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Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion?

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Hi, I recently flew and a week later my ears felt like they were waterlogged, in the evening I was in a bar with very loud music and the next day my ears felt as is they had an infection and were ringing, three days later I went to the local doctor and he said my ears needed syringing which he did, they felt better but the next day the ringing came back and I fel as if my ears were infected and I was unsteady on my feet, two days later I went back and he said I had sinusitis and he gave me anti biotics, steroids and some medication for the sinusitis, I took the course and the last couple of days I felt well but then I woke up one morning and the ringing was bad, it was like that for three days and someone gave me the number of another doctor who came out to me and said there is no ear infection or didnt suspect sinusitis but gave me Nasonex nasal spray and a very low dosage of blood pressure lowering tablets as he said it was a bit on the high side, yesterday it seemed like things were getting better but this morning I have woken up to the ringing again, mainly in my right ear and when I swallow I hear a cruch/popping noise.
Posted Wed, 6 Nov 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 24 minutes later
Brief Answer:
Barotrauma.

Detailed Answer:
Hi,

Thank you for your query.

1. This seems to be Barotrauma of the ears and sinuses which commonly develops after a flight.

2. Request a doctor to add a decongestant. Local decongestant nasal drops containing 0.1% Xylometazoline (Otrivin) are available OTC. Steam inhalation helps.

3. The crunching / popping noise is due to air flow, fluid bubbles and movement of the cartilage and muscles which move during while swallowing,speaking, yawning and blowing the nose and cheeks.

4. If there is persistent ear blockage, get your ear drums examined and a Tympanometry (Impedance Audiometry) done.

5. The ringing sound is known as Tinnitus. Thw treatment of tinnitus may be discussed after you upload the eardrum examination and test results.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion? 2 hours later
Hi
Thank you for your reply, the doctor has prescribed Nasonex actuation Nasal Spray Suspension with the blood pressure tablets is the Nasal Spray similar to the Nasal drops you mention?
The ringing is not quite as bad as it has been and most of yesterday/ last night it was fine untill this morning, it is now pm and the ringing has toned down a lot since this morning, but it is still there in the background, it also seems as though my right ear is ringing more than my left.
My concern is the doctor didnt think it is a sinus problem as when he checked my ears he couldnt see any problems, the only symptom I have regarding my sinus is that my nose gets blocked, each nostril taking it in turns.
Apart from the ringing I feel the best I have since this started three weeks ago, the only symptoms are the ringing in the ears and the popping/cruching and they feel a bit pressured,
Many thanks
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Nasonex contains mometasone, a steroid, which will take 7-10 days to reach it's desired action. They are good for long term relief.

2. Xylometazoline decongestant nasal drops act instantly and cannot be used for more XXXXXXX a week or so, especially since you have mild hypertension. They are good for instant relief.

3. It seems that after this nasal congestion, sinusitis and ear blockage subside, the Tinnitus will also subside.

4. The alternate congestion of the nose is known as the Nasal Cycle and is a normal phenomenon. However, it is known to go haywire and cause probelms itself.

5. Here, if the ear tests are normal, the chances of full recovery are high. Hence to predict the response to treatment, you need to get yourself examined and tested.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion? 1 hour later
Hi,
Thank you for your advice, I will get the nasil drops in the morning, which is best spray or drops?
One thing I never mentioned is that I cannot pop my ears, occasionaly I can but most of the time its not possible and I didnt want to force the issue.
I also have a tingling/mild ache around the point where they should pop is this consistent of your previous advise?
My other concern is I am working abroad at the moment so I am relying on local doctors whom I do not know, I fly back home two weeks tomorrow, what do you think the situation will be regarding that?
Many thanks
 
 
Answered by Dr. Sumit Bhatti 4 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Look for 0.1% or 0.05% Xylometazoline nasal drops (such as Otrivin) which should be available OTC. Use them twice a day, only as needed, for a few days (less than a week).

2. It is better to avoid forcibly popping your ears. Inability to do so indicates an ETD (Eustachian Tube Dysfunction).

3. The tingling / mild ache while trying to pop the ears is a sign of ETD.

4. Regular Steam inhalation, the decongestant drops and the Nasonex nasal spray should suffice till you get back. The ear tests and the ear drum examination will help a more accurate assessment. You may do that after you get back.

5. There is a possibility of this happening again on the return flight, hence you should book an ENT appointment at home in advance.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion? 8 hours later
Hi,
Thank you for your advice,
After a bad night I woke up this morning and the ringing is still there but touch wood not quite so loud, I will try th nasal drops you have recommended.
Do you think another course of anti biotics would help? if so which type?
It seems that every few days I have a good day with hardly any ringing, then just as I think things are improving the ringing comes back again, so this time I hope things improve especially if the nasal drops help.
Many thanks
Hi,
I have used the Otrivin (once so far) and it has made a big difference, the ringing has almost gone so thats good news, I will be using another dose tonight before I go to bed so hopefully I might have a good nights sleep.
As per my previous question do you think another course of anti biotics would be of any benefit? if so what type?
My last question is regarding the flying home in two weeks time, what medication should I take before the flight to hopefully stop this happening again, I am surprised this has happened this time as I fly on a regular basis and have never had a problem before.
I cannot thank you enough for your advice after seeing two doctors here you helped me more via the internet than they did seeing me face to face, once again thankyou.
 
 
Answered by Dr. Sumit Bhatti 15 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. There is no need to repeat a course of antibiotics.

2. Use the Otrivin drops once, an hour or so, before the flight.

3. Get a thorough examination after you get back to check why this happened. Any further medication may be decided after two weeks.

Wishing you a safe journey home.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion? 9 hours later
Hi,
Sorry to trouble you again, not such good news this morning, I went to bed with no noises but I woke up about two oclock this morning with a high pitched ringing, I sat up untill about 6 hopeing it would go away naturally so then I used the Otrivin, the noise has toned down a bit and I have also used steam, I gently tried to pop my ears they were still blocked as before so as you previously said I left it at that, the crunching/popping is still there which yesterday that also went.
Am I being a bit impatient or should I give it more time? yesterday after using the Otrivin the effect was immediate and I could feel it working in my ears, how long would I expect to have to wait for the Eustachian tubes to clear? I am hoping that the ringing etc is from the pressure, I dread the nights as everytime I start to feel progress is being made I wake up in the morning back where I started.
I am still using the Nasonex and have been doing so since Friday evening, should the Nasonex be starting to help as at the moment it doesnt appear to be doing anything.
With regards to taking the Nasonex and Otrivin can they both be taken around the same time?
Many thanks
 
 
Answered by Dr. Sumit Bhatti 50 minutes later
Brief Answer:
There is no cause for worry.

Detailed Answer:
Hi,

Thank you for writing back.

1. It will require sustained treatment and investigations to assess the ETD. You have decided to do this after you get back, hence the delay.

2. The fact that the tinnitus reduces is a good sign that you will be able to treat this in the future. Remember that in comparison, there are people with Tinnitus from other causes that does not respond to any therapy.

3. As explained earlier, the Nasonex will require many days and weeks to help reduce the ETD. A lot depends upon your examination, repeated audiometry test results and long term treatment.

4. Both Nasonex and Otrivin can be used together as they have a different mechanism of action. However, Nasonex is for long term use and Otrivin is for short term relief.

Wishing you a speedy recovery.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion? 26 minutes later
Hi,
Thank you for your quick reply,
Maybe I am trying to rush things, I have been making enquiries here about seeing a specialist this week here as I am still worried about the journey home, I would postpone it but its my daughters 21st but if the specialist advises against flying I will take his advice.
When I get back to the UK I will go to see a specialist and get checked out.
I am a lot better off than I was this time yesterday so at least things are going in the right direction.
Many thanks
Hi,
As I said earlier I woke up with a high pitched tone at about 2 oclock this morning, after taking the Nasal sprays around 6 this calmed down about 3-4 hours later and was almost gone, later on I dozed off on the sofa and woke up again to the high pitch tone again which after a while toned down but is now a high pitched/ buzzing sound, my ears still have not popped and when I swallow there is still a crackling sound. and there still feels like pressure at that point in both ears.
As you may have gathered I am worried sick about this, I now have a phone number for a specialist here so I will be phoning him first thing in the morning to make an appointment.
Are the sympotoms above consistant with your earlier diagnosis as even though overall things are just slightly better I am petrified that this could be permanent?
Many thanks again.
 
 
Answered by Dr. Sumit Bhatti 12 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. If you do see the local specialist, get the ear drum examination and the Impedance Audiometry (Tympanometry) done. It will help guide the treatment.

2. Your symptoms are suggestive of ETD and the Tinnitus is varying and responds to the treatment. Hence the Loud Tinnitus is unlikely to be permanent. It will reduce as the ETD is corrected.

3. This is a common problem and is not a cause for extreme worry. Kindly go ahead with the appointment.

4. The frequency of swallowing goes down during sleep and will worsen any existing Tinnitus due to ETD. Stress will worsen the awareness of the Tinnitus.

Wishing you a speedy recovery.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feel like ears are waterlogged and ringing. Took medication for sinusitis. No change. Suggestion? 2 days later
Hi,
I managed to get in and see the ear specialist on Wednesday eve, he did a few tests and said everything seemed to be in order, I showed him the medication I had been prescribed and he said straight away that I hadnt been given astrong enough dosage, he prescribed me Solupred ORO for 8 days, I had an appointment in the evening and in the afternoon before I went to see him my right ear toatally stopped ringing and there was only a low buzzing in my left ear, when I woke up in the morning both ears were totally free from noise all day and evening even though I only started to take the medication in the morning.
Last night I went to bed and it is only when I layed down that I had a low buzzing noise but it wasnt bad enough for me to get up, anyway I woke up very early and decided to read in bed lying on my right side and propping my head up under my ear to support my head, after a while I started to get a fairy high pitch tone just in that ear, I have been up for a couple of hours and it has toned down a bit, my ears have still not popped and when I swallow I get the cracking noise, the tone I got this morning is about half the volume I have had in the past, could it be the pressure I put under my ear has started the tone and do you think the buzzing when I lay down will subside? from what I can make out at the moment it is only my right ear that has any noise.
Many thanks
PS, the tone also changed from a high pitch to more of a buzzing sound
Regards
can I just ask a couple more questions please?
If someone has Tinnitus that is permanent does it come and go or is it continually there?
Does the fact that my ringing stops every few days suggest that it will stop after this course of medication?
Many thanks
 
 
Answered by Dr. Sumit Bhatti 2 hours later
Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for writing back.

1. Since your ear tests were within normal limits, the tinnitus may have the following components:
a. Intermittent ETD, as you do have the crackling sounds while swallowing.
b. Cochlear synaptic tinnitus (originating in the cochlea itself).
Both these would respond to the steroid (Solupred).
c. Cervical spondylosis. Every person has some changes in the cervical spine by this age. Yes, the odd propped up position may be responsible for this changed pitch. This is very common and need not be investigated unless the tinnitus is pulsatile or vascular.

2. Tinnitus usually varies even if it is permanent. There may be multiple components.

3. As I have said before, there is a good chance that the tinnitus will decrease once the ETD is controlled. There is now also the possibility of the tinnitus being provoked by the odd head position while reading in bed with the head propped up. This should be avoided.

4. It is also possible that the earlier buzzing was very mild and unnoticed in the past. Now, with the ETD, you are more aware of the buzzing and ringing.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by
 
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