Tinnitus, Ear Pressure, Nasal Congestion, and Neck Pain Symptoms

Q: Tinnitus, Ear Pressure, Nasal Congestion, and Neck Pain Symptoms

Hello, 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. <br>3) O

Symptoms such as tinnitus, a feeling of ear fullness, nasal congestion, and shoulder and neck pain?

Hello Doctor, about a week ago, my left ear became uncomfortable due to my phone's microphone accidentally switching to speaker mode at maximum volume.
Currently, the tinnitus in my left ear has intensified (sometimes affecting both ears).
Upon waking up in the morning, I experience a feeling of ear fullness and slight nasal congestion, along with soreness on both sides of my neck.
I have been taking corticosteroids (Prednisolone) and an antihistamine (LoraPseudo SR F.C) for a week, but there has been no improvement.
I would like to ask if noise-induced damage can cause such severe results? What could be the underlying issue (autonomic nervous system, Eustachian tube)? Is there a chance for recovery, or is it already irreversible damage?

mai, 20~29 year old female. Ask Date: 2020/12/13

Dr. Ji Zhaoyun reply Otolaryngology

Hello, 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: Often occurs alongside upper respiratory infections (like colds) or 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, often due to contaminated water or improper ear cleaning, leading to inflammation.
All of the above conditions can be appropriately managed with medication after consulting a physician.
If you have already undergone pure tone audiometry (which requires headphones in a soundproof room where sounds are presented and you respond by pressing a button, rather than just using a tuning fork), and it confirms 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 treatment window for sudden sensorineural hearing loss is two weeks, and early treatment yields better outcomes.
It is recommended to see a doctor directly for further evaluation.

Reply Date: 2020/12/13

More Info

Understanding the symptoms of tinnitus, ear pressure, nasal congestion, and neck pain can be complex, especially when they arise after a specific incident, such as exposure to loud noise. In your case, the sudden exposure to loud sound from your phone's speaker may have contributed to your current symptoms, which include increased tinnitus, ear fullness, nasal congestion, and neck pain.

Noise-Induced Hearing Loss and Tinnitus
Noise-induced hearing loss (NIHL) occurs when the hair cells in the cochlea (the hearing organ in the inner ear) are damaged due to exposure to loud sounds. This damage can lead to tinnitus, which is often described as a ringing, buzzing, or hissing sound in the ears. The severity of tinnitus can vary, and in some cases, it may become more pronounced after a loud noise exposure.
In your situation, the loud sound from the phone could have caused temporary threshold shifts in your hearing, leading to a sensation of fullness in the ear (often referred to as ear pressure) and exacerbating tinnitus. While some individuals may recover fully from such incidents, others may experience persistent symptoms, indicating potential permanent damage.

Ear Pressure and Eustachian Tube Dysfunction
The sensation of ear fullness or pressure can also be attributed to Eustachian tube dysfunction (ETD). The Eustachian tube connects the middle ear to the back of the nose and helps equalize pressure. If this tube is not functioning properly, it can lead to a feeling of fullness, discomfort, and even contribute to tinnitus. Nasal congestion, which you mentioned, can further exacerbate ETD, as it can block the Eustachian tube, preventing proper ventilation of the middle ear.

Neck Pain and Its Connection
Neck pain, particularly if it is bilateral, can sometimes be associated with tension or strain in the muscles surrounding the neck and head. This tension can be exacerbated by the discomfort caused by ear symptoms, leading to a cycle of pain and discomfort. Additionally, the neck pain could be a result of poor posture or muscle strain from holding your head in a certain position while using your phone.

Treatment and Prognosis
You mentioned that you have been taking steroids (Prednisolone) and an allergy medication (LoraPseudosr F.C) for a week without improvement. While steroids can help reduce inflammation and may provide relief in cases of sudden sensorineural hearing loss or severe inflammation, they may not always be effective for noise-induced tinnitus or Eustachian tube dysfunction.

Here are some recommendations:
1. Consult an Audiologist or ENT Specialist: A thorough evaluation by an audiologist or an ear, nose, and throat (ENT) specialist is essential. They can perform hearing tests to assess any potential hearing loss and evaluate the function of your Eustachian tubes.

2. Consider Sound Therapy: For tinnitus, sound therapy or tinnitus retraining therapy may help manage the perception of noise in your ears.

3. Nasal Decongestants: If nasal congestion is significant, using a nasal decongestant or saline nasal spray may help relieve pressure in the Eustachian tubes.

4. Physical Therapy: If neck pain persists, physical therapy may help address muscle tension and improve posture.

5. Monitor Symptoms: Keep track of your symptoms and any changes. If they worsen or new symptoms arise, seek medical attention promptly.

Conclusion
While noise-induced hearing loss can lead to persistent tinnitus and ear pressure, the prognosis varies among individuals. Some may experience improvement over time, while others may have lasting effects. Early intervention and appropriate management can significantly impact your recovery and quality of life. It is crucial to address these symptoms comprehensively to determine the best course of action for your specific situation.

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