Lymph Node Swelling and Ear Congestion: When to Seek Further Evaluation

Continuation of response #151830 regarding lymphatic swelling issues?

Later, I noticed some improvement in the right side of my neck, but it hasn't completely resolved.
The doctor continued to prescribe medication and advised me to return for a follow-up appointment for further observation.
Subsequently, I started to feel a sore throat again.
The doctor also prescribed expectorants.
My sore throat, along with nasal congestion and coughing, made it feel like I had caught another cold.
My nasal discharge began to turn yellow, and I started experiencing a persistent feeling of ear fullness every day.
I'm wondering if this ear fullness is caused by the cold or if I need to undergo further examinations.
I'm concerned about the possibility of something serious.
Previously, I had a neck ultrasound and an endoscopy, and the doctor did not indicate any abnormalities.

Jun Ge, 20~29 year old female. Ask Date: 2020/01/13

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the issue you mentioned regarding ear fullness may be due to: 1) Eustachian tube dysfunction: This is the most common cause and can occur not only during air travel, mountain 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: Often occurs alongside upper respiratory infections (such as colds) and sinusitis, and in severe cases, there may be ear discharge.
b) Chronic otitis media with acute exacerbation: This usually occurs when there is a pre-existing perforation in the eardrum, which can be aggravated by unclean water or improper ear cleaning, leading to inflammation.
All of the above conditions can be appropriately treated with medication after consulting a healthcare provider.
If you have already undergone a pure tone audiometry test (which requires headphones in a soundproof room, where sounds are presented for you to respond to, 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.
Wishing you safety and good health.
Sincerely, Dr.
Chi Chao-yun, Head of the ENT Department, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2020/01/13

More Info

When it comes to lymph node swelling and ear congestion, understanding the underlying causes and when to seek further evaluation is crucial for effective management. Based on your description, it seems you are experiencing a combination of symptoms that may be related to an upper respiratory infection, possibly exacerbated by allergies or other factors.

Firstly, lymph nodes can swell in response to infections, inflammation, or other stimuli. The lymph nodes in your neck may be reacting to an infection in your throat or nasal passages, especially if you are experiencing symptoms like a sore throat, nasal congestion, and cough. The fact that you have noticed some reduction in the swelling of the lymph nodes is a positive sign, indicating that your body may be responding to treatment or the infection is resolving.

However, the persistence of symptoms such as ear congestion and the sensation of fullness in the ears can be concerning. This sensation is often due to Eustachian tube dysfunction, which can occur when you have a cold or sinus infection. The Eustachian tubes help equalize pressure in the ears, and when they become blocked due to inflammation or mucus, it can lead to feelings of fullness or pressure in the ears. This can also contribute to discomfort and even temporary hearing changes.

Given that you are experiencing yellow nasal discharge, which may indicate a bacterial infection, and ongoing throat pain, it is advisable to follow up with your healthcare provider. They may consider additional treatments, such as antibiotics if a bacterial infection is suspected, or further evaluation if your symptoms do not improve.
In terms of when to seek further evaluation, consider the following guidelines:
1. Duration of Symptoms: If your symptoms persist beyond 10 days without improvement, or if they worsen after initially improving, it is important to seek further evaluation.

2. Severity of Symptoms: If you experience severe pain, high fever, or difficulty swallowing or breathing, you should seek immediate medical attention.

3. Changes in Lymph Node Characteristics: If the lymph nodes continue to swell, become hard, or are associated with systemic symptoms like fever or night sweats, further investigation may be warranted.

4. Impact on Daily Life: If your symptoms significantly interfere with your daily activities or quality of life, it is worth discussing with your healthcare provider.

In conclusion, while your symptoms may be related to a common viral infection, the presence of persistent or worsening symptoms warrants further evaluation. Your healthcare provider can perform a thorough examination and may recommend imaging studies or laboratory tests to rule out more serious conditions. It’s essential to communicate openly with your doctor about your concerns and any new symptoms that arise. Early intervention can help prevent complications and ensure a quicker recovery.

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