Ear Pressure and Potential Otitis Media: A Patient's Journey

Q: Ear Pressure and Potential Otitis Media: A Patient's Journey

Hello： The symptoms may be related to eustachian tube dysfunction causing middle ear effusion. <br>Continuous follow-up treatment at the clinic is recommended, and if the results are unsatisfactory, you may discuss with your physician whether a referral for further examination is

Otitis media related?

About a month ago, I started feeling a tightness and pressure in my left ear, along with a sensation of blockage.
I visited a clinic three times, but they couldn't identify any issues; they only mentioned that my Eustachian tube was obstructed and prescribed medication, which did not improve my condition.
I then went to a hospital for a consultation.
During my first visit, the doctor indicated that I was on the verge of developing otitis media, noting a slight retraction of my eardrum.
After a week of medication, I felt some improvement, but in the second week, I sensed fluid in my ear.
The doctor then used a needle to aspirate some fluid, but it wasn't much, and I continued taking medication.

By the third week, the doctor mentioned that I was almost better and prescribed another two weeks of medication, advising me to perform the Valsalva maneuver to help clear my ears.
Initially, I experienced some relief when I attempted the maneuver, but the blockage persisted.
I repeatedly tried to blow my nose, but the relief was temporary.
Initially, it was only my left ear, but now my right ear also feels strange.
My hearing seems fine, as I can understand others without issue, but when I speak, there is a noticeable difference in sound between both ears, along with a muffled sensation.
After three weeks without improvement, I consulted a different doctor.
This doctor advised me to stop the Valsalva maneuver, suggesting that trapped air might be causing the discrepancy in sound between my ears.
However, after a week of new medication, my symptoms remain unchanged.
The examination of my ears showed no hearing issues, but I do hear a popping sound in both ears when I yawn.
Doesn't this indicate that my Eustachian tubes are functioning? Why, then, am I unable to clear the blockage? Should I seek a more comprehensive evaluation at a larger hospital?

ys, 10~19 year old female. Ask Date: 2017/03/09

Dr. Zheng Jueyi reply Otolaryngology

Hello: The symptoms may be related to eustachian tube dysfunction causing middle ear effusion.
Continuous follow-up treatment at the clinic is recommended, and if the results are unsatisfactory, you may discuss with your physician whether a referral for further examination is necessary.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/03/09

More Info

Understanding ear pressure and potential otitis media can be quite complex, especially when symptoms persist despite treatment. Your experience highlights a common issue many patients face when dealing with ear-related problems, particularly when it comes to the Eustachian tube and middle ear conditions.

From your description, it seems you initially experienced a sensation of pressure and fullness in your left ear, which is often indicative of Eustachian tube dysfunction (ETD). The Eustachian tube connects the middle ear to the back of the throat and helps equalize ear pressure. When this tube becomes blocked, it can lead to a feeling of fullness, discomfort, and even potential fluid accumulation in the middle ear, which can progress to otitis media (middle ear infection).

You mentioned that your first doctor indicated you were close to developing otitis media, and subsequent treatments included medications and attempts to relieve pressure through techniques like the Valsalva maneuver (blowing with your nose pinched). While this technique can help equalize pressure, it may not always be effective if there is significant blockage or if fluid is present in the middle ear.

The fact that you felt some relief after the doctor drained fluid suggests that there was indeed fluid accumulation, which is common in cases of ETD or early otitis media. However, the persistence of your symptoms, especially the sensation of pressure in both ears and the auditory discrepancies when speaking, indicates that the underlying issue may not have been fully resolved.

The popping sounds you hear when yawning could suggest that your Eustachian tubes are intermittently opening, which is a good sign, but it does not necessarily mean they are functioning optimally. The sensation of pressure and the feeling of water in the ear can persist if there is ongoing inflammation or if the Eustachian tube is still not functioning properly.

Given that your symptoms have not improved significantly after several weeks of treatment and that you are now experiencing similar sensations in your right ear, it may be prudent to seek further evaluation. A more comprehensive examination at a specialized ENT (ear, nose, and throat) clinic or a larger medical center could provide additional insights. They may perform tests such as tympanometry to assess middle ear pressure and function, or even imaging studies if necessary, to rule out any anatomical issues.

In the meantime, it is essential to avoid any actions that could exacerbate the situation, such as forceful blowing of the nose, which can sometimes push fluid further into the ear. Instead, gentle techniques to promote Eustachian tube function, such as swallowing or chewing gum, may be more beneficial.

If you continue to experience symptoms like pressure, fullness, or auditory changes, it is crucial to follow up with a healthcare provider. Persistent issues could lead to complications if left untreated, including chronic otitis media or hearing loss. Your proactive approach to seeking care is commendable, and I encourage you to continue advocating for your health until you find a resolution.

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