Ear Congestion and Low-Frequency Tinnitus: Causes and Treatments

Left ear feels clogged with a low-frequency buzzing sound?

Hello, on May 5th, I visited an ENT clinic for low-frequency tinnitus in my left ear and underwent a nasal endoscopy (flexible scope).
The doctor said everything looked clean and there was no need to worry.
On May 6th, I went to the hospital's ENT department for the same issue, and the doctor suggested it might be related to the Eustachian tube, prescribing tranexamic acid (血迅) 250 mg and Carbinoxamine/Pseudoephedrine (CABIDRIN FC) 2.5/60 mg.
I took the medication once that afternoon, and I was very pleased to find that the low-frequency tinnitus in my left ear had disappeared by evening.
I took the medication again after dinner.
The next day, upon waking up, I felt a sensation of fullness in my left ear accompanied by a low-frequency roaring tinnitus (similar to the feeling of holding a bowl or shell over my ear, different from the previous buzzing sound like a refrigerator compressor).
I noticed an imbalance in hearing low-frequency sounds from the outside (the left ear felt blocked and the low frequencies were unclear).
I could hear my own voice more in the right ear, with less sound transmission to the left ear.
As of now (May 9th), it is still the same.
May I ask: (1) Is this a sign of worsening Eustachian tube obstruction? (2) Is there any relation to the nasal endoscopy potentially irritating the nasopharynx? (3) Could the medications tranexamic acid (血迅) 250 mg and Carbinoxamine/Pseudoephedrine (CABIDRIN FC) 2.5/60 mg be causing this? (4) Is tranexamic acid (血迅) 250 mg commonly used in ENT, and what is its purpose? (5) Could this be sudden sensorineural hearing loss? Thank you!

STD, 40~49 year old female. Ask Date: 2016/05/09

Dr. Zheng Jueyi reply Otolaryngology

Hello, in addition to the issues with the Eustachian tube, the sensation of ear fullness combined with difficulty hearing low-frequency sounds may also suggest inner ear edema or Meniere's disease.
If the symptoms persist without improvement, it is recommended to return to the hospital for a hearing evaluation.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2016/05/09

More Info

Understanding ear congestion and low-frequency tinnitus can be quite complex, as these symptoms can arise from various underlying conditions. Based on your description, it appears you are experiencing a combination of low-frequency tinnitus, ear congestion, and a sensation of imbalance in hearing. Let's address your questions one by one and provide a comprehensive overview of the potential causes and treatments.

1. Is this a more severe ear canal blockage?
It is possible that your symptoms indicate a worsening of Eustachian tube dysfunction (ETD), which can lead to ear congestion and altered auditory perception. The Eustachian tube connects the middle ear to the back of the throat and helps equalize pressure. If it becomes blocked or fails to open properly, it can cause a sensation of fullness in the ear, muffled hearing, and tinnitus. Symptoms can fluctuate, and it’s not uncommon for individuals to experience periods of relief followed by exacerbation.

2. Is there a relationship between the nasal endoscopy and the irritation of the nasopharynx?
Nasal endoscopy can sometimes cause temporary irritation or inflammation in the nasopharyngeal area, which may contribute to Eustachian tube dysfunction. If the Eustachian tube is already compromised, any additional irritation could exacerbate your symptoms. However, this is typically a transient effect, and if symptoms persist, further evaluation may be necessary.

3. Could the medications (tranexamic acid and Carbinoxamine/Pseudoephedrine) be causing these symptoms?
While it is unlikely that tranexamic acid would cause ear congestion or tinnitus, Carbinoxamine (an antihistamine) and Pseudoephedrine (a decongestant) can have side effects that may affect the ears. Antihistamines can sometimes lead to dryness in the mucous membranes, which might exacerbate feelings of congestion. Pseudoephedrine is intended to relieve congestion, but in some cases, it can lead to a rebound effect if used excessively, potentially worsening symptoms.

4. Is tranexamic acid commonly used in ENT? What is its purpose?
Tranexamic acid is primarily used to reduce bleeding in various medical contexts, including surgery and trauma. In ENT, it may be used in specific situations, such as managing bleeding during procedures or in patients with certain bleeding disorders. However, it is not a standard treatment for tinnitus or Eustachian tube dysfunction. Its use in your case may be more related to managing any bleeding risk rather than directly addressing your ear symptoms.

5. Could this be sudden sensorineural hearing loss?
Sudden sensorineural hearing loss (SSNHL) is characterized by a rapid loss of hearing, typically in one ear, and may be accompanied by tinnitus. While your symptoms of low-frequency tinnitus and ear fullness could suggest SSNHL, it is essential to consider the timeline and nature of your hearing loss. If your hearing has not significantly decreased, and if you have not experienced a sudden change in your ability to hear, it may be less likely. However, if you have concerns about SSNHL, it is crucial to seek immediate medical evaluation, as early intervention can improve outcomes.

Additional Considerations and Recommendations:
- Follow-Up with an ENT Specialist: Given the persistence of your symptoms, it would be beneficial to follow up with an ENT specialist for a thorough evaluation. They may recommend additional tests, such as audiometry or tympanometry, to assess your hearing and Eustachian tube function more accurately.

- Consider Allergy Management: If you have a history of nasal congestion or allergies, addressing these underlying issues may help alleviate your ear symptoms. Antihistamines or nasal corticosteroids may be beneficial.

- Avoid Self-Medication: Be cautious with over-the-counter medications, as they can sometimes complicate symptoms. Always consult with your healthcare provider before starting or stopping any medication.

In conclusion, your symptoms of low-frequency tinnitus and ear congestion could be related to Eustachian tube dysfunction, possibly exacerbated by recent medical interventions or medications. A thorough evaluation by an ENT specialist will be crucial in determining the underlying cause and appropriate treatment plan.

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