Persistent Ear Congestion: Causes, Remedies, and When to Seek Help

Q: Persistent Ear Congestion: Causes, Remedies, and When to Seek Help

Hello Jason, <br>The issues you mentioned could be due to： 1) Eustachian tube dysfunction： This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over. <br>2) Sudden sensorineural hearing loss

A feeling of fullness or pressure in the ear?

Since returning from military training (after shooting practice), I have been experiencing a persistent feeling of fullness in my ears, with the right ear being more severe.
There is also a constant sensation of blockage and pressure, and I often feel the urge to clear it.
I visited a clinic and two hospitals; the clinic indicated that my Eustachian tube function was poor, possibly due to allergies.
The doctor suggested chewing gum to improve the condition and prescribed some allergy medications, but they did not have much effect.
At the hospital, I underwent ear (hearing test) and nasal (endoscopy) examinations, which showed no abnormalities.
They noted that the right eardrum is more retracted than the left, but my hearing is normal.
The doctor reiterated that chewing gum could help and prescribed allergy medication and a nasal spray for me to use at home, but there has been no improvement.
What other options do I have? Should I see a different specialist? This issue significantly impacts my daily life.

Jason, 20~29 year old female. Ask Date: 2018/01/30

Dr. Ji Zhaoyun reply Otolaryngology

Hello Jason,
The issues you mentioned could be due to: 1) Eustachian tube dysfunction: This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over.
2) Sudden sensorineural hearing loss.
3) Otitis media: a) Acute otitis media: This often occurs alongside upper respiratory infections (like colds) and sinusitis, and in severe cases, there may be ear discharge.
b) Chronic otitis media with acute exacerbation: This usually happens when there is a pre-existing perforation in the eardrum, which can become inflamed due to unclean water or improper ear cleaning.

All of the above conditions can be appropriately managed with medication after consulting a healthcare provider.
If you have already undergone pure-tone audiometry (which requires headphones in a soundproof room, where you press a button in response to sounds, rather than just using a tuning fork), and it has been confirmed that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not had a pure-tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
The golden period for treating sudden sensorineural hearing loss is within two weeks, and early treatment yields better outcomes.
If symptoms persist, it is recommended to seek medical evaluation and treatment.

Wishing you safety and good health.

Sincerely,
Dr.
Chi Chao-Yun,
Director of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/01/30

More Info

Persistent ear congestion can be a frustrating and uncomfortable experience, and it often stems from various underlying causes. In your case, it seems that the issue began after a specific event (shooting practice), which may have contributed to the symptoms you are experiencing. Let's explore the potential causes, remedies, and when to seek further medical help.

Causes of Ear Congestion
1. Eustachian Tube Dysfunction: The Eustachian tube connects the middle ear to the back of the throat and helps equalize ear pressure. If this tube does not function properly, it can lead to a feeling of fullness or pressure in the ear. This dysfunction can be caused by allergies, colds, sinus infections, or even changes in altitude.

2. Allergies: Allergic reactions can cause inflammation in the nasal passages and Eustachian tubes, leading to congestion. Symptoms may include nasal congestion, sneezing, and itchy eyes, alongside ear pressure.

3. Barotrauma: This condition occurs when there is a difference in pressure between the inside of the ear and the external environment, often experienced during activities like flying or diving. It can lead to pain and a feeling of fullness in the ear.

4. Middle Ear Infections: While your tests have ruled out significant issues, mild infections can sometimes cause congestion without obvious symptoms.

5. Nasal Issues: Conditions such as sinusitis or nasal polyps can also contribute to Eustachian tube dysfunction and ear congestion.

Remedies
1. Chewing Gum or Swallowing: As suggested by your doctors, chewing gum or swallowing can help open the Eustachian tubes and equalize pressure. This is particularly effective during altitude changes.

2. Nasal Decongestants: Over-the-counter nasal sprays or oral decongestants can help reduce swelling in the nasal passages and Eustachian tubes, improving airflow and drainage.

3. Allergy Management: If allergies are suspected, antihistamines or nasal corticosteroids may help alleviate symptoms. It's essential to identify and avoid allergens when possible.

4. Warm Compress: Applying a warm compress to the affected ear can help relieve discomfort and promote drainage.

5. Steam Inhalation: Inhaling steam from a bowl of hot water or taking a hot shower can help open the Eustachian tubes and relieve congestion.

When to Seek Further Help
If your symptoms persist despite trying the above remedies, or if you experience any of the following, it may be time to seek further medical evaluation:
- Severe Pain: If you experience significant pain in the ear, it could indicate an infection or other serious condition.

- Hearing Loss: Any noticeable changes in hearing should be evaluated by a specialist.

- Persistent Symptoms: If the feeling of fullness or pressure does not improve over several weeks, further investigation may be necessary.

- Balance Issues: If you experience dizziness or balance problems, it could indicate an inner ear issue that requires attention.

Specialist Consultation
Given that you've already seen general practitioners, it may be beneficial to consult an Ear, Nose, and Throat (ENT) specialist. They can perform more detailed examinations, such as tympanometry or audiometry, to assess Eustachian tube function and middle ear pressure. Additionally, they can evaluate for any underlying conditions that may not have been apparent in previous visits.

In conclusion, persistent ear congestion can stem from various causes, and while some home remedies may provide relief, it’s essential to monitor your symptoms closely. If they continue or worsen, seeking a specialist's opinion will be crucial in identifying the underlying issue and finding an effective treatment plan.

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