Feeling numbness in ear and hearing loss. Is this a viral problem or chronic otitis media glue ear?

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Posted on Wed, 8 Aug 2012 in Ear, Nose and Throat Problems
Question: i had 2 days ago.... a sudden onset numbness of the right ear with diminished hearing loss(like being underwater with right ear).went into emergency..earlier, 1 hr prior had taken 600mg advil and 1 hr later 40 mg lipitor....the numbness and hearing loss lasted for approx. 4-5 hrs.then hearing improved back to normal. did the advil high dose and lipitor cause this? i have been suffering from a fluid like build up in 1st the left ear then the right ear from april 10th onward to present time.produce a milky colour mucus from back of throat when ears feel full. my family doctor had me on serc 16mg 3xday for 5 days,then biaxin xl 500mg,2xday for 7 days,then 600mg advil,1xday for 10days,then apo-prednisone 5mg,6xday for 4 days,referred to ent on XXXXXXX 28th,hearing function normal, no negative pressure in middle ear, bite normal, no tmj problems, but my fullness of left/right ear continues,precribed garasone drops,4 drops/day as needed, no improvement after 5-7 days, drops instilled in left ear only, as most troublesome, is this a viral problem or chronic otitis media with effusion or glue ear?? please help.
doctor
Answered by Dr. Naveen Kumar 3 hours later
Hi

Thanks for the query and a detailed description.

The symptoms you are experiencing could be due to inflammation of the sinuses (sinusitis) and the Eustachian tube catarrh.

The post nasal discharge, sensation of ear blockage and alternate blockage of the ear are the symptoms of acute sinusitis. When there is any anatomical block in the nose, nasal allergy, flu, etc., it will obstruct the opening of the sinuses. Once the sinuses get blocked, there is stagnation of the secretions in the sinuses giving rise to pressure sensation in the head. The accumulated secretions slowly trickle off from the sinuses into the back of the nose and then into the throat, thus causing hawking.

When there is inflammation in the nasal cavity, it spreads to the opening of the Eustachian tube at the nasal end, leading to blockage of the tube and pressure sensation in the ear. The amount of pressure and the blockage can be confirmed with an Impedance audiometry.

Q: Did the advil high dose and lipitor cause this?
A: It is very unlikely that the above two medicines can cause the sudden loss of hearing or numbness over the ear. The most probable cause could be the sudden blockage of the Eustachian tube, which got relieved after few hours.

Q: Is this a viral problem or chronic otitis media with effusion or glue ear??
A: To be XXXXXXX it is difficult to answer this question without an ear examination. Your ENT doctor has told you that the eardrum is normal and there is no pressure build up in the middle ear. Hence, it is very less likely that it can be Otitis media with effusion. But, the probability of the Eustachian tube dysfunction cannot be ruled out.

My suggestion to you is:

1. Do steam inhalation 3-4 times a day, this will reduce the congestion in the nose and open up the sinuses.
2. Drink plenty of warm water; it keeps the nasal mucosa moist.
3. Use saline and steroid (such as fluticasone or momentasone) nasal spray for reducing the nasal congestion and opening up of the Eustachian tube.
4. Try taking mucolytics (such as bromhexine or ambroxol), to reduce the viscosity of mucus.
5. To stop all the medicines you are taking as these will not be beneficial; ear drops are useless, because the eardrum is intact and it will not be able to penetrate into the middle ear. It does more harm than good.
6. Avoid smoking/alcohol/coffee/chilled food and beverages.

Hope this answers 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. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naveen Kumar 3 hours later
Dear Doctor, thank you so much for your quick reply. I have scheduled a follow up with my ent. In regard to your analysis of an acute sinus infection, I have not suffered since the onset of my symptoms with the classic stuffy nose, pain in head or sinus cavities. My nose has remained clear and I can breathe through it freely. My understanding is that sinusitis is caused by a bacterial infection not viral and I have had a very potent round of biaxin xl which should have knocked that down. So why the possible continued inflammation? You mentioned possible nasal allery,could the cause be then allery or environmentally related,such as dust,mold,or pollen? I have never suffered before to any known allergies. I also hear clicking noises in my ears,where I heard none before. I also am using the ear Popper device which forces a gentle puff of ear up the Eustachian tube while swallowing to allow any fluid to drain.I have had some limited relief from this and in last 3weeks the condition had improved. My concern is that it can take months to return to normal. Whe
n can I expect my ear function to return to normal? I have never had any ear concerns in 47 yrs until now.Also I had my tonsils out at age 7,but unsure of adenoid removal. Could enlarged anenoids be blocking my Eustachian tube function? I do not smoke or drink or expose my ears to headphones or loud music/comcerts,I use earplugs when going to the cinema,I believe I have sensitive ears.
doctor
Answered by Dr. Naveen Kumar 2 hours later
Hi

Thanks for writing back

1.     Sinusitis is inflammation of the paranasal sinuses, which may be due to infection, allergy, or autoimmune issues. To start with, the infection is usually viral in origin and resolve over a course of 5-7 days. Many of the times this can be superadded with bacterial infection and the problem may persist for long. Secondly, sinusitis need not always present with the classical symptoms such as nasal stuffiness, headache, nasal discharge, etc.

In case of blockage of the posterior ethmoidal sinuses or sphenoid sinus, the classical symptoms are not noticed; there could be only few features noticed such as post nasal drip, ear blockage with or without headache. This can be confirmed with a nasal endoscopy.

2.     The clicking noise what you are hearing when opening the mouth, yawning and drinking water are due to opening and closing of the Eustachian tube. This is generally not noticed until there is partial or complete block in the tube. The ear popper works in the similar way and it tries to open up the blocked tube, but it is not going to reduce the congestion around the tube. This can be relieved with nasal sprays and steam inhalation.

3.     If proper medications are used, the ear block should reduce within a couple of weeks.

4.     It is very unusual that the adenoids can persist at this age. If it does, it will be in those individuals having severe nasal allergy. This can also be confirmed with a nasal endoscopy.

5.     Request your ENT specialist to perform a nasal endoscopy and an Impedance audiometry; this will clear most of our doubts.

Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naveen Kumar 14 hours later
Dear Doctor XXXXXXX thank you for all the expert advice. I will certainly try the steam inhalation and drinking warm water along with nasal sprays as prescribed by my ent. It has certainly calmed my nerves to get another opinion and further suggestions and diagnosis.
I should also mention I experienced a trauma in the form of a puncture to a lesion of the hard palette in janof 2011. I went to emergency after biting down on a hard cracker and pierced the lesion causing substanial bleeding which required emerg room doctor to use a silver nitrate stick to stop the bleeding. Follow up with an ent and xrays showed no abnormalities and he said everything was ok. My question is could this past injury have any bearing on my present ear troubles?
I will request the nasal endoscopy and Impedance audiometry as you suggested. Thank you ever so much for your kind reply and expertise on this my troubling matter. Yours sincerely, XXXXXXX p.s. do you practice in the toronto,canada area, I would very much like to get referred to you.


doctor
Answered by Dr. Naveen Kumar 16 minutes later
Hi

Welcome back

Q: My question is could this past injury have any bearing on my present ear troubles?
A: No, it is not possible for the trauma over the hard palate to cause any damage to Eustachian tube or ear apparatus. The Eustachian tube lies far behind, above the soft palate.

Q: Do you practice in the toronto,canada area?
A: No, my practice is in Oman. I work for Badr Al Samaa Group of Hospitals and Polyclinics.

I wish you will recover soon. God bless you.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Naveen Kumar

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