For Eustachian tube dysfunction (ETD), medical experts often recommend a two-pronged approach using oral decongestants and nasal steroid sprays. Oral pseudoephedrine (Sudafed) is the "gold standard" for temporarily shrinking the swollen tissues in the nasopharynx to allow the tube to open. However, for long-term management in 2026, nasal steroids like fluticasone (Flonase) or mometasone are preferred, as they reduce the underlying inflammation without the "rebound" effect associated with oxymetazoline (Afrin) sprays.