tube closing failure, which can be characterized by the repetitive barotrauma induced by sniffing or reverse Valsalva maneuvers 2
- Eustachian tube dysfunction, which can be caused by various factors, including nasal congestion, allergies, and colds 5, 6
Symptoms and Diagnosis
The symptoms of ear pressure caused by Eustachian tube dysfunction can be unspecific, but diagnosis can be made using various methods, including:
- The Eustachian tube score (ETS-5) for patients with a perforated ear drum, and the ETS-7 score for patients with an intact ear drum 4
- Measurement of middle ear pressure and ventilation 3, 5
- Observation of Eustachian tube function and anatomy 6
Treatment Options
Treatment options for ear pressure caused by Eustachian tube dysfunction vary depending on the underlying cause, but can include:
- Steroid nasal sprays and regular performance of the Valsalva maneuver for obstructive dysfunction 4
- Tube dilation with the Bielefelder balloon catheter for obstructive dysfunction 4
- Saline nasal irrigation, estrogen-nasal ointment, and craniocervical manual therapy for patulous Eustachian tube 4
- Laser surgery and balloon tuboplasty for impaired tube function 3