Dear Doctor Jahn,
It’s been months and one of my ears never “popped” clear after a flight! To make things worse, when I sing it sounds like I’m wearing earplugs. I’ve had scans, etc. and there appears to be nothing wrong. There’s no allergies or anything else I can think of – help! Those who have to listen to my singing beg you!
-Rob
Dear Rob,
It sounds like the problem is with your eustachian tube, the passage that connects the middle ear to the back of your throat. Two possibilities come to mind. More commonly, the tube gets blocked. This can be due to inflammation, allergies, tissue (like adenoids) blocking the end of the tube in the back of the throat. Your ENT doctor should be able to determine any of these possibilities by looking in the back of your nose, looking at your ear drum, and then testing the middle ear pressure (tympanogram).
Less common, and often missed, is a eustachian tube that is abnormally OPEN. This condition (patulous eustachian tube) is confusing, because the symptoms are a bit like the closed tube. The ear feels blocked. Typically, these patients say the voice echoes up into the ear, and, classically, you feel better when you are lying down than when you have been up and about all day. Also, it is worse when the adrenaline is pumping, such as with exercise or performing. Weight loss also predisposes to this condition.
You need to see another ENT, have them test your eustachian tube for abnormal patency.If you do have this, one option is a little weight gain, another might be the placement of a small vent tube in your ear drum.
-Anthony F. Jahn, MD, FACS, FRCS(C)
This discussion is for general information and not to be construed as specific medical advice that you should obtain from your own physician.

Dr. Jahn is an internationally renowned otolaryngologist based in Manhattan with a sub-specialty interest in the professional voice. His practice includes classical and popular singers. He holds academic appointments at Mount Sinai School of Medicine and Westminster Choir College in Princeton. He is Medical Director at Jazz at Lincoln Center, and former Director of Medical Services at the Metropolitan Opera in New York. Dr. Jahn has published several books for vocalists, including “Vocal Heath for Singers” (Singdaptive) and “The Singer’s Guide to Complete Health” (Oxford University Press).