How Can Nasal Obstruction CAUSE Clogged Ears?

It is not uncommon that patients who suffer from a clogged nose also develop clogged ears.

Why??? There are 2 major and 1 minor reasons.

First a little anatomy lesson.

In the back of the nose, there is an opening that leads into a tunnel (eustachian tube) that goes up into the ear. When the ears get clogged, a person can get the pressure out by "popping the ears." This can be accomplished by yawn, swallow, or trying to blow out the nose that is pinched shut. When the ear pops, what happens is that the tunnel opens up allowing pressure to come out the ear. Watch video:



Mucosal Swelling

Now when the patient's nose gets obstructed, it may mean the nasal lining has become swollen making it difficult to breath. It also means the tunnel that goes up into the ear may be swollen shut as well. As such, it may become difficult if not impossible to pop the ears. This is known as eustachian tube dysfunction.

Negative Pressure Inside the Nose

However, there is a more active process that may lead to ear clogging beyond just mucosal swelling of the eustachian tube.

When the nose is obstructed, every time the patient tries to breath in thru the nose, negative pressure is built up in the back of the nose where the eustachian tube opening is located. As such, this negative pressure inside the nose can get transmitted up into the ear resulting in negative pressure to slowly build up in the ear as well which can ultimately cause a clogged ear sensation. This is just like sucking on a straw to draw fluid out of a cup, though in this case, the straw is analogous to the eustachian tube, the fluid is air, cup is the ear, and the mouth is the nose.

Bernoulli's Principle

In fluid dynamics, Bernoulli's principle states that for an inviscid flow, an increase in the speed of the fluid occurs simultaneously with a decrease in pressure.

To use an example, if you are driving a car with the window down, the fast-moving air outside the car creates a negative pressure inside the car causing things to not just blow around, but does cause some suction effect to things within the car (paper inside the car potentially getting "sucked" to the outside).

When the nose becomes clogged, airflow increases in the back of the nose (think garden hose where you have the same amount of water flow, but by changing the nozzle diameter, flow can be increased by making diameter smaller or decreased by making diameter larger). Due to Bernoulli's principle, negative pressure builds up inside the ear due to this increased nasal airflow.

This negative pressure can be transmitted into the ear causing it to become clogged.

So there you have it... 3 reasons why a clogged nose can lead to clogged ears!

That also means that often, if you just treat the clogged nose... the clogged ears will get better as well!

Devices That Help Fix Clogged Ears

Clogged ears due to eustachian tube dysfunction or fluid in the ears is one of the most common complaints seen in an ENT clinic. Beyond medications like steroids & nasal sprays or even surgery (ear tubes) to resolve this complaint, a fundamental physical maneuver the patient MUST also be doing is called "valsalva". Valsalva is the attempt to "pop" the ears by yawn, swallow, or attempting to gently blow air out the nose that is pinched shut.

The yawn and swallow are passive maneuvers to pop the ear whereby trying to gently blow air out the nose while keeping it pinched shut to create intra-nasal pressure is an active maneuver.

The key concept is that medications do not pop the ears for you... YOU have to pop the ears yourself. Medications just help accomplish this task.

Typically, when things are truly clogged and it is very difficult if not impossible to pop the ears open, actively trying to pop the ears open is key. Yawning and swallowing typically is ineffective.

However, there are patients who can't quite grasp the idea of HOW to pop the ears by nose pinching. OR, they are too scared that they might rupture their eardrums (which could happen if the nose-blowing is too aggressive).

Furthermore, what about the 2 years old who doesn't even understand how to nose-blow let alone valsalva?

As such, there are two main devices to perform the active valsalva for such individuals. Please note, I have no financial ties to either companies to disclose.

Otovent

The first is a simple balloon called Otovent (can be purchased on Amazon). In essence, you snug the balloon up against the nose and try to inflate the balloon up. The balloon itself provides the necessary and sufficient back-pressure into the nose resulting in an active valsalva. This is mainly used by children who can appreciate the visual feedback.

EarPopper

The second is an electronic device, EarPopper (also can be purchased on Amazon), that pushes air into the nose. So, rather than having the lungs "push" air into the nose to create intra-nasal air pressure, this device replaces the lungs and pushes air into the nose from the front. This device comes in two flavors: Home and Pro versions.

Please keep in mind that there's another electronic device which supposedly helps with ear popping called EarDoc which is not recommended as it uses an unproven concept.

So there you have it...

Read more about this condition here.

Products That Help Pop the Ear Due to Eustachian Tube Dysfunction or Fluid in the Middle Ear:

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Geared Toward Adults

Balloon Geared Toward Kids

Help! My Ears Feel Clogged / Full (Eustachian Tube Dysfunction)

This blog article is a reprint of the original Fauquier ENT webpage article found here.

Introduction (Click here to skip to nasal spray use) Before going into an explanation of why there are occasions when the ear doesn't feel right (ear fullness, clogged ears) or makes unusual noises (ear crackling/popping), one must understand the anatomy of how the ear works when things are normal. If your ears hurt, click here. To the right is a diagram of a normal ear with structures labelled. The middle ear space (colored in with yellow) is an air-filled region of the ear that is cut-off from the outside world except for one 1.5 inch long passageway called the eustachian tube which opens into the back of the nose (see picture or video). If the eustachian tube doesn't open normally, the middle ear space becomes isolated.

Image is a modification of that found in Wikipedia under GNU Free Documentation License.

When the eustachian tube functions normally, every single time you swallow, yawn, blow your nose, etc, your ear "pops". This popping is when the eustachian tube opens transiently allowing air to pass from the middle ear to the back of the nose which is open to the environment.

Watch video explaining this phenomenon.

SO, why does my ear feel full sometimes?

Assuming there is no earwax present which could cause symptoms of ear fullness, for most people, the ear fullness is due to their inability to pop their ears easily (or, open up the eustachian tube). Why would this cause ear fullness (and if severe enough, a persistent ear pain)? It's because there is a PRESSURE difference between the air pressure in the middle ear and the pressure outside across the eardrum. When there is a pressure difference, the eardrum either bulges outward (positive pressure) or bulges inward (negative pressure). Basically, when the eardrum bulges inward or outward, it creates a sensation of fullness for the person.

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Eardrum bulges inward when the pressure outside is greater than the pressure in the middle ear space (ie, occurs when a plane is landing or if you dive deep into water)... The first picture reveals a pressure of "30" outside the ear (remember, the ear canal is open to the outside) whereas the pressure is only "10" inside the ear. This will cause the eardrum to bulge inward until the pressure outside and inside the ear matches at "30."

Images are a modification of that found in Wikipedia under GNU Free Documentation License.

Eardrum bulges outward when the pressure outside is less than the pressure in the middle ear space (ie, occurs when a plane is taking off or if you drive up a tall mountain)... The situation is reverse from that above. With the middle ear pressure of "30" being more than the ouside pressure of "10,", the eardrum bulges outward until the pressure inside and outside matches at "10."

Images are a modification of that found in Wikipedia under GNU Free Documentation License.

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Normally, by popping your ears, the pressure difference will normalize (ie, no pressure can build up in a balloon if there is a hole) and the eardrum will go back into a neutral position. If the pressure difference is severe, the eardrum can bulge to the point it can pop like a balloon, a situation known as a perforated eardrum. Of note, people suffering predominantly from negative ear pressure are at risk of developing fluid in the middle ear which may lead to middle ear infections (otitis media) and hearing loss. So, what would cause the eustachian tube to not open up properly? Well, something could be physically blocking the opening of the eustachian tube in the nose, most notably large adenoids. In rare cases, it could even be a tumor. Endoscopy is required to evaluate for these possibilities. More commonly, the eustachian tube does not open properly due to inflammatory conditions, especially allergies, resulting in the tube becoming inflamed and swollen. That's why when people get a cold or allergies are bad, their ears also becomes affected. This condition is known as Eustachian Tube Dysfunction.

To read more about this condition and how to treat it, click here.

Products That Help Pop the Ear Due to Eustachian Tube Dysfunction or Fluid in the Middle Ear:

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Geared Toward Adults

Balloon Geared Toward Kids