Persistent Ear Congestion: Causes and Solutions After Surgery

Unilateral ear fullness sensation?

Hello Doctor, I have been experiencing a feeling of fullness in my right ear for over six months.
Three months ago, I went to the hospital for an examination (they used a nasal endoscope and a tube that went into my ear with a screen to magnify the images).
The doctor said that the blockage in my ear was caused by a deviated septum, so I underwent septoplasty and inferior turbinate reduction.
However, it has been three months since the surgery, and my right ear still feels blocked.
What could be the possible reasons for this? Thank you!

LaLa, 20~29 year old female. Ask Date: 2011/10/31

Dr. Xu Jiazhen reply Otolaryngology

A feeling of fullness in the middle ear is primarily caused by Eustachian tube dysfunction, which can arise from various factors.
One significant cause is hypertrophy of the inferior nasal turbinates.
If symptoms persist after surgery, alternative treatment options may be considered, such as the placement of ventilation tubes in the middle ear or the use of nasal sprays to reduce inflammation at the Eustachian tube's nasal opening.
These are common approaches.
For further evaluation and management, it is advisable to discuss with your treating physician.

Reply Date: 2011/10/31

More Info

Persistent ear congestion after surgery can be a frustrating and concerning issue. Based on your description, it seems that you have undergone surgery to correct a deviated septum and reduce the size of the inferior turbinates, which are common procedures aimed at improving nasal airflow and, consequently, Eustachian tube function. However, the continued sensation of ear congestion can arise from several factors.

Firstly, it is essential to understand the anatomy and function of the Eustachian tube, which connects the middle ear to the back of the throat. This tube helps equalize pressure in the middle ear and drains fluid. If the Eustachian tube is not functioning correctly, it can lead to a feeling of fullness or congestion in the ear. After surgery, inflammation or swelling in the nasal passages can persist, potentially affecting Eustachian tube function. This can result in a sensation of ear fullness, even if the nasal obstruction has been addressed.

Another possibility is that there may be residual fluid in the middle ear, known as otitis media with effusion. This condition can occur when the Eustachian tube does not open properly, preventing fluid from draining. This fluid buildup can lead to a sensation of fullness and can affect hearing. A follow-up examination, including tympanometry or audiometry, may be necessary to assess the status of the middle ear and determine if fluid is present.

Additionally, the sensation of ear congestion can also be related to allergies or sinus issues. If you have a history of allergic rhinitis, it is possible that post-operative inflammation or new allergens could be contributing to your symptoms. Nasal sprays or antihistamines may help alleviate these symptoms if allergies are a factor.

In some cases, the sensation of ear fullness can be related to muscle tension or dysfunction in the muscles that control the Eustachian tube. Stress and anxiety can exacerbate these symptoms, leading to a cycle of discomfort. Techniques such as relaxation exercises, physical therapy, or even myofascial release may be beneficial in these instances.

If your symptoms persist, it is crucial to follow up with your ENT specialist. They may recommend further imaging studies, such as a CT scan, to evaluate the anatomy of your nasal passages and Eustachian tubes more closely. This can help identify any structural issues that may not have been addressed during your initial surgery.

In summary, persistent ear congestion after surgery can result from various factors, including Eustachian tube dysfunction, residual fluid in the middle ear, allergies, or muscle tension. It is essential to communicate your ongoing symptoms with your healthcare provider, who can guide you through the appropriate diagnostic and therapeutic steps to alleviate your discomfort. Remember, recovery can take time, and addressing these issues may require a multifaceted approach.

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