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What Do My Lab Test Reports Indicate?
Question: Hello Dr. Bhatti,
I had a bad cough and cold last month on 01/07/2017 self medicated with Zathrin AX 500 5 days and Febrex Plus .
I started getting a blocked ear and pain on the 06/07/2017 was diagnosed with Otitis media for which I was given prednisone 10mg (3days) and alegra M 120 nasal saline water . The liquid behind the ear drum cleared but still had blocking sensation in the right ear with difficulty in equalizing pressure in the right ear being a frequent flyer.
On the 27/07/2017 was diagnosed with Sinusitus had an an X-ray PNS open mouth report said mild mucosal thickening seen in right maxillary sinus and marked mucosal thickening seem in left. Also the Dr noticed right ear wasn't popping after the vasalva and ear drum looked pale . Was given refzil 500 for 6 days , mucolite Sr, fluticasone nasal spray and solspre nasal. Thereafter sinus had cleared up with a follow up PNS X-ray.
Due to the constant pain in the ear on 07/08/2017 I was told a CT scan and the report says mild fullness in the region of the right focca of rossenmuller seen ? inflammatory and right tonsil and subcentimetre cervical nodes bilaterally.
My question is whether the pain in my right ear could be due to this inflammation also there is pain in the left ear lesser than right and both varies with intensity. An endoscopy also was done today and the Dr sees some inflammation of the right fossa of Rosenmuller but has ruled out any abnormality or clinical significance found as CT scan was done with a contrast .
Second question or could the pain be a eaustician tube dysfunction as it takes a while for the eaustician tube to heal in spite of a normal tympannogram and audiometry which I had done.
Thank you Sir in advance . Appreciate ur feedback
I had a bad cough and cold last month on 01/07/2017 self medicated with Zathrin AX 500 5 days and Febrex Plus .
I started getting a blocked ear and pain on the 06/07/2017 was diagnosed with Otitis media for which I was given prednisone 10mg (3days) and alegra M 120 nasal saline water . The liquid behind the ear drum cleared but still had blocking sensation in the right ear with difficulty in equalizing pressure in the right ear being a frequent flyer.
On the 27/07/2017 was diagnosed with Sinusitus had an an X-ray PNS open mouth report said mild mucosal thickening seen in right maxillary sinus and marked mucosal thickening seem in left. Also the Dr noticed right ear wasn't popping after the vasalva and ear drum looked pale . Was given refzil 500 for 6 days , mucolite Sr, fluticasone nasal spray and solspre nasal. Thereafter sinus had cleared up with a follow up PNS X-ray.
Due to the constant pain in the ear on 07/08/2017 I was told a CT scan and the report says mild fullness in the region of the right focca of rossenmuller seen ? inflammatory and right tonsil and subcentimetre cervical nodes bilaterally.
My question is whether the pain in my right ear could be due to this inflammation also there is pain in the left ear lesser than right and both varies with intensity. An endoscopy also was done today and the Dr sees some inflammation of the right fossa of Rosenmuller but has ruled out any abnormality or clinical significance found as CT scan was done with a contrast .
Second question or could the pain be a eaustician tube dysfunction as it takes a while for the eaustician tube to heal in spite of a normal tympannogram and audiometry which I had done.
Thank you Sir in advance . Appreciate ur feedback
Brief Answer:
Intermittent, mild ETD.
Detailed Answer:
Hi,
Thank you for your query.
1. The pain and discomfort is due to intermittent, mild ETD (Eustachian Tube Dysfunction). In such cases, the Impedance Audiogram (tympanogram) will appear normal. The pain and discomfort of ETD is typically centred in and below the ear.
2. The slight swelling in the Fossa of Rosenmuller (FOR) will increase the ETD as it lies behind the inner, nasal opening of the ET. This swelling will usually be lymphoid (tonsil-like) tissue considering your history and test results. Frequent flying with intermittent ETD will also cause ear and sinus barotrauma.
3. Sustained treatment with all of these medications together (which you have taken at different times) will settle this problem.
4. This is a very common problem and will settle down. The only unusual finding is the swelling in the FOR. This has been checked with a contrasr enhanced scan and an endoscopy has been done, which is good. This needs a follow up in a few weeks.
5. If this still persists after a few weeks od sustained treatment, you can share your test results, scan and endoscopy images, it will help understand your problem.
I hope that I have answered your query. if you have any further questions, I will be available to answer them.
Regards.
Intermittent, mild ETD.
Detailed Answer:
Hi,
Thank you for your query.
1. The pain and discomfort is due to intermittent, mild ETD (Eustachian Tube Dysfunction). In such cases, the Impedance Audiogram (tympanogram) will appear normal. The pain and discomfort of ETD is typically centred in and below the ear.
2. The slight swelling in the Fossa of Rosenmuller (FOR) will increase the ETD as it lies behind the inner, nasal opening of the ET. This swelling will usually be lymphoid (tonsil-like) tissue considering your history and test results. Frequent flying with intermittent ETD will also cause ear and sinus barotrauma.
3. Sustained treatment with all of these medications together (which you have taken at different times) will settle this problem.
4. This is a very common problem and will settle down. The only unusual finding is the swelling in the FOR. This has been checked with a contrasr enhanced scan and an endoscopy has been done, which is good. This needs a follow up in a few weeks.
5. If this still persists after a few weeks od sustained treatment, you can share your test results, scan and endoscopy images, it will help understand your problem.
I hope that I have answered your query. if you have any further questions, I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Thanks for your detailed reply.
1. At present I'm not taking any prescribed medication except saline pray (Solspre) and Furamist AZ twice a day. Do you suggest any medication for the underlying ETD problem or the swelling of FOR to subside as it is not helping the ET by suppressing it in its close proximity
2. I have never had Otitis media thereafter ETD for more than a week. Could this intermittent / persistent ETD be due to the sinusitis after the AOM.
3. Present symptoms are slight muffled hearing in crowded places, sensitivity to loud sounds and slight tinnitus
4. I'm a little worried Dr. As this has never taken this long over a month.
1. At present I'm not taking any prescribed medication except saline pray (Solspre) and Furamist AZ twice a day. Do you suggest any medication for the underlying ETD problem or the swelling of FOR to subside as it is not helping the ET by suppressing it in its close proximity
2. I have never had Otitis media thereafter ETD for more than a week. Could this intermittent / persistent ETD be due to the sinusitis after the AOM.
3. Present symptoms are slight muffled hearing in crowded places, sensitivity to loud sounds and slight tinnitus
4. I'm a little worried Dr. As this has never taken this long over a month.
Brief Answer:
It will settle down.
Detailed Answer:
Hi,
Thank you for writing back.
1. Add Tab. Allegra-M once a day, Mucolite SR once a day and an anti-inflammatory medication such as Disperzyme twice a day (dissolved in water and taken 1 hour before or 2 hours after meals). You can try Nasowash. This in addition to your current medication. Take these for at least 2 weeks.
2. The Sinusitis, ETD and resultant OM (Otitis Media) worsens over time. Flying also worsens the episodes.
3. I recommend that you repeat the Audiology tests and upload the results.
4. This will settle down.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
It will settle down.
Detailed Answer:
Hi,
Thank you for writing back.
1. Add Tab. Allegra-M once a day, Mucolite SR once a day and an anti-inflammatory medication such as Disperzyme twice a day (dissolved in water and taken 1 hour before or 2 hours after meals). You can try Nasowash. This in addition to your current medication. Take these for at least 2 weeks.
2. The Sinusitis, ETD and resultant OM (Otitis Media) worsens over time. Flying also worsens the episodes.
3. I recommend that you repeat the Audiology tests and upload the results.
4. This will settle down.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
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. Arnab Banerjee
Answered by
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