Pressure on the ears causes diagnosis treatment

Prere on the ears (ear prere)Whether unilateral or bilateral – prere on the ears (ear prere) can have many causes. In many cases, other ear complaints occur at the same time as the feeling of prere. Learn how to get rid of the prere on your ears.

This text is based on medical literature, medical guidelines and current studies and has been reviewed by medical experts. Often unilateral or bilateral prere on the ears is harmless. Occurs only temporarily – for example, when you enter a tunnel by train. However, ear prere can also be a symptom of various diseases.

Depending on the cause, other symptoms besides the feeling of prere in the ear may occur, such as:

If the prere on the ears remains longer, one should let the cause clarify medically.

Prere on the ears (ear prere): causes

Unilateral or bilateral prere on the ears (ear prere) can have various causes. It usually occurs when the eustachian tube is not properly ventilated or when the prere balance to the middle ear does not function properly. Experts then speak of a so-called ventilation disorder or tubal ventilation disorder. This can be the case, for example, when the eustachian tube

– is swollen shut, – is blocked (z. B. due to an enlarged pharyngeal tonsil) or – does not open properly.

If no air exchange is possible, negative prere can develop in the ear, causing the eardrum to bulge inwards. This can feel uncomfortable or even painful. Lead to a feeling of prere or a kind of fullness in the ear.

If the eustachian tube is blocked, secretions may accumulate in the middle ear and press against the eardrum. This can also cause ear pain or other ear discomfort, such as prere in the ear.

If fluid accumulates for a longer period of time, this can lead to a middle ear infection in the long term. Especially small children are often affected, because in them the eustachian tube is not yet fully developed and is proportionally shorter than in older children and adults. This causes them to develop inflammation more quickly, during which the mucosa in the eustachian tube often swells and closes it off.

Certain factors can contribute to prere in the ear, such as changes in altitude, anatomical conditions, infections, allergies, or a permanently open eustachian tube.

Ear prere due to changes in altitude

Depending on the altitude, there is also a change in air prere. Normally, the eustachian tube compensates for the difference in prere to the middle ear. If this does not function properly, one feels an unpleasant or even painful prere on the ears.

Typical changes in altitude that lead to prere in the ear include:

– when taking off or landing in an airplane – when riding an elevator in a high-rise building – when climbing mountains – when diving

Ear prere due to anatomical conditions

In some people, the eustachian tube is naturally narrower and can become misaligned more easily, which can cause prere equalization problems more quickly. People with tighter ear trumpets are also more likely to have problems with prere in the ears when traveling by air – especially during the landing approach. But also a (mostly congenital) deviated septum can lead to prere in the ear.

Ear prere due to infections

Infections in the ear or nasopharynx can cause ear prere to increase. In the case of a middle ear infection, for example, fluid can accumulate in the middle ear (sog. (e.g., tympanic effusion) and thus increase the prere.

But respiratory infections (such as a cold) or sinusitis can also be accompanied by prere on the ears, for example if the eustachian tube is swollen shut or obstructed by secretions (so-called "ear infection"). tubal catarrh).

Ear prere in allergies

In the context of an allergy, the mucous membranes in the nasopharynx can swell, on the one hand, and increased mucus production on the other hand. This can affect the function of the eustachian tube.

Ear prere due to constantly open eustachian tube

The so-called gaping (open) tube syndrome can also lead to prere on the ears. If there are changes in the fatty and connective tie around the eustachian tube, this may result in the eustachian tube being constantly open. This can have a number of causes, such as weight loss or low prere in the veins. But also changes in the surrounding cartilage or muscles are possible.

Other possible causes of ear prere

Other possible causes that can lead to prere in the ear include:

– too much earwax in the ear canal – enlarged pharyngeal or palatine tonsils – temporomandibular joint problems – muscle tension in the palate/jaw area

Relationship of eustachian tube and prere in the ear

The eustachian tube (also called the tuba auditiva) plays an important role in ear prere. It connects the nasopharynx with the middle ear – more precisely with the tympanic cavity. The main function of the eustachian tube is to "ventilate" the middle ear and thereby equalize the prere in the middle ear with the external prere (i.e. the air prere in the nasopharynx).

In addition, the eustachian tube can drain secretions from the middle ear into the throat. The tubular connection runs from the tympanic cavity diagonally forward downward into the nasopharynx. On the one hand, this facilitates drainage, but also offers a certain protection against germs or rising infections.

Only if the middle ear is free of secretions and the prere corresponds to the external prere, the eardrum can vibrate freely and allow normal hearing.

If the prere balance via the eustachian tube does not function properly, this can manifest itself as a feeling of prere in the ear.

The eustachian tube is about 3 to 4 centimeters long. Its walls are usually collapsed. The eustachian tube is therefore completely closed lengthwise. When open, its diameter is about 2 to 3 millimeters.

The eustachian tube opens briefly when you chew, swallow or yawn. This allows air to enter and equalizes the prere in case of unequal prere conditions. Sometimes a cracking or popping sound is heard as the eustachian tube opens and prere equalizes. Just by swallowing regularly, the eustachian tube opens on average once a minute.

If the prere conditions change and the external prere increases in relation to the middle ear, the eardrum bulges inward due to the negative prere in the ear. This may feel uncomfortable or even painful. Affected people often feel prere on their ears or have the feeling that something is stuck in their ears and filling them.

Prere on the ears (ear prere): Diagnosis

To find out what causes prolonged prere on the ears (ear prere), the otolaryngologist can perform several tests.

Otoscopy (ear examination)

Otoscopy can be used to detect changes in the eardrum, for example.

In some cases, otoscopy is combined with the Valsalva maneuver, in which the patient exhales with a closed mouth and nose and pushes air into the eustachian tube. If the prere is equalized by the Valsalva maneuver, the doctor can see that the eardrum is bulging.

Pneumatic otoscopy

Another method to test the function of the eustachian tube is the so-called pneumatic otoscopy.

A special otoscope is used to seal the external auditory canal airtight, and air is introduced into the auditory canal via a connected balloon, which is then released again. The doctor observes how the eardrum reacts to the prere created or whether it moves.

Nasal endoscopy (rhinoscopy)

A nasal endoscopy (rhinoscopy) provides information about possible inflammatory processes in the area of the nose and makes it possible to examine the opening of the eustachian tube.


The properties of the eardrum and middle ear can also be additionally tested with so-called tympanometry. This is done by measuring the prere in the middle ear in comparison to the external prere by means of a small probe in the external auditory canal.

Hearing test

A hearing test can clarify whether there may be hearing problems.

Examinations in other specialties

If the causes of ear prere are not in the ear, but possibly in the area of the temporomandibular joints or the muscles of the palate and jaw, other specialties (e.g., the ear) are usually examined. B. A dentist with a specialization in functional diagnostics) is consulted for the diagnosis.

Get rid of prere on the ears (ear prere)

Often, unilateral or bilateral prere on the ears (ear prere) lasts only a short time and disappears by itself, so that no treatment is necessary. In some cases, however, it lasts for days or even weeks. Therapy may then be required.

Short-term help against ear prere

Simple measures such as yawning, chewing or swallowing can often help against prere in the ear in the short term.

The so-called Valsalva maneuver can also reduce the feeling of prere in the ear: inhale and then gently exhale while keeping your mouth closed and holding your nose. This forces air into the eustachian tube. Prere equalization can take place. When the prere is successfully equalized, a kind of soft crackle or click is heard.

Avoiding ear prere during air travel

Anyone who has problems with prere on the ears during air travel can use decongestant nasal drops or a nasal spray about half an hour before takeoff to help equalize the prere in the ears. For longer flights, nasal drops or nasal spray should be used again about half an hour before landing. (Note: Liquids may only be carried in hand luggage in a sealable and transparent 1-liter plastic bag.)

Have earwax plug removed

If too much earwax or a plug of earwax in the ear canal is causing the prere in the ear, this can be easily remedied by an ear rinsing performed by an otolaryngologist.

Treat the causative disease

If the ear prere is caused by a disease, this should be treated. Medication is then often used (depending on the cause), such as:

– decongestant nasal spray – anti-allergic agents – glucocorticoids – antibiotics

If the ear prere arises because fluid has accumulated behind the eardrum (e.g., a tympanic membrane), it can be treated with the. B. (e.g., due to a chronic inflammation of the middle ear), it may be necessary to insert a so-called tympanostomy tube into the eardrum in a minor surgical procedure, especially in smaller children. This creates a connection between the external auditory canal and the middle ear, so that the fluid can drain off and air exchange is possible again.

Anatomical problems

If anatomical conditions (such as a deviated septum or an enlarged pharyngeal tonsil) are the cause of the prere on the ears, surgical measures may be appropriate.

Balloon dilatation

In the case of a permanently narrowed eustachian tube, newer procedures such as balloon dilatation, i.e. widening of the eustachian tube by means of a balloon catheter, may also be considered.

This method, which is still quite new, involves using a special endoscope to insert a balloon catheter through the nose and throat into the constricted eustachian tube, which is then inflated with physiological saline solution for a short time, causing it to expand.

Experts suspect that stretching causes tiny fractures in the cartilage tie that surrounds the eustachian tube, giving it more room and a larger diameter. In this way, the ventilating function of the ear can be. This may also improve accompanying ear complaints such as prere in the ear again.

Whether a balloon dilatation will prove successful in the long term, however, cannot be said at this point in time. Comparative analyses of previous studies – also due to the small number of subjects – do not yet allow a conclusive statement to be made.

Laser tuboplasty

Another newer method is the so-called laser tuboplasty. In this surgical procedure, a laser is used to remove tie from the entrance to the eustachian tube, thereby enlarging it. This is supposed to have a positive effect on the ventilation disorder.

It is not possible to say with certainty how successful this method is. Comparative analyses of previous studies do not come to a clear result. In the studies compared, the number of participating subjects was also too small.

– Randrup, T. S., et al.Balloon eustachian tuboplasty: a systematic review. Otolaryngology – Head and Neck Surgery, Vol. 152, Eat. 3, pp. 383-392 (March 2015) – Norman, G., et al.Systematic review of the limited evidence base for treatments of Eustachian tube dysfunction: a health technology assessment. Clinical Otolaryngology, Vol., 39, Iss. 1, pp. 6-21 (February 2014) – Sudhoff, H., et al.: Therapy of chronic obstructive dysfunctions of the Eustachian tube. ENT, Vol. 61, Iss. 6, pp. 477-482 (June 2013) – Schroder, S., et al.: Chronic tubal dysfunction in adults. ENT, Vol. 61, Eat. 2, pp. 142-151 (February 2013) – Behrbohm, H., et al.: Short textbook ear, nose and throat medicine. Thieme, Stuttgart 2012 – Caffier, P. P., et al.Impact of laser eustachian tuboplasty on middle ear ventilation, hearing, and tinnitus in chronic tube dysfunction. Ear and Hearing, Vol. 32, Iss. 1, pp. 132-139 (February 2011) – Arnold, W., Ganzer, U.: Checklist Otorhinolaryngology. Thieme, Stuttgart 2011 – Zilles, K., Tillmann, B. N.: Anatomy. Springer, Heidelberg 2010 – Probst, R., et al.: Otorhinolaryngology. Encyclopedia of Diseases. Examinations. Thieme, Stuttgart 2008 – Boenninghaus, H.-G., Lenarz, T.: Otorhinolaryngology. Springer, Heidelberg 2007

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