Tinnitus and Ear Pressure: Causes, Symptoms, and Treatment Options

Tinnitus and ear fullness?

Hello Doctor, about three months ago I suddenly experienced tinnitus and a feeling of fullness in my left ear.
Initially, I had occasional dizziness, so I went to a clinic where they diagnosed me with allergic rhinitis causing post-nasal drip.
After taking medication, my dizziness improved, but I then went to Chang Gung Memorial Hospital for further evaluation.
The doctor there also suggested that the issue was related to pressure imbalance caused by my nasal condition and prescribed Mometasone nasal spray, which I have been using for about two months.
My tinnitus and ear fullness have been fluctuating; sometimes it's so faint that I can hardly feel it, while other times it becomes quite loud.
Does this indicate any improvement? When the sound is loud, yawning causes a sharp sound in my left ear, but there is no sound when it's quieter.
Swallowing or opening my mouth also produces a popping sound in my left ear.
The tinnitus sounds like an "e" sound.
At Chang Gung, they performed an endoscopic examination and said there were no growths.
Could you please tell me what condition I might have? Should I continue taking the medication, or should I seek another doctor? Additionally, since my left ear is affected, and the doctor used the right nostril for the endoscopy, can they actually see the left side? Do I need to undergo another examination? Thank you for your response, Doctor!

John, 20~29 year old female. Ask Date: 2015/07/28

Dr. Zheng Jueyi reply Otolaryngology

Hello, if you have already been examined, the most common issue is Eustachian tube dysfunction.
Since the opening of the Eustachian tube is located in the nasopharynx, the entire nasopharyngeal area can be observed regardless of which side the endoscope is inserted from.
As the recovery of Eustachian tube function may take several weeks, it is recommended to continue taking medication and return for follow-up at the outpatient clinic afterward.
Wishing you peace and good health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/07/28

More Info

Tinnitus and ear pressure issues can be quite distressing, and understanding their causes, symptoms, and treatment options is essential for effective management. Based on your description, it seems that your symptoms began approximately three months ago with sudden onset tinnitus (ringing in the ear) and a feeling of fullness or pressure in the left ear. Initially, you experienced some dizziness, which was attributed to allergic rhinitis leading to post-nasal drip. After treatment with medication, your dizziness improved, but the tinnitus and ear fullness persisted, fluctuating in intensity.

Causes of Tinnitus and Ear Pressure
Tinnitus can arise from various underlying conditions, including:
1. Eustachian Tube Dysfunction: This occurs when the tube that connects the middle ear to the back of the nose fails to open properly, leading to pressure imbalances. This can cause a sensation of fullness and may contribute to tinnitus.

2. Allergic Rhinitis: Allergies can cause inflammation and congestion in the nasal passages, leading to pressure changes in the ears. This can exacerbate symptoms of tinnitus.

3. Middle Ear Issues: Conditions such as otitis media (middle ear infection) or fluid accumulation can also lead to pressure imbalances and tinnitus.

4. Noise Exposure: Exposure to loud sounds can damage the hair cells in the inner ear, leading to tinnitus.

5. Other Medical Conditions: Conditions like Meniere's disease, acoustic neuroma, or even temporomandibular joint (TMJ) disorders can also manifest with tinnitus and ear pressure symptoms.

Symptoms
From your account, the symptoms you are experiencing include:
- Fluctuating tinnitus intensity, sometimes loud and sometimes barely noticeable.

- A sensation of fullness or pressure in the left ear.

- Sharp sounds when yawning or swallowing.

- Clicking or popping sounds when swallowing or opening your mouth.

These symptoms are consistent with Eustachian tube dysfunction and possibly related to your allergic rhinitis.

Treatment Options
1. Medication: Continuing with the prescribed nasal corticosteroids (like the one you mentioned, "莫鼻卡") can help reduce inflammation and improve Eustachian tube function. If you notice improvement in your symptoms, it may be beneficial to continue the medication as directed by your physician.

2. Eustachian Tube Exercises: Techniques such as swallowing, yawning, or the Valsalva maneuver (pinching your nose and gently blowing) can help equalize ear pressure. However, if these maneuvers are not effective, it may indicate a more significant issue.

3. Allergy Management: If allergies are contributing to your symptoms, consider discussing additional allergy management strategies with your healthcare provider, which may include antihistamines or other treatments.

4. Follow-Up with an ENT Specialist: Since you have already undergone an endoscopic examination, it is essential to ensure that the examination was thorough. If your symptoms persist or worsen, seeking a second opinion from another ENT specialist may provide additional insights or alternative treatment options.

5. Hearing Evaluation: If tinnitus continues to be bothersome, a comprehensive audiological evaluation may be warranted to assess your hearing and determine if there are any underlying auditory issues.

Conclusion
In summary, your symptoms appear to be related to Eustachian tube dysfunction, likely exacerbated by allergic rhinitis. Continuing your current medication while monitoring your symptoms is advisable. If you do not see significant improvement, consider consulting another ENT specialist for further evaluation. It is crucial to address these symptoms promptly to prevent any potential long-term effects on your hearing or quality of life. Always communicate openly with your healthcare provider about your symptoms and any changes you experience.

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