Plugged Ear Problems

A

anon

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Background: Mid-20s, full time pilot, no medical history. For the past 2 weeks one of my ears has felt "full" as though there is some fluid trapped inside. It has brought about some mild tinnitus. I have never had any episodes of vertigo with these symptoms, although the feeling of fullness is certainly very annoying.

I went to an ENT's office, where a PA examined my ears. The PA stated there was no evidence of fluid being trapped in my affected ear. This PA wants me back to conduct a hearing test given the onset of tinnitus.

I had no symptoms of a cold when I went to the office, but I am starting to feel congested as though I am getting a common cold, so I am suspect of the PA's inability to find evidence of fluid and feel like I should go get a second opinion, or just see if these symptoms pass in the next two weeks. I have taken Sudafed but there has been no relief of the problem with my ear.

The reason I'm posting is because this PA brought up the possibility of Meniere's disease. I was never diagnosed with it, but the PA said it was merely a possibility. In reading about Meniere's it seems as though vertigo is a real problem for people who have it. I have NOT experienced vertigo, but there is certainly an annoying sensation that comes with having one ear feel like it is plugged all day.

What should I do? I'm worried about getting an incorrect diagnosis of Meniere's, losing my medical, and then having all of these symptoms go away never to be seen again. Of course, there is a possibility that I could have Meniere's, at which point I'd need to start figuring out what to do with myself when the FAA pulls my medical. But I want to be sure I go about this the right way to make sure I don't take any action that I'm going to regret.
 
I'd give it a couple months then reevaluate. This has happened to me in the past and has worked itself out.

The worst event was doing a steep decent into Kirkuk in a C130 which was finally cleared at night a couple days later when liquid came out of my ear.

PS. I have 100% zero medical qualifications or training
 
You need at least three of the classic symptoms to have a Meniere's diagnosis. There are five symptoms that can manifest, chiefly vertigo. (Without vertigo, there is no true Meniere's). It is the vertigo that would be disqualifying for your medical.

Other symptoms include roaring tinnitus, low-frequency sensorineural hearing loss (typically fluctuating), aural fullness (without middle ear fluid), and nausea. The combinations of symptoms vary. It was once thought to be caused by excess cerebrospinal fluid in the inner ear, but now is suspected to be an autoimmune condition. Most Meniere's patients experience poor word recognition scores on audiometric tests. Meniere's is almost always unilateral (affecting one ear).

The P.A. is correct in ordering a comprehensive audiological evaluation (hearing test). Make sure the audiologist includes tympanometry, which evaluates the middle ear function. In many instances, aural fullness is related to abnormal middle ear pressures, which cannot be diagnosed by visual inspection of the ear drum (otoscopy). Tympanometry can provide an accurate, objective test of middle ear pressure. The hearing test will tell if there is anything abnormal occurring in the inner ear.

Aural fullness and tinnitus can also be associated with TMJ syndrome.

Talk to the ENT before letting the P.A. give you a diagnosis of Meniere's!
 
Thank you for the responses.

For what it's worth, the tinnitus is high pitch near 16 kHz.
 
Rushie said:
Maybe in jest but actually might help. My guess is eustachian tube dysfunction.
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I've had that for years. I manage it with a combination of modern and traditional medicine.

I also had an ENT tell me years ago that I had all the symptoms of Meniere's except the compulsory vertigo -- and I'm pretty sure that he tried his best to trigger it. He also tried his best to treat the rest of the symptoms, but failed. It was a former Chinese doctor turned American pharmacist who finally pointed me in the direction of some herbal measures that helped.

He's since retired, but I've tweaked his "prescription" over the years with the help of osteopaths and open-minded allopaths. It's pretty much a non-issue these days. Aside from the herbs and such, the most important thing I have to do is limit my sodium intake. If I do nothing other than that, the symptoms become just a minor annoyance. With the herbs and medications (plus avoiding sodium), they go away completely or nearly-so.

I would suggest that OP find an open-minded ENT and talk to him/her about it. Back in olden days, I used to find the D.O.s to be a lot more open-minded than the M.D.s in terms of being open to and informed about alternative medicine; but I've been told that the freshly-minted M.D.s and D.O.s are pretty much interchangeable.

In the meantime, lemon bioflavonoids (not "citrus" bioflavonoids) may be worth a try. The particular pills in the link help me quite a bit and are much less expensive than the ones you can buy in a drugstore that are specifically marketed to tinnitus sufferers. If I had to choose the single most helpful thing I do to manage the ETD (other than limiting sodium intake), it would be taking those particular pills.

Disclaimer: I am not a doctor. I'm not even particularly smart. I'm just a good guinea pig.

Rich
 
I had never heard of those before. I too am a fan of alternative medicine. I've spent a lot of years experimenting with herbal (just the legal ones!) and alternative remedies and have discovered that some are extremely effective while being safer than prescription meds, while at the same time I am a proponent of getting anything of concern checked by a "regular" doctor. Like you Rich I have had these symptoms sans the vertigo and sans any nausea. The theory finally settled on by my doctor and myself is that I have a tube that tends to plug, not necessarily with mucus or anything, but due to allergies, the tissues may swell and just keep it from opening, and then the ambient pressure changes lead to the differential between middle ear pressure and the world, leading to symptoms. And/or a small amount of fluid gets trapped back there. The bottom line is my tendency to allergies but without rhinitis (runny nose) so I don't perceive that I am having an attack. What I have is inflammation in the back of the sinuses and post nasal drip, so my symptoms are tube dysfunction and an occasional cough.
 
Rushie said:
I had never heard of those before. I too am a fan of alternative medicine. I've spent a lot of years experimenting with herbal (just the legal ones!) and alternative remedies and have discovered that some are extremely effective while being safer than prescription meds, while at the same time I am a proponent of getting anything of concern checked by a "regular" doctor. Like you Rich I have had these symptoms sans the vertigo and sans any nausea. The theory finally settled on by my doctor and myself is that I have a tube that tends to plug, not necessarily with mucus or anything, but due to allergies, the tissues may swell and just keep it from opening, and then the ambient pressure changes lead to the differential between middle ear pressure and the world, leading to symptoms. And/or a small amount of fluid gets trapped back there. The bottom line is my tendency to allergies but without rhinitis (runny nose) so I don't perceive that I am having an attack. What I have is inflammation in the back of the sinuses and post nasal drip, so my symptoms are tube dysfunction and an occasional cough.
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I think you're right, and I've also noticed the allergy correlation.

The lemon bioflavanoids help a lot. So does vincamine / vinpocetine, but it can cause sleeplessness and bizarre dreams. Not scary bizarre, just weird. Sometimes they're pretty entertaining, actually. The lemon bioflavanoids will keep you awake all night too if you overdo them, but without the dreams (probably because you can't get to sleep anyway).

1 gram of the lemon bioflavanoids with breakfast and lunch, plus 10mg of vincamine or vinpocetine with breakfast on bad allergy days, seems to be the ticket for me. I won't take either one any later than lunchtime if I plan to sleep that night, however.

Other stuff that's helped over the years include ginger root, licorice root, capsaicin, cat's claw (of course), and stinging nettle. On the pharma side of things, any of the nasal corticosteroids will help if you use a Valsalva maneuver to get the stuff into the tube. (One of the doctors at the V.A. turned me on to that one.) So there are a lot of things that will help. But the lemon bioflavanoids work best for me for this particular problem -- and I've tried pretty much everything at one point or the other. YMMV.

Rich
 
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Try some over the counter Allegra (NOT Allegra-D). It's the only non-scrip antihistamine that works for my ears and it's legal to use when flying. The doc sounds a little ahead of himself regarding Meniere's (been there, done that).

Olopatadine is another antihistamine that may help. It's a spray up your nose thing so it goes right to your sinuses. It works well for me.
 
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The symptoms sound like Eustachian tube dysfunction...usually triggered by allergies. I have had the same thing and the doctor usually finds a post nasal drip as well. It can take weeks to drain properly.
 
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