Allergies: Nasal Bleeding and Ear Pressure Symptoms

Nasal allergies occasionally accompanied by blood and ear congestion?

Hello Doctor: I have a congenital allergy, and my nose has rarely been clear since childhood.
However, using over-the-counter nasal sprays usually helps.
Recently, with the changing weather, my nasal allergies have worsened.
I’m not sure if this is related, but I have also been experiencing intermittent ear fullness for the past two to three weeks.
It’s not severe and hasn’t affected my hearing.
About six months ago, I experienced pain in the area below my right ear when I exerted myself.
I visited a general clinic, and the doctor prescribed anti-inflammatory medication, which improved my condition after a few days.
However, two months ago, I had a mild recurrence, but it wasn’t as severe as before.
I consulted an ENT specialist, who only prescribed ear drops.
I forgot to use the drops after one or two applications, but I noticed that the issue resolved on its own.

About a month ago, I occasionally noticed blood when blowing my nose, but it was fresh blood, seemingly due to a possible injury inside my nose (though I can’t be certain).
This lasted for two to three days and then disappeared.
However, yesterday, which was about a month later, I noticed some blood streaks in my nasal discharge, possibly due to a recent cold or blowing my nose too forcefully.
This resolved within an hour.
Last week, I discovered a small lump on the left side of my neck (next to the spine) and consulted a dermatologist.
The doctor said it was a lymph node and advised me to monitor it since I had a cold.
Six days later (today), the lump is almost undetectable.

I’m unsure if this is related to the cold, but I’ve been waking up with a slight feeling of pressure in my head, which usually develops into a headache by the afternoon.
Taking extra-strength acetaminophen alleviates the pain.
Additionally, I feel some discomfort at the junction of my nasal cavity and throat.
The last time I saw a doctor, they noted some redness and applied a topical medication.
Sometimes, I experience pain below my left ear, which worsens when pressed.
I also have a history of jaw dislocation, making it difficult to distinguish whether the pain is from my jaw or below my ear.
There are no noticeable lumps in that area.

All these symptoms are mild and can be alleviated with general medication, but they seem to be close to the symptoms of nasopharyngeal cancer.
Is there any possibility of that?

Niming, 20~29 year old female. Ask Date: 2017/11/25

Dr. Li Jiaxuan reply Otolaryngology

It is recommended that you visit the ENT (Ear, Nose, and Throat) outpatient department for a nasopharyngoscopy to address your concerns.
Wishing you good health.

Reply Date: 2017/11/25

More Info

Understanding the relationship between allergies, nasal bleeding, and ear pressure symptoms is crucial for managing your health effectively. Based on your description, it seems that you are experiencing a combination of allergic rhinitis, possible nasal trauma, and ear-related issues, which can often be interconnected.

Allergies and Nasal Symptoms
Allergies can lead to chronic nasal congestion, which you mentioned has been a lifelong issue for you. When the nasal passages are inflamed due to allergens, they can become more susceptible to injury. This inflammation can also lead to increased mucus production, which may explain the blood you noticed in your nasal discharge. The presence of blood, especially if it is bright red, often indicates that there may be a small tear or irritation in the nasal mucosa, which can occur from frequent nose blowing or from the dry air associated with seasonal changes.

Ear Pressure and Pain
The sensation of ear pressure or fullness is commonly associated with Eustachian tube dysfunction. This tube connects the middle ear to the back of the nose and throat, and its primary function is to equalize pressure. When you have nasal congestion from allergies, the Eustachian tube can become blocked, leading to a feeling of fullness in the ears. This can also contribute to discomfort or pain, particularly if there is any inflammation or infection present.

Your history of facial pain, particularly when exerting yourself, could suggest a few possibilities. It might be related to sinus pressure, especially if you have sinusitis, which can occur alongside allergies. The pain you felt in the area below your ear could also be related to referred pain from sinus issues or even temporomandibular joint (TMJ) dysfunction, especially since you mentioned a history of jaw dislocation.

Nasal Bleeding
The occasional nasal bleeding you experience, particularly after blowing your nose, is not uncommon in individuals with allergies. The nasal mucosa can become fragile and prone to bleeding, especially if it is dry or irritated. If you notice that the bleeding persists or worsens, it would be advisable to consult with an ENT specialist for a thorough examination.

Lymph Node Swelling
The swelling you felt in your neck, which was identified as a lymph node, is often a response to infection or inflammation in the body. Since you mentioned recent cold symptoms, this could be a normal reaction as your body fights off the illness. The fact that the swelling has decreased significantly is a positive sign.

Headaches and Other Symptoms
The headaches you experience, particularly upon waking, could be related to sinus pressure or tension headaches, which are common in individuals with nasal congestion. The pain you feel in the back of your head could also be tension-related, especially if you are experiencing discomfort in your jaw or neck.

Concerns About Nasopharyngeal Cancer
While you expressed concern about symptoms potentially indicating nasopharyngeal cancer, it is essential to remember that many of the symptoms you described—such as nasal bleeding, ear pressure, and headaches—are more commonly associated with allergies, sinusitis, or other benign conditions. Nasopharyngeal cancer typically presents with more severe symptoms, such as persistent nasal obstruction, significant bleeding, and possibly a lump in the neck that does not resolve. However, if you have persistent symptoms or new concerning signs, it is always best to consult with a healthcare professional for appropriate evaluation and peace of mind.

Recommendations
1. Consult an ENT Specialist: Given your ongoing symptoms, it would be wise to see an ENT specialist who can perform a thorough examination, including nasal endoscopy if necessary, to assess for any underlying issues.

2. Manage Allergies: Continue using your nasal sprays as directed, and consider discussing with your doctor about other allergy management strategies, such as antihistamines or nasal corticosteroids.

3. Monitor Symptoms: Keep track of your symptoms, especially any changes in bleeding, pain, or swelling, and report these to your healthcare provider.

4. Stay Hydrated: Ensure you are drinking plenty of fluids, as this can help keep your nasal passages moist and reduce irritation.

5. Avoid Irritants: Try to avoid known allergens and irritants, such as smoke or strong odors, which can exacerbate your symptoms.

In conclusion, while your symptoms may be concerning, they are more likely related to allergies and sinus issues rather than a serious condition like nasopharyngeal cancer. However, ongoing evaluation and management are essential for your comfort and health.

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