What causes ear eustachian tube blockage when holding your breath, and what should you do about it?

Generally, ear blockage or eardrum discomfort during breath-holding may be caused by temporary dysfunction of the Eustachian tube, sudden pressure changes, secretory otitis media, allergic rhinitis, or chronic sinusitis. Depending on the specific condition, patients can improve symptoms through general management, medication, or surgical treatment. Details are as follows:

1. Temporary Eustachian Tube Dysfunction

During breath-holding, the Eustachian tube may fail to open in time to regulate pressure, leading to a pressure imbalance across the eardrum and causing a sensation of blockage. Stopping breath-holding and performing swallowing or yawning movements, or gently blowing while pinching the nose (Valsalva maneuver), can help open the Eustachian tube and equalize pressure.

2. Sudden Pressure Change

Holding breath during diving, mountain climbing, or elevator rides causes rapid external pressure changes. The Eustachian tube cannot adjust quickly enough, resulting in pressure compression on the eardrum and a blocked sensation. Slowly regulating breathing and avoiding sudden breath-holding can help. Chewing gum during pressure changes may promote recovery of Eustachian tube function.

3. Secretory Otitis Media

Eustachian tube blockage leads to fluid accumulation in the middle ear. During breath-holding, this fluid impedes pressure transmission, causing significant ear blockage and possibly mild hearing loss. Under medical guidance, medications such as cefuroxime axetil tablets, eucalyptus oil and pinene enteric soft capsules, mometasone furoate nasal spray, and Eustachian tube inflation therapy may be used.

4. Allergic Rhinitis

Allergic reactions cause nasal mucosal swelling, which compresses and blocks the opening of the Eustachian tube. During breath-holding, the inability to regulate eardrum pressure results in a blocked sensation. As directed by a physician, cetirizine hydrochloride tablets, budesonide nasal spray, and montelukast sodium chewable tablets can be used, along with avoiding allergens such as pollen and dust mites.

5. Chronic Sinusitis

Long-term sinus inflammation increases nasal secretions, blocking the Eustachian tube opening. During breath-holding, unequal pressure across the eardrum causes a blocked feeling, often accompanied by purulent nasal discharge and headache. Under medical supervision, medications such as cefaclor capsules, Biyuan Tongqiao granules, and saline nasal irrigation solutions may be used. In severe cases, sinus surgery may be required.

To prevent issues, avoid frequent forceful breath-holding. Limit activities like diving or flying during colds or rhinitis flare-ups. Maintain nasal patency and treat nasal conditions promptly. Regularly rinse nasal passages with saline solution to reduce infection risk. If ear blockage persists for more than one week, or is accompanied by ear pain or hearing loss, seek medical attention promptly.