Ear Congestion After Nasal Surgery: Causes and Concerns

Ear congestion

Hello Dr.
Cheng,
I have been working in Bangkok for a long time.
Due to nasal congestion, I returned to Taiwan at the end of January for "inferior turbinate reduction" and "septoplasty." My nasal breathing has been quite smooth since the surgery, but I have developed issues with my ears.
I have a persistent feeling of fullness in both ears, which improves while I sleep, but after I wake up in the morning, the sensation returns about an hour later.

Two weeks ago, I visited a local hospital where the doctor conducted some simple tests (using headphones to determine the direction of sound) and said my hearing was fine.
He prescribed some allergy medication, but after taking it for 3-4 days with little improvement, I stopped.
I would like to ask Dr.
Cheng:
1.
Given my situation, could this be a postoperative complication? I have researched various related materials online, and it seems that my issue is not commonly reported.
2.
I have allergic rhinitis, and I found a study suggesting that inferior turbinate reduction might affect the filtering function of the nose, potentially worsening my allergic rhinitis and impacting my Eustachian tubes.
Could this be the case?
3.
Is there a possibility that this could be nasopharyngeal cancer, considering I only have the ear fullness symptom? The local doctor examined me with a circular mirror-like instrument but did not provide any specific feedback.
However, I am concerned because the medical standards in Thailand are relatively lower than in Taiwan.
Thank you, Dr.
Cheng, for patiently reading through my many questions.
Lastly, I want to express that working abroad has made me appreciate the quality of healthcare in Taiwan even more.
Thank you to all the doctors in Taiwan!

DAVID, 30~39 year old female. Ask Date: 2013/04/05

Dr. Zheng Jueyi reply Otolaryngology

Dear David,
1.
It is generally rare for this surgery to cause dysfunction of the Eustachian tube.
2.
The inferior turbinate is mostly partially resected, and the filtering function of the nose is usually not significantly affected.
However, if allergic rhinitis symptoms are severe or poorly controlled, it may lead to Eustachian tube dysfunction.
3.
The nasopharynx can be examined using a mirror, but if symptoms persist without improvement, it is better to conduct a detailed examination using nasopharyngoscopy.
Wishing you peace and health.
Sincerely,
Dr.
Jue-Yi Cheng
Director, Department of Otolaryngology
Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2013/04/05

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding ear congestion following your recent nasal surgery. It’s understandable to feel anxious about these symptoms, especially after undergoing procedures like inferior turbinate reduction and septoplasty. Let’s address your questions and concerns systematically.

1. Post-Surgical Symptoms: It is not uncommon to experience ear congestion or a feeling of fullness in the ears after nasal surgery. This can be attributed to several factors, including swelling of the nasal passages, changes in airflow, and the function of the Eustachian tubes, which connect the middle ear to the back of the nose. After surgery, the Eustachian tubes may not function optimally, leading to a sensation of ear fullness or pressure. While these symptoms can be bothersome, they often resolve as healing progresses. If your symptoms persist or worsen, it is advisable to follow up with your ENT specialist for further evaluation.

2. Impact of Allergic Rhinitis: You mentioned having a history of allergic rhinitis, which can indeed exacerbate symptoms related to ear congestion. Allergic rhinitis can lead to inflammation and swelling in the nasal passages, which may affect the Eustachian tubes' ability to equalize pressure in the ears. The surgery you underwent may have altered the nasal anatomy, potentially impacting the filtering function of the nose, which could lead to increased allergy symptoms. It’s essential to manage your allergic rhinitis effectively, as uncontrolled allergies can contribute to ongoing ear issues. Consider discussing with your doctor about optimizing your allergy management plan, which may include antihistamines or nasal corticosteroids.

3. Concerns About Nasopharyngeal Cancer: It’s natural to worry about serious conditions like nasopharyngeal cancer, especially when experiencing unexplained symptoms. However, the primary symptom of nasopharyngeal cancer is typically not ear congestion alone. Other symptoms may include nasal obstruction, nasal bleeding, hearing loss, or a lump in the neck. If your examination by the doctor did not reveal any concerning findings, and if you have no other alarming symptoms, the likelihood of cancer is low. However, if you continue to have concerns, a thorough evaluation, including a nasopharyngoscopy, may provide peace of mind.

4. Next Steps: Given that your symptoms have not improved significantly with allergy medications, it may be beneficial to revisit your ENT specialist. They can perform a more detailed examination, possibly including audiometric testing to assess your hearing and Eustachian tube function. If necessary, they may recommend further interventions, such as nasal saline irrigation, decongestants, or even a referral to an allergist for specialized care.

In summary, while ear congestion after nasal surgery can be concerning, it is often a temporary issue related to the healing process and underlying allergic conditions. Maintaining good communication with your healthcare providers and following up on your symptoms will be crucial in managing your recovery effectively. Thank you for your kind words about the healthcare system in Taiwan, and I wish you a smooth recovery and improved health.

Best regards,
Doctor Q&A Teams

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