Echo in the ear when speaking may be caused by physiological factors such as water in the ear from swimming, or pathologic factors such as otitis media. 1. Physiological factors. Water in the ear when bathing or swimming, not cleaned in time, often with earplugs, poor sleep, etc., causing the ear echo when talking. 2. Pathological factors. Caused by otitis media, abnormal opening of Eustachian tube, ear canal cerumen and other diseases. (1) Otitis media. Due to bacterial and viral infections, otitis media causes ear pain, ear blockage, tinnitus and other symptoms, which leads to an echo in the ear when speaking. (2) Abnormal opening of the Eustachian tube. The abnormal opening of the Eustachian tube is induced by excessive swallowing and chewing, resulting in symptoms such as ear stuffiness, ear pain, and tinnitus, which leads to the above symptoms. (3) Cerumen in the ear canal. There are small pieces of cerumen on the tympanic membrane. When speaking, the tympanic membrane vibrates and drives the cerumen, thus producing an echo. If there is echo in the ear when you speak, you should go to the hospital in time for treatment of the symptoms.