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Why Does My Ear Still Feel Blocked After a Cold? An ENT in Gangnam, Seoul Explains

Answered by Dr. Kim Yoo Suk, MD · Board-certified otolaryngologist · Former professor, Yonsei & Ajou University · Consultations in English

The Eustachian tube is usually to blame

The Eustachian tube connects the middle ear to the back of the nose. It opens briefly when you swallow or yawn to equalize pressure and drain fluid. During a cold, sinus infection, or allergy flare, the lining of the nose and tube swells. The tube then stays closed, air in the middle ear is absorbed, and pressure drops. This is Eustachian tube dysfunction(ETD).

Common symptoms

• A full, plugged, or underwater feeling in the ear
• Muffled hearing
• Popping or crackling sounds, especially when swallowing
• Mild ear discomfort
• Hearing your own voice or breathing loudly (autophony) in some cases
• Mild tinnitus

When fluid builds up

If the tube stays blocked, fluid can collect behind the eardrum, a condition called otitis media with effusion. It is not usually painful, but it reduces hearing. In adults it typically follows a cold and often resolves over weeks to a few months. Persistent fluid on only one side in an adult should have the back of the nose examined.

Things that may help at home

• Swallow, yawn, or chew gum to encourage the tube to open
• Gentle autoinflation: close your mouth, pinch your nose, and blow very gently until you feel a pop; stop if painful
• Treat nasal congestion with saline rinses and, if appropriate, a steroid spray
• Use decongestant sprays only for a few days at most
• Avoid diving until the ear clears

Flying and diving with a blocked ear

A blocked Eustachian tube makes pressure changes painful and can cause airplane ear or barotrauma when diving. If possible, postpone diving until the ear clears completely. Swallowing, chewing, and gentle autoinflation during descent can help with unavoidable flights.

When to see an ENT

• The blocked feeling lasts more than about three weeks
• Hearing loss is sudden or significant, which could be sudden sensorineural hearing loss rather than ETD
• Ear pain, fever, or discharge develops
• Symptoms are only on one side and keep returning
• Dizziness accompanies the blocked ear

What we do at Gangnam Yonsei ENT

Dr. Kim Yoo Suk, a board-certified otolaryngologist and former Yonsei clinical assistant professor whose rhinology background is particularly relevant because ETD so often starts in the nose, examines both the ear and the nose. Tympanometry measures pressure and movement of the eardrum to detect negative pressure or fluid, and a hearing test distinguishes conductive from inner ear loss. A nasal endoscopy checks the opening of the Eustachian tube, the adenoid area, and the sinuses.

Treatment focuses on the underlying nasal problem, such as allergic rhinitis or sinusitis. If fluid persists and affects hearing, myringotomy, a small opening in the eardrum to drain fluid, sometimes with a ventilation tube, may be discussed.

English consultations are available near Gangnam-gu Office Station; see location and hours. Related: when sudden hearing loss is an emergency and whether adult ear infections need antibiotics.

Related questions

How long can a blocked ear last after a cold?

Most people's ears clear within one to three weeks as nasal swelling settles. Fluid behind the eardrum can take longer, sometimes several weeks to a few months. If it lasts more than about three weeks or hearing drops suddenly, see an ENT.

Is it safe to pop my ears by blowing with my nose pinched?

Gentle autoinflation is generally safe for most adults. Blow softly, never forcefully, and stop if it causes pain or dizziness. Avoid it if you have an active ear infection or a known eardrum perforation unless your doctor advises otherwise.

Can allergies cause a blocked ear?

Yes. Allergic rhinitis swells the lining around the Eustachian tube opening, which can cause pressure, popping, and muffled hearing. Treating the allergy with sprays, rinses, and trigger avoidance often improves ear symptoms.

This answer is general medical information written and reviewed by an ENT specialist. It is not a diagnosis. Please see a doctor for an examination. In an emergency in Korea, call 119.