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Why am I having constant lightheadedness and clicking sound in ears?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At February 28, 2018
Reviewed AtJuly 12, 2023

Patient's Query

Hello doctor,

My symptoms are constant lightheadedness, feeling like a drunk all the time, fatigue after a couple of hours, and a clicking sound when swallowing in both ears for the last eight weeks. Yawning also causes a clicking sound. Ear fullness in both ears, some weird, very low buzzing sound in the right ear but also shows up in the left ear but goes away. The audio test is normal. The ear pressure test is normal for the left ear but not for the right. MRI and CT scan are also normal. Endoscopy shows normal eustachian opening but some allergic inflammation. There is no fever. I have been prescribed Betahistine 16 mg 3 times and FM 24 1 tablet at night. I am a type 1 diabetic and have Addison's disease too. I am on Hydrocortisone three times daily for Addison's disease, Insulin three times for diabetes, and Thyroxine for hypothyroid. Now, this may be eustachian tube dysfunction, but my doctor has not communicated properly about how much time it takes to resolve it. Do other people have similar problems? I have heard stories of people not recovering for 20 to 30 years. What does that mean?

Hello,

Welcome to icliniq.com.

We need to look at your reports and investigation films for the correct diagnosis. Kindly upload all the reports and relevant investigation films and get back to us. Eustachian tube dysfunction does not take that long to heal. Appropriate medicines will help you get relief from the problem. Do revert back for further help.

Patient's Query

Hi doctor,

Thank you for the reply.

I have attached the files. Kindly guide me.

Hello,

Welcome back to icliniq.com.

I have gone through all the reports and have correlated with your symptoms (attachment removed to protect patient identity). My diagnosis is middle ear effusion on the right side and minimal dysfunction on the left. Investigations point to the pathology on the right, whereas nothing points to any pathology on the left. All the symptoms are due to this. Middle ear effusion can occur due to multiple reasons, eustachian tube dysfunction being only one of the causes. More importantly, recurrent nasal block or allergy, or nasal discharges can affect the eustachian tube, causing reduced functioning. In your CT scan, we can see a mucosal thickening in both maxillary and frontal sinuses. The discharges produced in these sinuses empty into the nasal cavity, and they pass above and below the Eustachian tube, opening to fall into the throat. When mucosal thickening is present, there will be an increased amount and viscosity of secretions which cause a block of the Eustachian tube opening. Moreover, you have a deviated nasal septum to the right side which reduces space in that nasal cavity. Additionally, your turbinates are hypertrophied, which means they are swollen in size. The swelling could be due to inflammation or allergy. The result of all this is reduced functioning of the eustachian tube. Hence according to me, the nasal problem is causing the ear issue. The trigger for these problems (why this should occur now when you have been having this all through your adulthood) is unknown, and it could be pollution, allergy, subclinical inflammation, dental problems, rhinitis, etc. I want you to recollect if you have had a runny nose, allergy, itching of the nose, sneezing, watering of eyes, or itching of eyes or throat. Any throat pain or nose block, or thick nasal discharge? All of these point toward a nasal problem that can lead to eustachian tube dysfunction. When there is reduced functioning of the Eustachian tube, it causes reduced air ventilation of drainage of the middle ear. The same results in the production of fluid in the middle ear, which is not drained into the nose as would happen normally. In the right ear B type tympanostomy suggests that there is definite fluid. Considering your symptoms in the left ear may be the fluid is temporary and gets resolved spontaneously. The same has caused ear block, feeling of lightheadedness, ear fullness, clicking sound, buzzing sound, and fatigue. When I come to your questions, this problem does not last 20 years if you take appropriate treatment. However, a lot of people do have these symptoms and fluid in the ear problem. A lot of small kids have problems due to adenoids and tonsils. My advice would be to take appropriate treatment for the middle ear effusion and sino-nasal condition. After that, your ear should get better. I would say this will take about a fortnight to a month for complete recovery with apt medicines and not more than that. As preventive measures, avoid dust, smoke, winds, pollution, cold foods, and citrus fruits. Medicines would be anti-inflammatory sprays in the nose with decongestants and mucolytics to remove the ear fluid. Definitive treatment with regard to nasal pathology requires studying your CT scan. That would mean you will have to upload the CT films. Right now, you have only uploaded a printed report which is the radiologist's assessment of your nose. A complete ENT specialist assessment of the nose and sinuses would require studying the films. Kindly upload those. The nasal problem requires definite treatment to prevent the ear condition from recurring.

Patient's Query

Hi doctor,

Thank you for the reply.

This sounds very logical and promising. You are right, I had very bad sinus congestion two times four months back with total nose blockage, and the dizziness started from that time, and other symptoms progressively came. Now, can I upload the MRI scan as a picture against the light, or do you need to see it in the recommended format?

Hey,

Welcome back to icliniq.com.

I do not need to see it in the recommended format. If you take a picture in front of the tube light, that will be good enough. Now when you recollect and report the symptoms more chronologically, I feel the problem is right like I diagnosed it. You do not have to worry about it. We shall get it right.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shyam Kalyan. N
Dr. Shyam Kalyan. N

Otolaryngology (E.N.T)

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