Left Ear Congestion: When to Seek Medical Attention - Otolaryngology

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Hello Keith,
Thank you for sharing your detailed medical history and symptoms regarding your left ear congestion and dizziness. Based on your description, it seems you are experiencing a complex interplay of symptoms that could be related to several underlying conditions, particularly involving the ear and possibly the Eustachian tube function.

From what you've described, your symptoms of dizziness, particularly the sensation of wanting to lean to the left, along with the feeling of congestion in your left ear, suggest a possible dysfunction of the Eustachian tube. The Eustachian tube connects the middle ear to the back of the nose and throat, helping to equalize pressure in the ear. When this tube does not function properly, it can lead to a feeling of fullness or pressure in the ear, and in some cases, it can contribute to balance issues, which might explain your dizziness.

Your history of allergies, particularly allergic rhinitis, could exacerbate Eustachian tube dysfunction. Allergies can lead to inflammation and swelling of the nasal passages and Eustachian tubes, making it difficult for them to open and close properly. This could explain why you feel that your left ear is not "opening" as it should, even when you try techniques like the Valsalva maneuver (pinching your nose and blowing) to equalize pressure.

Additionally, the discomfort in your left ear, along with the occasional pain and the sensation of it being "blocked," could be indicative of several conditions:
1. Eustachian Tube Dysfunction: This is the most likely cause, especially given your history of allergies. It can lead to a feeling of fullness, pressure, and even mild hearing changes.

2. Middle Ear Issues: Conditions like otitis media (middle ear infection) or fluid accumulation can cause similar symptoms. However, since you mentioned that hearing tests have been normal, this may be less likely.

3. Vestibular Issues: Given the dizziness, there could be a vestibular component, possibly related to the inner ear structures. This could be benign paroxysmal positional vertigo (BPPV) or another vestibular disorder.

4. Reflux Issues: You mentioned having gastroesophageal reflux disease (GERD), which can sometimes contribute to ear symptoms due to the proximity of the Eustachian tube to the throat.

Considering your symptoms have worsened with increased stress and that you have a history of chronic inflammation in the nasal passages, it would be prudent to seek medical attention. While it may be tempting to wait and see if the symptoms improve, the combination of your symptoms—especially the persistent ear congestion and dizziness—warrants a thorough evaluation.
A visit to an ear, nose, and throat (ENT) specialist would be beneficial. They can perform a comprehensive examination, possibly including a tympanometry test to assess Eustachian tube function and a more detailed hearing test if necessary. If there is any concern about the underlying causes, such as the previous findings of EBV or any changes in your nasal passages, further imaging or tests may be warranted.

In summary, while some of your symptoms may be manageable with home care and observation, the persistence and worsening of your ear congestion and dizziness, especially in the context of your medical history, suggest that it would be wise to consult with a healthcare professional sooner rather than later. They can provide you with a tailored treatment plan, which may include medications for allergies, nasal sprays, or other interventions to help alleviate your symptoms.

Take care, and I hope you find relief soon!