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Blocked Ear And Muffled Hearing. Had Acute Otitis Media. Took Cepodem And Febrex. Kenacort Injection Given For Eustachian Tube Dysfunction. Have Dizziness

Posted on Mon, 16 Jul 2012

Question: Had acute otitis media. Acute URTI on 11 may2012. Was given cepodem xp , febrex plus. Recovered from otitis media after medication but still had blocked ear and muffled hearing . I was told its a Eaustician tube dysfunction was given kenacort 40 mg injection in buttocks on 22may 27 may and 5th XXXXXXX 2012. Along with ETD I have started getting clicking sound in ear was told twitching of muscle connected to Eaustician tube. Will this blocked sensation with clicking sound clear with time. ENT has told me to continue febrex plus . Audiometry and tympanogram normal. Suggest any alternate medication. Also I have been getting slight dizziness could be connected with ETD.

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi

Thanks for the query

Yes, your doctor's diagnosis is correct; the problem you are suffering from is Eustachian tube dysfunction.

The clicking sound you perceive is due to opening and closing of the nasal end of the Eustachian tube. This usually persists in some individuals following an attack of flu or sinusitis; this is due to the presence of residual congestion around the opening of the nasal end of the Eustachian tube.

You can try using saline nasal spray, followed by steam inhalation 3-4 times a day, this helps in relieving the congestion of Eustachian tube. Also, you can try using steroid nasal spray (such as Fluticasone or Momentasone) which can be beneficial.

Finally, the dizziness could be related to alternate closing and opening of the Eustachian tube which is causes pressure changes in the middle ear and this is usually transient. If this persists you can consult your doctor for a complete examination.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (16 hours later)

Thank you doctor for your prompt reply. It is the first time that I have had such a bad Eaustician tube dysfunction. When I had URTI approx once in 2 - 3 yrs it wasnt that severe maybe partial Blocked Eaustician tube and the duration lasted not more the 6 to 10 days after having anti booties and decongestants. My question is that does one get at least a partial blocked Eaustician tube whenever one gets URTI. Coz this one had seriously affected my confidence due to muffled hearing along with blocked sensation. it has lasted for over 3 weeks to a month. Improvement slowly felt in the last 7-10 days.My Dr. Had Said nothing to worry about at all. Still wanted a second opinion. Thanks again for your help.

Answered by Dr. Naveen Kumar Nanjasetty (4 hours later)

Hi

Thank you for writing back

Yes, an individual can have the Eustachian tube blocked during an attack of flu or URTI. This is due to the inflammation and congestion around the opening of the Eustachian tube when there is an URTI/flu. But, in most of the cases it gets relieved once the inflammation settles down.

In certain individuals, the blockage of the Eustachian tube does not settle down even after the flu or URTI has subsided, this is because of the residual congestion or scarring around the tube, muscular in-coordination and nasal allergy.

In this situation, the next best treatment is steroid nasal spray and steam inhalation to reduce the local inflammation and congestion around the tube. Slowly, the congestion will clear off and the hearing will become normal. Also, avoid smoking (if any) and coffee.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (3 days later)

Hello doctor thanks for replying. I need to ask you this question . I had exerted lot of pressure closing my mouth and nose to blow out thru my eaustician tubes in the descent of an airplane recently. Could that have seriously injured or damaged my ET coz the pressure exerted to blow was quite a lot. Needed to know as that also could be the reason why my ETubes are not opening. Present status muffled sound has gone at least 50 to 60%. but still can feel a block in both ears. Sorry to ask you again since this has taken me one month now. Is it normal for the E tubes to take upto 4- 6 weeks to open. Thanks again

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi

Welcome back

According to you, the muffled sounds have started to disappear, that means it is a good sign of improvement. Sooner, the Eustachian tube will return to its original status. Please do continue with the recovery measures as I have mentioned in my previous response.

Secondly, forceful blowing of the nose in order to relieve the Eustachian tube block can cause damage to the tube particularly when there is common cold or flu. Do not worry! Forget whatever has happened in the past. Tubes usually open up depending upon the amount of damage it has sustained, lesser the damage, sooner the recovery.

Please do continue with the measures as advised. You will become normal soon. Do not feel sorry, we are glad to answer all your questions and keep you satisfied.

Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (42 hours later)

Hello doctor. will it be safe for me to travel by air with blocked Eaustician tubes and also would like to know how many days do I use the spray and dosage, I was prescribed oxy spray Oxymetazoline hydrochloric Nasal Spray which i used initially for 3 days and discontinued because i was told you get addicted to it. Also the steroid spray is it harmful in any way as side effects. Also as i mentioned earlier I had Kenacort 40mg injections but didnt find any relief.
\Status as of today I feel the blocked ET is clearling up slowly can hear without muffled sound but still feel blocked in both ears. Thanks Doctor and Regards.

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi XXXXXXX

Thanks for writing back

1. Will it be safe for me to travel by air with blocked Eaustician tubes?

A: No, it is not safe for air travel with blocked Eustachian tubes. But, if it is inevitable then you can use Oxymetazoline nasal spray prescribed by your doctor an hour before the flight journey, if it is a short travel. For a long haul, you need to use it an hour before ascent of the flight and an hour before descent of the flight.

2. How many days do I use the spray and dosage?

A: Steroid nasal spray can be used till your ear problems get resolved completely and for a maximum period of 5-6 months. You can use steroid spray containing either fluticasone or momentasone.

3. The steroid spray is it harmful in any way as side effects?

A: The amount of steroid present in the nasal spray is very less, and it is absolutely safe without any side effects. Dryness and nasal bleed are noticed rarely when the spray is used for a very long period.

4. I had Kenacort 40mg injections but didnt find any relief.

A: Injectable steroid gives only temporary relief, but the best treatment is instillation of local steroids.

It is good to know that your condition is improving. Wish you speedy recovery. Take care, Good Luck.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naveen Kumar Nanjasetty (37 minutes later)

Thanks Doctor. How many times a day should I use the steriod spray.And not to mention the clicking sound is still very much there. But as you mentioned this is becase of opening and closing of eaustician tube, When i open my jaw the clicking increases. Also, lastly your tel no has been given in your profile. Can one call you on tel. or this is the only medium of communication. Thanks . Will inform you an update of my status in a few days.
P.S - The reason I had asked you about travelling by air is because Im a pilot and have done just one flt on 9 th ( 5 hrs one way) didnt feel anything abnormal was told if there was no fluid and neg pressue built up it safe ( Just for your info)

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi XXXXXXX

Thanks for writing back

Steroid spray should be used once in the morning as soon as you get up from the bed. You need to shake the bottle well, put your head down, insert the nozzle into the nose, spray 2 puffs on each side, immediately lift up the head and take a XXXXXXX breath. All these should be done quickly so that the liquid does not flow down.

I do stay in Oman; my local number has been mentioned in my profile you can call me on that number.

As you are a pilot you need to be a little more careful. Avoid flight journey when you are having cold or get treated before you go on the flight. Steroid spray is much safer and can be used till your symptoms are completely resolved.

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. Chakravarthy Mazumdar