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Q. I have plugged sensation in my right ear for the past six months. Kindly help.

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 11, 2020 and last reviewed on: Sep 18, 2020

Hello doctor,

I am 28 years old. I started smoking a year before (two units daily). For the past six months, I have plugged/fullness feeling in my right ear. Sometimes pop sound also occurs. When I yawn or chew gum, it decreases but again returns. Fullness and pressure sensation is felt across the right ear along with the right cheek. In the beginning, I consulted a local ENT he suggested Amoxicillin and Levocetirizine, it reduced but again returned back. Currently, I am on six day course of Azithromycin and Levocetirizine. X-ray of the sinus and soft tissue of the neck revealed nothing as per ENT. I have this pressure and fullness sensation. Please help. I have no difficulty in breathing or swallowing. Acidity is slightly present, and I am not taking any medicine.

#

Hi,

Welcome to icliniq.com.

There are two problems out there.

1. Eustachian tube catarrh: the eustachian tube basically ventilates the nose and the ear. In a situation where it does not function, a negative pressure develops in the side of the ear leading to feeling of vaccum, ringing sounds, feeling of fluid in the ear and sometimes decreased hearing as well.

This can be treated by attempting to open the tube by the following advice. 1. Using decongestant nasal drops containing Oxymetazoline or Xylometazoline three drops thrice daily for one week.

2. Take tablet containing a combination of Phenylephrine and Levocetirizine one tablet twice daily after food for one week.

3. Doing Valsalva exercises.

4. Taking steam inhalation three to four times a day.

Any associated allergic issue has to be treated in a proper manner, other wise the symptoms will recur.

2. GERD with LPR (gastroesophageal reflux with laryngopharyngeal reflux).

Even though you might asymptomatic in between, the inflammation in the throat often exists in the hidden form and can resurface when adequate care is not taken.

Why does hidden acid reflux become so problematic?

As you know, the stomach usually has got cells which release hydrochloric acid and thus keep the gastric environment acidic in nature. Your entire mucosal lining from the mouth, throat and food pipe (esophagus) is not meant to handle anything acidic. Of the three structures the throat is the most sensitive due to its rich nerve supply. If in a given situation, your mouth, throat or food pipe chronically comes in contact with acidic contents, an inflammation starts which the body initially takes care of, but once this compensation wears out, you start developing symptoms that you have mentioned. Please try to follow the advice mentioned below:

1. Maintain a strict diet, eating on time.

2. Avoid spicy, oily, and cold food/drinks.

3. Keep a gap of two hours between meals and going to bed.

4. Do not overeat, rather keep your stomach half empty and have regular intermittent light food like fresh cut fruits in between major meals.

5. Saltwater gargling 8 to 10 times a day for 15 days.

6. Avoid alcohol and smoking as it can potentiate reflux.

Treatment plan:

Take tablet Pan D 40 mg (or its equivalent) once in the morning before breakfast for one month, syrup Mucaine gel (or its equivalent) 1 tablespoon three times a day 20 minutes before meals for one month.

Make sure you follow the precautionary measures as much as possible as mere medications will not fetch long term relief. This typically takes two to three weeks for things to normalize and for symptoms to subside.

There is absolutely nothing that you need to worry about as this is a treatable entity and things will be fine in a few weeks duration. I hope this helps.

Thank you doctor,

Is cigarette smoking the cause of the problem? I am smoking only for the past year. I am very tensed and anxious. Do I have to worry about it, or is it a simple issue and will resolve with medicines? Please suggest brand name for the medicines.

#

Hi,

Welcome back to icliniq.com.

Cigarette smoking can be one of the causes of the problem in concern, and it might not be the only reason. There is absolutely nothing that you need to worry about as things will normalize within two to three weeks or maybe earlier.

Ensure all the medications and precautionary measures mentioned earlier are followed so that there are maximum benefit and relief from the symptoms you are currently facing.

There are different brand names available out there, and sometimes the pharmacy that you visit might not have the specific brand name. The drug name has been mentioned, and any alternative brand name containing these medications will suffice.

I hope this helps.

Thank you doctor,

You have suggested to take tablet containing the combination of Phenylephrine and Levocetirizine. You have not mentioned the strength. Should Levocetirizine be of 5 mg and phenylephrine of 10 mg?

One more thing the nasal decongestant which you have mentioned, if it is not available in drops then can I purchase it in spary form? Should I spray it in both nostrils? How many spray should be done?

#

Hi,

Welcome back to icliniq.com.

Yes, you can take Levocetirizine 5 mg and Phenylephrine 10 mg. If nasal decongestant is not available in drop form, you can use two puffs in each nostril three times a day for one week.

I hope this helps.

Thank you doctor,

The pressure in the ear is less and the blocked sensation has reduced much. Still a little bit is present. I conducted some tests. Is everything normal?

#

Hi,

Welcome back to icliniq.com.

The tests look fairly normal to me except for the AS curve and dip in the 2k frequency range on the pure tone audiometry that could be suggestive of otosclerosis. However, there are some fallacies due to device error and you shoud not worry much. I would suggest you to continue the same treatment mentioned in the previous message. 1. Tablet Sinarest (Levocetirizine with Phenylephrine combination) one tablet twice daily for the next 15 days.

2. Duonase nasal spray two puffs both the nostrils two times a day for three weeks.

3. Tablet Allegra (Fexofenadine) one tablet in the morning and evening after food for the next 15 days.

4. Otrivin nasal drops three drops thrice daily for one week.

5. Keep a gap of 40 minutes between Otrivin and Duonase nasal spray.

6. Tablet Pan D one tab in the morning and evening 30 minutes before food.

Let us wait for another one month as this could take at least two to three months for things to subside. It is good to note that you have had some improvement and this indicates that the treatment and management is working for you.


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