Persistent Sore Throat and Hearing Issues: What Could Be Wrong?

Repeated sore throat and difficulty hearing?

Hello, doctor.
In mid-March, I caught a cold, and my symptoms mostly started with a scratchy throat, followed by severe coughing accompanied by phlegm that I couldn't expel.
Eventually, I developed intense throat pain that made it difficult to eat, and I experienced noticeable nighttime coughing.
I went to the clinic for treatment, which provided some improvement.
However, at the end of March, the same symptoms reappeared.
After another visit to the clinic and completing the medication, I experienced improvement again.

Recently, I've started to notice a decrease in my hearing in both ears; sounds have become very faint, similar to the pressure changes experienced during a flight.
Sometimes, yawning a few times helps to relieve the pressure in one ear, but it doesn't last long before the hearing diminishes again.
I've also been producing a lot of phlegm that I can't cough up, and now my throat is starting to hurt again.

Could this be a common cold, or is there another underlying cause? Thank you for your help!

Xiao Jie, 20~29 year old female. Ask Date: 2014/04/14

Dr. Zheng Jueyi reply Otolaryngology

Hello, it is possible that the symptoms of ear fullness or difficulty hearing may be caused by fluid accumulation in the middle ear or dysfunction of the Eustachian tube following a cold.
It is recommended to blow your nose one side at a time rather than using force on both sides simultaneously.
Additionally, you may consider using cold medications for treatment.
If symptoms persist for more than a week without improvement, it is advisable to visit a hospital for a detailed examination.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2014/04/14

More Info

Hello! Thank you for reaching out with your concerns regarding your persistent sore throat and hearing issues. Based on your description, it seems that you may be experiencing a combination of symptoms that could be related to several underlying conditions, particularly involving the upper respiratory tract and the Eustachian tube function.

Firstly, your initial symptoms of a sore throat, severe coughing, and phlegm production suggest that you may have had a viral upper respiratory infection, commonly known as a cold. These infections can lead to inflammation and irritation of the throat, which can cause pain and difficulty swallowing, especially if the throat becomes very sore. The fact that you experienced improvement with medication indicates that you were likely dealing with an infection that responded to treatment.

However, the recurrence of your symptoms, along with the new development of hearing issues, raises some important considerations. The sensation of muffled hearing, similar to what one experiences during a flight due to pressure changes, suggests that there may be involvement of the Eustachian tube. The Eustachian tube connects the middle ear to the back of the throat and helps equalize pressure in the ear. When you have a cold or throat infection, inflammation can lead to Eustachian tube dysfunction, causing a feeling of fullness or pressure in the ears and muffled hearing.

The presence of phlegm that you are unable to cough up could also indicate post-nasal drip, where mucus from the nasal passages drips down the back of the throat, further irritating it and potentially contributing to your sore throat. This can occur alongside upper respiratory infections and allergies.

Given your symptoms, it is essential to consider the possibility of a secondary bacterial infection, such as acute sinusitis or even acute otitis media (middle ear infection), especially if your symptoms persist or worsen. These conditions can develop following a viral infection and may require different treatment, such as antibiotics.

Here are some recommendations for managing your symptoms and seeking further evaluation:
1. Hydration and Humidification: Drink plenty of fluids to help thin mucus and stay hydrated. Using a humidifier in your room can also help keep your throat moist and ease irritation.

2. Over-the-Counter Medications: Consider using over-the-counter pain relievers, such as ibuprofen or acetaminophen, to help alleviate throat pain. Decongestants may also help relieve nasal congestion and improve Eustachian tube function.

3. Nasal Irrigation: Saline nasal sprays or rinses can help clear mucus and alleviate nasal congestion, which may improve your Eustachian tube function.

4. Follow-Up with a Specialist: If your symptoms do not improve within a few days or if they worsen, it would be wise to consult an Ear, Nose, and Throat (ENT) specialist. They can perform a thorough examination, including hearing tests and possibly imaging studies, to assess for any underlying issues such as sinusitis or middle ear problems.

5. Monitor Symptoms: Keep track of your symptoms, including any changes in hearing, throat pain, or the presence of fever. This information will be helpful for your healthcare provider in determining the best course of action.

In summary, while your symptoms may initially suggest a common cold, the combination of persistent sore throat and hearing issues warrants further evaluation to rule out complications such as Eustachian tube dysfunction, sinusitis, or other infections. Seeking medical advice from an ENT specialist will provide you with a clearer understanding of your condition and appropriate treatment options. Take care, and I hope you feel better soon!

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