Ear Pressure and Tinnitus: Causes and Solutions

The ears feel stuffy and swollen, and there is a popping sound when swallowing?

Hello Doctor: Since the end of last year (around December), I have been experiencing a faint ringing in my left ear, and I hear a popping sound when I yawn or swallow.
During my first visit to a clinic, it was found that the ear pressure in my left ear was somewhat lower.
Due to a family history of hearing loss, I was referred to a larger hospital for a hearing test, which showed no issues.
However, it was noted that both of my eustachian tubes are relatively narrow.
The doctor speculated that the cold weather might have caused the eustachian tubes to constrict and prescribed muscle relaxants for me.
However, after taking the medication for a few days, there seems to be no significant change, although the feeling of fullness has slightly decreased but still persists, and I can still perceive the tinnitus.
Additionally, I have a history of nasal allergies and underwent surgery to remove nasal polyps within the past six months.
I would like to inquire: 1.
Can eustachian tube narrowing and low ear pressure cause tinnitus? 2.
Would you recommend any further examinations? If so, which areas should I get checked? 3.
If I can start taking care of this through daily habits, what would you suggest? Thank you.

Niming, 20~29 year old female. Ask Date: 2023/01/12

Dr. Zheng Jueyi reply Otolaryngology

1.
Eustachian tube dysfunction may cause tinnitus.
2.
If you have already been examined at the hospital and no significant abnormalities were found, you may start by adjusting your lifestyle habits or addressing nasal allergies.
3.
Eustachian tube dysfunction is often associated with nasal allergies and gastroesophageal reflux disease (GERD).
It is recommended to reduce the intake of coffee, tea, or sugary foods, and to drink plenty of water or chew gum to exercise the muscles around the Eustachian tube.

Reply Date: 2023/01/12

More Info

Understanding ear pressure and tinnitus can be quite complex, especially when symptoms like ear fullness, popping sounds, and tinnitus are involved. Based on your description, it seems you are experiencing a combination of issues that may be related to eustachian tube dysfunction, which can indeed lead to ear pressure imbalances and tinnitus.

1. Eustachian Tube Dysfunction and Tinnitus: The eustachian tube connects the middle ear to the back of the throat and helps equalize ear pressure. When this tube is narrowed or not functioning properly, it can lead to a feeling of fullness in the ear, changes in ear pressure, and even tinnitus. The popping sounds you hear when yawning or swallowing are often the result of the eustachian tube trying to open to equalize pressure. If the tube is chronically narrowed, as you mentioned, it can contribute to persistent tinnitus.
2. Further Investigations: Since your hearing tests came back normal, it may be worthwhile to explore other potential causes of your symptoms. You might consider seeing an otolaryngologist (ENT specialist) who can perform a thorough examination of your eustachian tubes and middle ear. They may recommend imaging studies, such as a CT scan, to assess the anatomy of your eustachian tubes and surrounding structures. Additionally, a tympanometry test can evaluate how well your eardrum is functioning and whether there is fluid in the middle ear.

3. Management and Lifestyle Adjustments: In terms of managing your symptoms, there are several strategies you can implement in your daily life:
- Nasal Decongestion: Since you have a history of nasal allergies and nasal polyps, managing your nasal congestion can help improve eustachian tube function. Consider using saline nasal sprays or a humidifier to keep your nasal passages moist. Over-the-counter antihistamines may also help if allergies are a contributing factor.

- Avoiding Allergens: Since you have nasal allergies, try to identify and avoid allergens that trigger your symptoms. This may include dust, pollen, or pet dander.

- Eustachian Tube Exercises: You can perform exercises to help open the eustachian tubes. These include the Valsalva maneuver (pinching your nose and gently blowing) or the Toynbee maneuver (pinching your nose and swallowing). However, do these cautiously and consult your doctor if you have any concerns.

- Stay Hydrated: Drinking plenty of fluids can help thin mucus and promote better drainage in your nasal passages and eustachian tubes.

- Limit Caffeine and Alcohol: Both substances can contribute to dehydration and may exacerbate tinnitus in some individuals.

- Stress Management: Since stress can worsen tinnitus, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine.

In summary, your symptoms of ear pressure and tinnitus are likely related to eustachian tube dysfunction, which can be exacerbated by your history of nasal allergies. It is advisable to consult with an ENT specialist for further evaluation and management. Meanwhile, implementing lifestyle changes to manage your nasal allergies and practicing eustachian tube exercises may provide some relief. Remember to monitor your symptoms closely and seek medical attention if they worsen or change significantly.

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