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What Casues Pressure In Inner Ear?

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Posted on Wed, 15 Oct 2014
Question: I have a history of sinus problems that I have attributed over many years to reaction to allergens. My sinuses react to temperature changes; I have bad "allergy days" even though I live in southern California where weather doesn't change much. I had a sinus polyp removed 10 yrs ago. I am a 50 yr old male and recently returned from 3 months of constant travel. I stopped smoking and stopped drinking caffein 6 weeks ago when I returned. My left frontal sinus has been very sore to the touch on my eyebrow. I have felt very fatigued and attributed that to the nicotine withdrawal and to the sinus. I have no fever. I saw an ENT when I returned who put me on antibiotics for a week 3 weeks ago. I finished the prescription but don't notice a change. I don't like to take them because I think they may contribute to an ongoing yeast/fungal infection between my toes which I treat with prescribed ointment. For 10 days, I did a twice daily sinus flush with saline, holding my head down in an effort to get the rinse into my upper frontal sinus. All mucus was clear and I can't tell if it reached the upper sinuses. I also took Sudafed which I hoped would shrink the membranes and reduced some pressure. My concern now is that I feel pressure in my inner ear and beside my nose on that side below the sore eyebrow area. Should I be concerned about saline rinse (distilled salt water) getting into my Eustacian tube and should this sinus issue continue to make me feel very bad.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)
Brief Answer:
Ear discomfort is not due to nasal douching...

Detailed Answer:
Hi

Thanks for posting the query and an elaborate history. I will try my best to help you with this problem.

1. The cause of discomfort in the left ear may not be due the nasal douching. While doing a nasal douche, it is not possible for the water to enter into the left ear. This is because, the Eustachian tube is an elastic tube which is obliquely placed and requires considerable amount of pressure to open it up. A simple nasal douche cannot push the water into the Eustachian tube. Also, the water cannot reach upto the frontal sinuses. The douching clears the secretions in the maxillary sinuses and few ethmoidal sinuses.

2. The pressure in the left ear could be secondary to the nasal congestion and inflammation around the Eustachian tube. When the Eustachian tube is inflamed or edematous, the nasal end of the tube gets blocked firmly, thus trapping the air and creating pressure in the middle ear. This can be relieved with steam inhalation and saline nasal spray.

3. To discuss about the left frontal sinus headache. If your doctor has already performed the X-Ray of the paranasal sinuses and found out that there is blockage of the frontal sinuses, then the antibiotics and other supplementary medicines may be effective. If there is no blockage of the sinuses seen, then the above said medicines may not work and it may be related to sudden withdrawal of the caffeine and smoking.

My suggestions to you are:
1. Drink plenty of warm water
2. Do steam inhalation regularly
3. Use saline and a steroid nasal spray to relieve the sinus and nasal congestion.
4. Avoid pseudoephedrine, this causes more dryness of the mucus membrane and may worsen the Eustachian tube block.
5. Get a CT scan of the paranasal sinuses done to identify the blocked areas in the sinuses.

Hope I have answered your query; I will be available for the follow up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (15 hours later)
Thank you for your response.
I do not have much nasal congestion, but have used a steam inhaler morning and evening to help open the left frontal sinus. I thought that by hanging my head down between my legs using the twice daily saline douch might help open the drainage tube of the frontal sinus. I had a CT scan a month ago that showed "stuff" in that cavity and was given an antibiotic in case there was infection. My condition is better but I still have some soreness above left eye. Today there is less pressure from inner ear and sinus below my eye. I am drinking 8 glasses of cold water a day. Why should it be warm? I do not have nasal congestion today, it seems to come and go. Do I need to use both saline and steroidal nasal sprays? Do both of them shrink the nasal membranes? Do I need another CT scan to determine if the frontal sinus is draining? The saline douch makes me feel better. Is it safe to do it daily indefinitely since I have ongoing sinus issues?
Thanks for your help.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (24 minutes later)
Brief Answer:
No need to repeat the CT Scan...

Detailed Answer:
Hi

Thanks for writing back

1. Warm water increases the blood circulation of the mucus membrane, thus clearing the inflammation of tissues. As the Eustachian tube is closely related to the soft palate, drinking warm water reduces the congestion around the Eustachian tube opening. Viceversa, cold water causes spasm of the tiny blood vessels, thus retaining the inflammatory mediators in the tissues and worsening of the problems.

2. Steroid nasal spray reduces the inflammation of the nasal mucosa and opens the sinus ostium. While, the saline nasal spray increases the ciliary motility and causes effective clearing of the thick retained secretions. Also, it prevents the nose from drying. As your frontal sinus is still blocked, it is better to contine with both the sprays.

3. No, there is no need of repetition of the CT Scan, as the previous one is just a month old and your doctor would have assessed the findings. Also, it is not advisable to get exposed to the radiation very often.

4. Warm saline nasal douching is good for the releasing the sinus block, so please continue the same. It is absolutely safe without any side effects.

Hope I have cleared your doubts. I wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (4 days later)
nasal douching for sinusitis

A CT scan done a month ago by my ENT showed "stuff" in the left frontal sinus cavity. I don't know if the osmium was blocked. The eyebrow area was very sore. I took the prescribed antibiotics but there was little change. I found a sinus flush online that attempts to reach the frontal sinus. Standing in the shower, I fill my nose with saline solution and then drop my head down between my legs so that gravity will take the water to my forehead. This process makes my sinuses feel better. The instructions are to stop after 10 days. It also warns of the danger of getting the solution into the ear canal which has happened to me. The person promoting the flush is not a physician. Does the flush seem safe to you? If so, can it be done everyday?
doctor
Answered by Dr. Naveen Kumar Nanjasetty (2 hours later)
Brief Answer:
Try XXXXXXX Neti, to clear the sinuses...

Detailed Answer:
Hi

Welcome back

Yes, the nasal douching can be done everyday but it's not the way which you are doing.

The nasal douching can be done in the standing position, with the head tilted parallel to the ground and keeping the mouth open. Next, you can run water into the upper nostril in such a way that, it exits through the other nostril. This is a novel way to clean your sinuses, it's termed as 'Jala neti'.

Secondly, it's very difficult for the water to enter the middle ear, unless the nasal end of the tube is patent. Logically speaking, when we try to pop out the ears, we close both the nose & mouth and try to force the air into the ear inorder to open the tube. In this sort of situation, mere nasal douching cannot allow water into the ear.

Hope this clears your doubts.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (3 hours later)
Is there any way to irrigate the sinuses so that the frontal sinus can be cleansed? I use a netipot but I don't think it reaches the sinus cavity above the eyes.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (9 hours later)
Brief Answer:
You can continue with the present method...

Detailed Answer:
Hi

Welcome back

To be XXXXXXX I am not aware of this sort of sinus flush.

Neti pot has been tried and advocated since ages to cleanse the sinuses. Even my patients do have remarkable improvement after doing this.

To make things much more clear to you. Majority of the sinuses open into a single channel called middle meatus, with a distance of less than 1cm between each of them. Hence, with any sort of nasal rinse the water will reach almost all the sinuses and clears of the clogged secretions.

If you feel, the present nasal douching is giving you good relief, you can continue it. I don't think there are any side effects by doing saline douching.

Hope my answers are helpful to you

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (35 hours later)
in this 1 minute video:

https://www.youtube.com/watch?v=VL8pqYVdYG8

it shows the balloon as a way to open the passage way to drain a lot of mucus, and then the inflammation goes down. do you think the balloon can be a good idea for me if my CT scan showed just a bit of gunk over my left eye? i feel pressure there, and it does feel like the passage way may be closed, but it mostly feels inflamed. Can the balloon help inflammation if there isn’t a lot of gunk up there, just that one bit? And if it’s intermittent, does that mean it’s more about allergens and the balloon wouldn’t help?
doctor
Answered by Dr. Naveen Kumar Nanjasetty (11 hours later)
Brief Answer:
Ballon sinoplasty may be beneficial...

Detailed Answer:
Hi

Welcome back. I sincerely apologize for the delay in answering your query.

You are right; balloon sinoplasty is a recent innovation in treating the sinus related problems. The balloon present in the stent dilates the opening of the sinuses, thus aiding in effective clearance of the sinus secretions.

Balloon Sinoplasty is most commonly performed on the frontal, maxillary, and sphenoid sinuses, as they are solitary sinuses. The multiple honey comb shaped ethmoidal sinuses, if involved, are generally opened using the standard functional endoscopic sinus surgery technique.

Hence, depending upon the location of the problem, I can suggest you whether balloon sinoplasty would be beneficial or not. The problem may be related to the allergens also. In that case, the clinching diagnosis will be the history, which needs to be correlated with the findings. Please upload the CT Scan images, so that I can help you in a better way.

Hope this clarifies your doubts; revert back to me if you have any further queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Naveen Kumar Nanjasetty (43 hours later)
I continue to wonder if there is a connection between the fungal wounds between my toes and my sinusitis. My dermatologist said the open wounds on my feet and the rash in my groin area were caused by candida growth. My Internist said my blood work showed no yeast overgrowth. Candida on the outside but not the inside? My ENT prescribed antibiotics for my sinusitis but there is no improvement. Now I read that antibiotics may weaken the immune system. I've also read that a Mayo Clinic study in 1999 showed that 96% of patients with sinusitis had inflamed nasal membranes caused by immune response to FUNGUS, not viruses or bacteria. Is the fungal problem on my feet a clue to the problem in my sinuses? If the sinus problem is caused by fungus, is there a remedy? A way to clear out the fungus and a way to avoid it in the future?
Thank you for continuing to consider my problem.
doctor
Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)
Brief Answer:
Infection on the foot is not related to the sinus

Detailed Answer:
Hi

Thanks for writing back

1. Is the fungal problem on my feet a clue to the problem in my sinuses?
A: No, fungal infection on the foot is not related to the sinusitis. Fungal infection in the nose is related to the environmental factors (working in damp places, wood industry, carpenters, etc.) and reduced immunity in the body (AIDS, chronic diabetes, long term usage of steroid nasal sprays, etc.).

2. If the sinus problem is caused by fungus, is there a remedy?
A: Yes, the fungal debris if seen inside the sinus cavity has to be cleared by surgical intervention (endoscopic approach). A course of oral antifungal medicines may be required, depending on the type of fungus and severity of the infection.

3. A way to clear out the fungus and a way to avoid it in the future?
A: The cause of this opportunistic infection should be taken care to prevent future attacks. Prevent those things which induces allergic reaction in the nose, then, the fungus will clear off by itself.

a. Avoid dusty and smoky environments, if exposed; cover the nose with a clean cloth.
b. Avoid sleeping under the fan or in front of the air-conditioner. Get the AC filter cleaned regularly.
c. Avoid smoking/chilled food and beverages/coffee
d. Eat plenty of fresh fruits and vegetables; this will boost up your immunity.
e. Avoid perfumes.
f. Systemic problems need to be rectified simultaneously.

Hope this clarifies your doubts.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Naveen Kumar Nanjasetty

Otolaryngologist / ENT Specialist

Practicing since :2001

Answered : 2540 Questions

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What Casues Pressure In Inner Ear?

Brief Answer: Ear discomfort is not due to nasal douching... Detailed Answer: Hi Thanks for posting the query and an elaborate history. I will try my best to help you with this problem. 1. The cause of discomfort in the left ear may not be due the nasal douching. While doing a nasal douche, it is not possible for the water to enter into the left ear. This is because, the Eustachian tube is an elastic tube which is obliquely placed and requires considerable amount of pressure to open it up. A simple nasal douche cannot push the water into the Eustachian tube. Also, the water cannot reach upto the frontal sinuses. The douching clears the secretions in the maxillary sinuses and few ethmoidal sinuses. 2. The pressure in the left ear could be secondary to the nasal congestion and inflammation around the Eustachian tube. When the Eustachian tube is inflamed or edematous, the nasal end of the tube gets blocked firmly, thus trapping the air and creating pressure in the middle ear. This can be relieved with steam inhalation and saline nasal spray. 3. To discuss about the left frontal sinus headache. If your doctor has already performed the X-Ray of the paranasal sinuses and found out that there is blockage of the frontal sinuses, then the antibiotics and other supplementary medicines may be effective. If there is no blockage of the sinuses seen, then the above said medicines may not work and it may be related to sudden withdrawal of the caffeine and smoking. My suggestions to you are: 1. Drink plenty of warm water 2. Do steam inhalation regularly 3. Use saline and a steroid nasal spray to relieve the sinus and nasal congestion. 4. Avoid pseudoephedrine, this causes more dryness of the mucus membrane and may worsen the Eustachian tube block. 5. Get a CT scan of the paranasal sinuses done to identify the blocked areas in the sinuses. Hope I have answered your query; I will be available for the follow up queries. Regards Dr. Naveen Kumar N. ENT and Head & Neck Surgeon