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What causes blocked ears?

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Posted on Mon, 16 Jun 2014
Question: HI i am suffuring from sinusitis and after having this issue for 2-3 months i got my right ear blocked (middle ear infection) as liquid is trapped behind the ear. ENT suggested to go for sinusitis and grommet surgery. ENT mentioned that he would like to correct the bend in my nose, which i am not very sure, what exactly it means, and certainly i do not need to go for any structural changes, and only for sinus issue. 5 days back my ear started discharging white and then slight yellow, odourless liquid, and my GP said that it is infection and he put me on Augmentin for 5 days now (amoxcillin 500 and Potasium culvinate 125), now my discharge is not there. so i need to know if the treatment so far is good, and whether i need to go for the sinus surgery first or go for grommet in my ear to resolve that issue, as for sinus i am taking chinese herbs, hot soups, acupunture therapy etc, so i am assuming that would help, but please guide.from last couple of weeks i started feeling pain in my joints started from my knee and below, my mother has feet joint pain severe, which i believe is arthritis but not sure what type of that arthritis is. Anyways i went to GP last week and he asked for some blood test, which i attached here as 'full blood test', which seems to be inclusive and currently i am on augmentin for my ear infection, panadol osteo (which is panadal 635 mg), but my pain is not coming down and almost spread to all of my joints and it is too severe during night that i cannot change my side while sleeping. current blood reports were examined by local GP and he said inflammation is there and some sort of viral or bacterial infection is there, but not able to conclude what actually is the issue. he mentioned to another XXXXXXX GP before referring to me to a rheumatologist. so i need help to understand these blood report and what need to be done
doctor
Answered by Dr. Abhishek Sharma (2 hours later)
Brief Answer:
Get XXXXXXX test , Chest X ray and Urine test

Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
I have gone through your query, Its very common to have blocked ears after cold. It is because of blockage of the Eustachian tube or the ventilation tube which maintains the pressure difference behind the ear drum . This tube is connected to the middle part of ear to the back of nose.
There is edema or inflammation at the nasal end of tube which causes it to get blocked and so fluid collection occurs behind the ear drum.
Now you have infection which is causing ear discharge. That suggests a ear drum perforation.
The treatment given in such cases --
-Antibiotics which you are taking ie Amoxicillin .
-In addition Antihistaminics like loratidine, ebastine, cetrizine etc and Decongestant tablet like phenylephrine.
-Nasal decongestant drops like xylometazoline.
-Also taking steroid tablets would decrease the inflammation and will give a good relief.

But you have joint problem too in addition which suggests a systemic disorder.
The ANA report is not conclusive. But ESR and CRP both are raised .
What i suggest is get an XXXXXXX (anti–neutrophil cytoplasmic antibodies) test done to rule out Wegeners Granulomatosis.
In addition get done Urine examination for casts and RBC ; Chest X ray posteroanterior view.To rule out Wegeners granulomatosis.
In this disease there is involvement of Upper respiratory tract like nose ,ears etc ; Kidneys and Lungs Mainly but there is also involvement of joints in the body.
This is a systemic disorder involves many organs of the body.

Till then do not start any steroid medication . As steroids will suppress the disease and it may go undiagnosed.

There does not seems to be any need for surgery. Nasal biopsy might be required if there is a ulcer or crust but that should be done after the blood work.

I hope this would help.Get the test done earliest to get to a diagnosis.
In doubt do reply.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Abhishek Sharma (22 minutes later)
Thanks Dr Abhishel for your answer, though i would like to be more clear on my queries so get the right answers from you, my apologies for not writing the right queries as i was utilizing this sight first time.

Q1 First of all is there any connection with my blood issue with Sinus and ear blockage? as sinus issue started in Feb, Ear blockage happened in April and the blood and all joints pain issue started in May.

Q2. if we talk about sinus, i have shared the CT scan report, does that give a good indication of my sinus issue? do i need to see if i can send you the photos of sinus ct scan (i dont know how i can do that, but i can try, if needed, so suggest).

Q3. is the sinus issue acute or chronic, can that be cured with the help of medicines, the current ENT said that there is a bend in my nose, so he would like to correct that and then also clear the sinusitis, so do you think is that the right thing to go, or i can wait? Pls note that currently the day time i can still survive and my nose remain open, but as soon as i lie down on bed my nose immediately blocks, i had all the medicines taken from march till april including, steroids nasal spray, anti-histamine nasal spray, Decongestant tablets, anti alergic tables etc, but none of them worked.

Q4. my right ear is blocked i checked with GP yesterday and he said there is no redness, inflammation is there, no perforation, and due to light yellow discharge, he said i have an ear infection so he put me on augmentin (amoxcillin 500 and potasium culvinate 125) for 5 day (twice a day). So is that right for the time being?

Q5. as my right ear is blocked i got my hearing test done and i cannot hear approx 60% from my right ear, and i can feel the stuffiness feeling in my right ear and my head, and at times especially after driving for an hour i can feel a lot of pressure in my both ears and head, and feel that i can have little less hearing in my left ear too, but that feeling is temporary and when i wake up in morning that is gone.

Q7. Since, i have the above feeling ENT suggested to have Grommet fit into my right ear drum to fix my issue, as honestly it is challenge for me, and since i need to do air-travel for my work then due to air pressure change my ear-drum can rupture, so could you confirm this understanding and would you suggest to go for this grommet surgery or is there any other option to get rid of this problem, pls note as i mentioned above i had taken already or decongestants, and antibiotics, but nothing worked so far.

Regarding the blood reports i am also checking with the orthopedics on this portal and certainly i will take your advice as well and discuss with them, for next course of action.

Waiting for your response, thanks XXXXXXX
Q8 another one i would like to ask, do you think if i go for sinus surgery which i guess is endoscopy , it would resolve my ear blockage issue too

doctor
Answered by Dr. Abhishek Sharma (32 minutes later)
Brief Answer:
No to surgery at present

Detailed Answer:
Hello again,
If you have joint pains then first is to get any systemic disease ruled out as your ESR and CRP are raised , secondly your nose and ear disease is not getting treated with oral medicines both antibiotics and decongestants.

The disease progression you had from nasal disease to ear disease and now joint pains, plus the blood reports all suggest you need to be further evaluated.

What it seems to me from your history ,Surgery should not be done ,as i already said , at this stage at all. If this is any systemic disease then surgery could be a big mistake and the healing will not occur at all and will lead to suffering.

Blood issue and sinus issue are connected like in disease like Wegeners granulomatosis, sarcoidosis etc.

You have hearing loss which suggests that the disease has not cleared till now.

Grommet insertion should be avoided as ear blockage will clear up with steroid medications as i said previously , and a grommet insertion procedure could be avoided , in addition artificial perforation will also be avoided.
But steroids to be avoided ,till a diagnosis is made.

Do get done the investigations i advised or consult your doctor and discuss with him.
I hope have answered, still in doubt do reply.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Abhishek Sharma (9 hours later)
Thanks Dr XXXXXXX your message is clear to me, however, i have few more follow up questions / clarifications:
1. first of all GP has tried using some oral medicines & Nasal sprays with me, see attached medicine history, and based on that you can see some nasal spray and some oral medicines antibiotics and decongestants were prescribed by Doctor, but none of them worked.

2. GP or ENT here didn't mentioned of any medicine/steroids etc, which can clear of my middle ear fluid, they said the only option is to wait if it dries or drains by itself or have grommet insertion. so could you suggestion any medicine here, which i can check with the doctor, as in Australia in any case you cannot buy any medicine without priscription of a doctor, so don't worry about it. but pls give some idea, so i can talk to the doctor here, as my ear blockage is now annoying and i need to fly in early july and before that i need to have my ear problem resolved, as otherwise my ENT said that there is a chances of ear drum rupture during air travel due to air pressure change.

Rest as you mentioned, i will talk to GP today and get the tests done asap what you have suggested.
Thanks XXXXXXX
Note: pls have a look at the medicine history file, attached
doctor
Answered by Dr. Abhishek Sharma (3 hours later)
Brief Answer:
Get the tests done

Detailed Answer:
Hello,
I have seen the medicine chart.
You can in addition use Nasal decongestant drops ie xylometazoline drops.
Secondly it seems ,you have not used steroid nasal sprays properly . The steroid nasal sprays take at least 5-6 days to show the response and then slowly built up. But you have discontinued the nasal sprays after 8 days .
This is not the proper way of using the steroid nasal sprays .

The medicines which i prescribe are---
--Antibiotic like Roxithromycin or Levofloxacin for 8 days
--Antihistaminic like Loratidine , Ebastine, Cetrizine for 2 weeks
--Oral Decongestant like Phenylephrine for 2 weeks
--Nasal decongestant like Xylometazoline drops for 10 days
--Anti Reflux medicine like Omeprazole , pantoprazole for 10 days

I do not give steroid nasal sprays in the very first instance as the patients do not use them for long time ,as the number of medicines get increased. I think the same has happened to you .

Anyways , your problem seems to be different , it does not seems to be simple sinusitis blocking the ears.

According to the disease suspicion i have a question to you , Do you have fever or malaise or weakness or night sweats, weight loss etc in addition and which you have not mentioned .??

Yes do consult to your doctor and discuss with the things , as he could be the best judge as he is in position of examining you , and get the necessary investigations done , which i advised previously.

In doubt do reply,
Regards
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Abhishek Sharma (1 hour later)
HI Dr XXXXXXX

no, the nasal sprays never stopped after few days, the dates i gave are the dates, when doctor prescribed and i start using them:-) Omanaris was used for full month, and then Duasage was used for 1 month and only nasonex was used for few days and stopped, as i felt that it is not helping me much.

Regarding your question, yes from past few weeks i get sweat a lot at night, and also feel chills if i woke up at midnight for washroom. I can feel feverish as soon as the evening starts as well from past few weeks.

Rest i also believe that i was not put on right medication by the doctors here and that is one of the reason for checking with you;-).

I will talk to my GP here and then come back to you. thanks once again for your answers. XXXXXXX missed to mention that from yesterday night i have started pain in my fingers and i cannot twist the door knob or hold the pen/spoon tightly as it hurts me, may be arthritis issue.....?
doctor
Answered by Dr. Abhishek Sharma (1 hour later)
Brief Answer:
consult your GP

Detailed Answer:
Hello XXXXXXX
It is good if you used the nasal sprays for a month or so.

This finger problem could be because of the arthritis.

Discuss with your doctor as soon as possible and get the necessary investigations done.

Do reply with the investigation reports . I am looking forward to see the results and come to a diagnosis.
Regards
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Abhishek Sharma

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What causes blocked ears?

Brief Answer: Get XXXXXXX test , Chest X ray and Urine test Detailed Answer: Hello XXXXXXX Thanks for writing to HCM I have gone through your query, Its very common to have blocked ears after cold. It is because of blockage of the Eustachian tube or the ventilation tube which maintains the pressure difference behind the ear drum . This tube is connected to the middle part of ear to the back of nose. There is edema or inflammation at the nasal end of tube which causes it to get blocked and so fluid collection occurs behind the ear drum. Now you have infection which is causing ear discharge. That suggests a ear drum perforation. The treatment given in such cases -- -Antibiotics which you are taking ie Amoxicillin . -In addition Antihistaminics like loratidine, ebastine, cetrizine etc and Decongestant tablet like phenylephrine. -Nasal decongestant drops like xylometazoline. -Also taking steroid tablets would decrease the inflammation and will give a good relief. But you have joint problem too in addition which suggests a systemic disorder. The ANA report is not conclusive. But ESR and CRP both are raised . What i suggest is get an XXXXXXX (anti–neutrophil cytoplasmic antibodies) test done to rule out Wegeners Granulomatosis. In addition get done Urine examination for casts and RBC ; Chest X ray posteroanterior view.To rule out Wegeners granulomatosis. In this disease there is involvement of Upper respiratory tract like nose ,ears etc ; Kidneys and Lungs Mainly but there is also involvement of joints in the body. This is a systemic disorder involves many organs of the body. Till then do not start any steroid medication . As steroids will suppress the disease and it may go undiagnosed. There does not seems to be any need for surgery. Nasal biopsy might be required if there is a ulcer or crust but that should be done after the blood work. I hope this would help.Get the test done earliest to get to a diagnosis. In doubt do reply.