Eustachian Tube Dysfunction and Ear Pain After Otitis Media

Eustachian tube dysfunction as a complication of otitis media?

Hello Doctor, I had a right ear middle ear infection 12 years ago.
Due to inadequate medication, a small clinic drained the fluid for me.
Since then, I have experienced recurrent infections several times, and my ear occasionally has unexplained sharp pain.
A few days ago, I felt more pain (intermittently), so I went to the clinic.
The doctor examined my ear with an otoscope and said it didn’t seem like I had a middle ear infection.
However, I mentioned that I occasionally feel sharp pain deep inside.
I also feel something unusual in the right side of my throat and ear when I swallow.
The doctor replied that it was normal because of the history of my middle ear infection.
At that moment, I forgot to tell him that I have been experiencing sudden tinnitus for a long time, which usually lasts for about an hour and occurs quite frequently, but not every day.
I learned online that pinching my nose and blowing can help open the Eustachian tube, but regardless of whether I have tinnitus, I can only equalize pressure in my left ear.
Even when there is no tinnitus in my right ear, I don’t hear a popping sound.
This time, the doctor prescribed antibiotics, which I have already finished, and the pain has subsided.
Could you please explain why I am prone to tinnitus? How can I improve this in my daily life? If I suddenly experience pain in my ear, can I use over-the-counter ear drops for middle ear infections? Thank you for your answers, Doctor.

zero zero, 20~29 year old female. Ask Date: 2023/11/29

Dr. Zheng Jueyi reply Otolaryngology

There are many factors that can cause tinnitus.
If it persists without improvement or is accompanied by hearing loss, it is advisable to seek medical evaluation.
Additionally, if there is sudden pain in the ear, it is not recommended to self-administer ear drops for otitis media.
Instead, you can take pain relievers, and if there is no improvement, you should seek medical evaluation.

Reply Date: 2023/11/29

More Info

Eustachian tube dysfunction (ETD) is a common condition that can lead to various ear-related symptoms, including ear pain and tinnitus (ear ringing). Your history of recurrent otitis media (middle ear infection) and the subsequent treatment you received, including the drainage of fluid, may have contributed to the current issues you are experiencing.

The Eustachian tube connects the middle ear to the back of the throat and helps equalize pressure in the ear. When this tube is not functioning properly, it can lead to a feeling of fullness in the ear, discomfort, and even pain. In your case, the intermittent sharp pain and the sensation of fullness, especially when swallowing, suggest that the Eustachian tube may not be opening and closing as it should. This dysfunction can be exacerbated by factors such as allergies, respiratory infections, or even changes in altitude, which can affect the pressure in the middle ear.

Your experience of tinnitus, particularly if it occurs frequently but not daily, can also be linked to Eustachian tube dysfunction. The pressure changes in the middle ear can irritate the auditory nerve, leading to the perception of ringing or buzzing sounds. It is important to note that while tinnitus can be benign, it can also indicate underlying issues that may need further evaluation.

In terms of management, there are several strategies you can adopt to help alleviate your symptoms:
1. Nasal Decongestants: If you have nasal congestion, using a decongestant can help reduce swelling in the Eustachian tube and promote better drainage.

2. Nasal Steroid Sprays: These can help reduce inflammation in the nasal passages and Eustachian tube, improving function.

3. Valsalva Maneuver: As you mentioned, pinching your nose and gently blowing can help equalize pressure in the ears. However, be cautious not to blow too forcefully, as this can cause damage.

4. Stay Hydrated: Drinking plenty of fluids can help thin mucus and promote drainage.

5. Avoid Irritants: Smoking and exposure to secondhand smoke can worsen Eustachian tube dysfunction, so avoiding these can be beneficial.

6. Warm Compress: Applying a warm compress to the affected ear may help relieve pain and discomfort.

Regarding your question about using ear drops for middle ear infections, it is crucial to consult with a healthcare professional before self-treating. While some over-the-counter ear drops may provide temporary relief, they may not address the underlying issue, especially if there is an active infection or if the eardrum is perforated. Using inappropriate medications can lead to complications or worsen the condition.

If your symptoms persist or worsen, it is advisable to seek further evaluation from an otolaryngologist (ENT specialist). They can perform a thorough examination, possibly including audiometric testing or imaging studies, to determine the exact cause of your symptoms and recommend appropriate treatment.

In summary, Eustachian tube dysfunction can lead to ear pain and tinnitus, particularly following a history of otitis media. Managing nasal congestion, practicing pressure equalization techniques, and avoiding irritants can help improve your symptoms. Always consult a healthcare professional before starting any new treatment, especially if you have a history of ear problems.

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