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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have clogged ears. Given antibiotic for sinus infection and ear infection. Proper diagnosis?

Answered by
Dr. Ravinder Sharma

ENT Specialist

Practicing since :1992

Answered : 332 Questions

Posted on Sat, 9 Feb 2013 in Ear, Nose and Throat Problems
Question: I have had clogged ears since Dec i went to the clinic and they gave me a antibody to take for ten days and told me I had sinus infection and ear infection. That helped a little I have no pain but just clogged ears. Went back and they gave me another antibody Z pack and said I had otitus media with effiusion. Told me to take the z pack and go to a ENT if it didn't get 100 percent better in 3 days. I am not having any pain just stopped up ears that make it uncomfortable. I can hear out of it but not as well as the other ear. I feel fluid in my other ear also but not as bad. Read where it could take up to a couple of months for the fluid to go away. Didn't want to pay another 55 dollar copay to be told that it could take time to heal but didn't know if I needed to go have it check again. I have only been off the z pack for 3 days. I am taking Allegra D to see if that would help but read were sometimes that could make it worst didn't know if I should just stop taking it and see if that would help. No fever or real pain just the uncomfortable feeling of something in my ear which of course makes me pull at it and try to unstop it could a ear drop help?? Was told my the first NP that I had a small hole in my ear drum but the second person said she didn't see that. I was also put on ear drops for that the first time? The second person just told me that she saw fluid and that the ear didn't look right but to take the z pack and I should feel better. What to do??
Answered by Dr. Ravinder Sharma 2 hours later
I am Dr Ravinder Sharma

On the basis of the information provided it appears you have secretory otitis media . However at one point you have written that you were told about a perforation in ear drum. If it is so than you have acute suppurative otitis media as the diagnosis.

First I would take it as secretory otitis media as everything in history is matching it. At this stage I can advise you for steam inhalation once a day, a mucolytic like bromhexine two times a day, antiallergic and decongestant combination (Alerid D) two times a day and a steroid nasal spray (Duonase ) twice a day once in each nostril. You can take this treatment for 2 to 3 weeks. If it is secretory otitis media it may improve with this in 6 to 8 weeks time. Z pack is not required if it is secretory otitis media. In some cases there may be a need of operative intervention (after 8 to 12 weeks) when the medication fails. It is called as myringotomy and grommet insertion( making a opening in ear drum and putting in a ventilating tube called as grommet)

Now about the second possibility - perforation in the ear drum. If it is so it will be appropriate to take Z pack and antibiotic ear drop. In majority of cases the hole in drum closes by itself if the ear is kept dry. However if the patient get recurrent infections of ear it may convert into ENT specialist if it is feasable.

I hope this answers your concern. Feel free to contac tme if you require more information about it

with regards
Ravinder Sharma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ravinder Sharma 29 hours later
I am going to try the suggestions that you gave me and see if that doesn't help. Do you think it will be okay to try this and then go see a ENT after. If so how long should I see some results from this. Did you mean Allegra D when you wrote Alerid D? Also are the steroid nasal spray OTC? I have some flonaise spray would that work as well as the Duonase? Just trying to try these before making another trip to the doctor. We have had alot of crazy weather here in GA and alot of people with sinus things due to the crazy weather so I know alot of this is allergy realated also. What is the name of the other medication that you stated (mucolytic like bromhexine) is it over the counter also. If not I will have to go see someone. Do you think my general practice doctor to help before I went to a ENT my insurance doesn't cover them as well as the GP. Thanks in advance. XXXXXXX XXXXXXX
Answered by Dr. Ravinder Sharma 6 hours later
Thanks for the follow up query

I would advise you for a ENT consultation first as there is no alternative to clinical examination.

For the rest of queries the answers are as below

Alerid D is cetrizine with decongestant
Allegra D is Fexofenadine with decongestant

They both are using to treat allergy and decrease congestion. Alerid D may cause some sedation but Allegra D is non sedatting.

Flonase nasal spray as as good as Duonase

You can first plan visit with GP first before starting medicines.

I hope this answers your concerns. Feel free to contact me if you require more information

with regards
Ravinder Sharma
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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