Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Family Medicine (Expert Forum)
Ear Problems
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Ear Problems
by hvipo, Apr 23, 2002 12:00AM
What next?
I'm sorry for such a lengthy explanation, but this has been going on a long time. I really don't know what else to do, and I hope that maybe you can give me some explanations or answers that my doctors didn't give me.
Back in August, I got a lot of pain in my left jaw. The pain went down my neck so much that I could barely move. Then it jumped over to my right side of neck and into my right ear. When I went to doctor, he said I had an infection in my Eustacheon tubes. Some kind of a shot, antibiotics, allergy medication, and a nasal spray got rid of the pain, but the feeling of fluid in my ear never went away. I went back to the doctor and he changed my prescription.
The feeling of fluid in my ear still never went away. I put off going to doctor again because of personal problems but my ear plugged up again in late December. It is usually in my right ear, but it does go into the left ear sometimes. I was told by my doctor it is normal to hop ears when in the eustacheon tubes. I've been on medication ever since. After six visits to my family doctor, he sent me to get a CT scan. I have a cyst under my right eye. Then I was referred to a ear nose and throat specialist. He said the cyst was common and nothing to worry about. He sent me to an audiologist. Although I have hearing loss for low frequency noises, my hearing test came out normal. The specialist cannot see any fluid and the hearing test came out normal; therefore, he doesn't know what's wrong. He is not ruling out an eustacheon tube problem, but he can't verify it.
Between the two doctors, I have been on Zyrtec-D, Flonase, Methylprednisone, Allegra-D, Levaquin, Clairitin, Bactrim, Biaxin, Duratess GP, Nasacort AQ, and Duratuss G. I am currently on Nasacort AQ and Duratuss G.
My family doctor and specialist seem to be contradicting each other. Family doctor told me that you can't see the fluid when it is in the eustacheon tube. He also said that I could suffer from problems hearing noises like whispers as long as there is fluid in eustacheon tubes and takes a long time to get rid of. Specialist was looking for fluid in ear. Because he can't see it and my hearing is normal, he's not sure if I have fluid in my ears. I just have the "sensation" of fluid in my ears. Don't get me wrong, he hasn't ruled it out, he just can't verify it. He also said that he didn't know what would cause me to have low frequency hearing loss.
Specialist's next step is allergy testing. That really confuses me. My allergies have never been severe. I wouldn't have gone to a doctor if it wasn't for my ears being plugged up. My allergy problems consist of a sore throat for a few days and then it goes away. Even if you find out what I'm allergic to, how is that going to make the fluid in my ears go away? I still have to work, clean, go outside even when there is heavy pollen - finding out what I'm allergic to won't change things.
What do I do now?
I'm sorry for such a lengthy explanation, but this has been going on a long time. I really don't know what else to do, and I hope that maybe you can give me some explanations or answers that my doctors didn't give me.
Back in August, I got a lot of pain in my left jaw. The pain went down my neck so much that I could barely move. Then it jumped over to my right side of neck and into my right ear. When I went to doctor, he said I had an infection in my Eustacheon tubes. Some kind of a shot, antibiotics, allergy medication, and a nasal spray got rid of the pain, but the feeling of fluid in my ear never went away. I went back to the doctor and he changed my prescription.
The feeling of fluid in my ear still never went away. I put off going to doctor again because of personal problems but my ear plugged up again in late December. It is usually in my right ear, but it does go into the left ear sometimes. I was told by my doctor it is normal to hop ears when in the eustacheon tubes. I've been on medication ever since. After six visits to my family doctor, he sent me to get a CT scan. I have a cyst under my right eye. Then I was referred to a ear nose and throat specialist. He said the cyst was common and nothing to worry about. He sent me to an audiologist. Although I have hearing loss for low frequency noises, my hearing test came out normal. The specialist cannot see any fluid and the hearing test came out normal; therefore, he doesn't know what's wrong. He is not ruling out an eustacheon tube problem, but he can't verify it.
Between the two doctors, I have been on Zyrtec-D, Flonase, Methylprednisone, Allegra-D, Levaquin, Clairitin, Bactrim, Biaxin, Duratess GP, Nasacort AQ, and Duratuss G. I am currently on Nasacort AQ and Duratuss G.
My family doctor and specialist seem to be contradicting each other. Family doctor told me that you can't see the fluid when it is in the eustacheon tube. He also said that I could suffer from problems hearing noises like whispers as long as there is fluid in eustacheon tubes and takes a long time to get rid of. Specialist was looking for fluid in ear. Because he can't see it and my hearing is normal, he's not sure if I have fluid in my ears. I just have the "sensation" of fluid in my ears. Don't get me wrong, he hasn't ruled it out, he just can't verify it. He also said that he didn't know what would cause me to have low frequency hearing loss.
Specialist's next step is allergy testing. That really confuses me. My allergies have never been severe. I wouldn't have gone to a doctor if it wasn't for my ears being plugged up. My allergy problems consist of a sore throat for a few days and then it goes away. Even if you find out what I'm allergic to, how is that going to make the fluid in my ears go away? I still have to work, clean, go outside even when there is heavy pollen - finding out what I'm allergic to won't change things.
What do I do now?
Doctor's Answer
by Forum-M.D.-DT, Apr 23, 2002 12:00AM
Thank you for visiting the Family Practice Forum.
OK, we now know that you have been on multiple antibiotics, antihistamines, nasal steroid sprays and have had little or no relief of this chronic problem.
I suspect what you are dealing with here is one of three possible conditions. (and possibly a combination thereof).
Otitis Media With effusion This refers to a condition where fluid collects in the middle ear, possibly containing bacteria. Normally fluid does not collect in the middle ear as
the middle ear is "ventilated" several times when you swallow (through the eustachian tube which opens up into the back of the throat). If the fluid in the middle ear does not drain into the back of the throat, usually due to either infection, or an increased amount of fluid, the fluid may cause a
change in the ability to hear properly, dizzyness, or pain. This condition is usually treated with antihistimines or antibiotics, but you have tried this and it has been of no help.
This leads me to the second possibility, that being Meniere's Disease. This condition is caused by fluid in the canals of the inner ear. Although it can be a troublesome condition, Meniere's is not a serious condition and is not contagious. People with Meniere's don't usually have symptoms all the time. When symptoms occur it is called and "attack." It usually affects only one ear but can affect both ears in about 30% of patients. The symptoms present during an attack include dizziness, a feeling of fullness or loss of hearing in the ear, and tinnitus (ringing in the ears).
Treatments for this condition include limiting dietary salt (less salt will likely help reduce the potential for fluid to build up in the canals of the inner ear), also a medicine called a diuretic (water pill) may be prescribed as the best treatment for this condition remains medication which helps reduce the potential for fluid to collect in the inner ear. During episodes of dizziness, a medication called "Antivert" may be prescribed. Additionally, for the nausea which commonly accompanies the "attacks", medicine may be helpful.
Meniere's disease has the classic three symptoms of 1) dizziness 2) hearing loss (at times very subtle) 3)ringing in the ears.
You didn't mention the ringing in the ears, but if you have this, I would much more strongly suspect Meneire's disease. You haven't been tried on a diuretic yet, perhaps this medication may be of some help in your case.
The third possibility is that you have a chronic sinus infection which is causing persistent fluid collection in the sinuses , middle ear and eustachian tube. It is possible, if this is the case that the anti-histamine/decongestants just have not been used "long enough". (I would choose Zyrtec-D ... possibly for up to a month in this case).
In conclusion, my thoughts are:
1. Meneire's disease and the possible use of a low-dose diuretic needs to be considered
2. Possibly the antihistamine/decongestant was not used LONG enough.
3. It would appear that the next "specialist" you need to see is an Ear Nose and Throat specialist (ENT), or possibly ask for the opinion of a second ENT.
I hope this helps!
OK, we now know that you have been on multiple antibiotics, antihistamines, nasal steroid sprays and have had little or no relief of this chronic problem.
I suspect what you are dealing with here is one of three possible conditions. (and possibly a combination thereof).
Otitis Media With effusion This refers to a condition where fluid collects in the middle ear, possibly containing bacteria. Normally fluid does not collect in the middle ear as
the middle ear is "ventilated" several times when you swallow (through the eustachian tube which opens up into the back of the throat). If the fluid in the middle ear does not drain into the back of the throat, usually due to either infection, or an increased amount of fluid, the fluid may cause a
change in the ability to hear properly, dizzyness, or pain. This condition is usually treated with antihistimines or antibiotics, but you have tried this and it has been of no help.
This leads me to the second possibility, that being Meniere's Disease. This condition is caused by fluid in the canals of the inner ear. Although it can be a troublesome condition, Meniere's is not a serious condition and is not contagious. People with Meniere's don't usually have symptoms all the time. When symptoms occur it is called and "attack." It usually affects only one ear but can affect both ears in about 30% of patients. The symptoms present during an attack include dizziness, a feeling of fullness or loss of hearing in the ear, and tinnitus (ringing in the ears).
Treatments for this condition include limiting dietary salt (less salt will likely help reduce the potential for fluid to build up in the canals of the inner ear), also a medicine called a diuretic (water pill) may be prescribed as the best treatment for this condition remains medication which helps reduce the potential for fluid to collect in the inner ear. During episodes of dizziness, a medication called "Antivert" may be prescribed. Additionally, for the nausea which commonly accompanies the "attacks", medicine may be helpful.
Meniere's disease has the classic three symptoms of 1) dizziness 2) hearing loss (at times very subtle) 3)ringing in the ears.
You didn't mention the ringing in the ears, but if you have this, I would much more strongly suspect Meneire's disease. You haven't been tried on a diuretic yet, perhaps this medication may be of some help in your case.
The third possibility is that you have a chronic sinus infection which is causing persistent fluid collection in the sinuses , middle ear and eustachian tube. It is possible, if this is the case that the anti-histamine/decongestants just have not been used "long enough". (I would choose Zyrtec-D ... possibly for up to a month in this case).
In conclusion, my thoughts are:
1. Meneire's disease and the possible use of a low-dose diuretic needs to be considered
2. Possibly the antihistamine/decongestant was not used LONG enough.
3. It would appear that the next "specialist" you need to see is an Ear Nose and Throat specialist (ENT), or possibly ask for the opinion of a second ENT.
I hope this helps!
I don't have allergies, asthma, diabetes, sinus, or any other possible causes. I associate this "ear thing" with an oral surgery to remove four wisdom teeth two years ago. Two doctors have dismissed this idea (including the oral surgeon), but it seems coincidental, especially since the pain started in my jaw and spread to my neck, landing in my ear, immediately after my gums began to heal.
I've taken antibiotics, sudafed, allegra, and cortizone. A second M.D. advised me to plug my nose and blow out my ears to pop them, and then swallow. It actually feels clear while I'm blowing, but then I can feel something snap shut and that dull ache comes back. The meds keep me up at night, and there is a virtual rock concert of popping and pounding going on in my ears.
I get temporary relief from ear coning (I became desparate six months ago and will buy cones when I'm in really bad pain). However, after the last time I coned, I experienced the worst sort of nausea -- like being pregnant with twin girls -- in the middle of the night. A friend said that some of the bad fluid probably drained into my stomach