Unilateral Ear Congestion: Causes and Solutions

Q: Unilateral Ear Congestion: Causes and Solutions

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

Unilateral ear fullness?

Hello Doctor, I have severe allergic rhinitis, which often causes nasal congestion, runny nose, and nosebleeds.
My mother had nasopharyngeal cancer, and recently I've been feeling a sense of blockage in my left ear.
It seems like there is no fluid or inflammation inside, and my hearing doesn't seem to be significantly affected.
However, sometimes I feel a sense of fullness in my left ear, making it difficult to hear very clearly.
Recently, whether I yawn or swallow, my right ear feels clear, but my left ear does not.
The only time I can slightly relieve the blockage in my left ear is when I pinch my nose, but it still doesn't feel completely clear.
I find myself pinching my nose multiple times a day just to feel a bit more comfortable.
When I do this, I notice that the right ear clears up much faster than the left, which takes more effort and time to relieve.
Sometimes, after clearing my nose, I feel a bit dizzy for a few seconds, but it resolves quickly.
I would like to ask the doctor what might be causing this.
Thank you.

Kenna, 20~29 year old female. Ask Date: 2022/07/28

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) 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 become inflamed due to unclean water or improper ear cleaning.
All of these conditions can be appropriately treated with medication after consulting a healthcare provider.
If you have already undergone pure tone audiometry (which requires headphones in a soundproof booth, where sounds are presented and you respond by pressing a button, 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, as there is a critical treatment window for this condition, and early intervention yields better outcomes.
Wishing you safety and good health.

Reply Date: 2022/07/28

More Info

Unilateral ear congestion can be a frustrating and uncomfortable experience, especially when accompanied by other symptoms such as nasal congestion, allergies, and a family history of serious conditions like nasopharyngeal cancer. Based on your description, it seems that your left ear feels congested, and you experience difficulty equalizing pressure compared to your right ear. This situation can be attributed to several potential causes, primarily related to the function of the Eustachian tube, which connects the middle ear to the back of the throat and helps regulate ear pressure.

Possible Causes
1. Eustachian Tube Dysfunction (ETD): This is the most common cause of unilateral ear congestion. The Eustachian tube can become blocked due to allergies, nasal congestion, or inflammation, preventing it from equalizing pressure effectively. Given your history of severe allergic rhinitis, it's likely that inflammation from allergies is contributing to the dysfunction.

2. Allergic Rhinitis: Your severe allergic rhinitis can lead to nasal congestion and swelling of the mucous membranes, which can affect the Eustachian tube's ability to open properly. This can result in a sensation of fullness or pressure in the ear.

3. Middle Ear Issues: Although you mentioned that there is no fluid or inflammation in the ear, conditions like otitis media (middle ear infection) can sometimes present with similar symptoms. However, since you have not reported any significant hearing loss or pain, this may be less likely.

4. Nasal Polyps or Structural Issues: Chronic nasal congestion can lead to the development of nasal polyps, which can further obstruct the Eustachian tube. Additionally, structural issues such as a deviated septum could contribute to your symptoms.

5. Pressure Changes: Activities like yawning or swallowing can help equalize pressure in the ears. If you find that your left ear does not respond as well as your right, it may indicate that the Eustachian tube on that side is not functioning optimally.

Recommendations for Management
1. Nasal Corticosteroids: Since you have a history of allergic rhinitis, using a nasal corticosteroid spray can help reduce inflammation in the nasal passages and Eustachian tubes, potentially improving your symptoms.

2. Decongestants: Over-the-counter oral or nasal decongestants may provide temporary relief by reducing nasal swelling and helping to open the Eustachian tube.

3. Allergy Management: If you haven't already, consider consulting with an allergist to explore options for managing your allergies, which may include antihistamines or allergy shots.

4. Eustachian Tube Exercises: Techniques such as the Valsalva maneuver (pinching your nose and gently blowing) can help equalize pressure. However, if you experience dizziness, it’s essential to do this cautiously.

5. Consultation with an ENT Specialist: Given your family history and persistent symptoms, it may be prudent to consult an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination, including audiometry tests to assess your hearing and possibly imaging studies if necessary.

6. Monitoring Symptoms: Keep track of your symptoms, including any changes in hearing, pain, or additional symptoms like dizziness. This information can be valuable for your healthcare provider.

Conclusion
Unilateral ear congestion, particularly in the context of allergies and nasal issues, is often related to Eustachian tube dysfunction. While self-management strategies can be helpful, it is crucial to seek professional evaluation, especially considering your family history of nasopharyngeal cancer. Early intervention can lead to better outcomes and peace of mind.

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