Patient's Query
Hello doctor,
I had a viral infection three weeks ago, and on the third day, I developed an ear infection in my right ear. The doctor prescribed Amoxicillin and Otomize ear spray (Dexamethasone, Neomycin, and Acetic acid) for seven days, to be used three times a day. The infection cleared, but I am still having an earache and reduced hearing.
I took an audiometry test (hearing test) twice, and on both occasions, there was mild to moderate hearing loss in my right ear. They also performed a speech test (speech discrimination test), and I could only hear 28 percent on my right side with background noise. I am also experiencing severe tinnitus (ringing sensation in the ear).
As a child, I had my adenoids and tonsils removed and had 30 percent hearing loss at that time. I had grommets (small ventilation tubes) inserted in my right ear, which were removed a year later. Due to the long waiting time to get a referral to an ENT specialist, I consulted an ENT privately. They suggested starting treatment with steroids (corticosteroids) first. If that does not work, the next step would be an injection inside the ear (intratympanic injection). If that also does not work, then I may have irreversible hearing loss.
I would like to get a second opinion on this. If the treatment plan is the same, I will need to travel soon for treatment. Please let me know your thoughts.
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern.
The reason for the involvement of the ear during a viral infection is due to eustachian tube catarrh (inflammation or blockage of the eustachian tube).
The eustachian tube helps ventilate the nose and the ear. When it does not function properly, negative pressure can develop in the ear. This can lead to a feeling of a vacuum, ringing sounds, a sensation of fluid in the ear, and sometimes decreased hearing.
This condition can be treated by trying to open the eustachian tube with the following measures:
Use decongestant nasal drops containing Oxymetazoline or Xylometazoline - three drops in each nostril, three times a day for one week.
Take a tablet containing a combination of Phenylephrine and Levocetirizine - one tablet twice a day after food, 12 hours apart, for one week.
Perform Valsalva exercises.
Take steam inhalation three to four times a day.
Avoid using cotton buds in the ear.
Avoid eating anything cold or spicy for the next two weeks.
Take care to avoid exposure to dust. All nasal allergies must be treated properly, or else the catarrh may return.
You may consider using a nasal spray containing Fluticasone and Azelastine - two puffs in each nostril, two times a day for six weeks.
This condition typically takes around two to four weeks to improve. Once the nasal allergies are controlled, the fluid in the ear will gradually reduce, and the associated symptoms (such as tinnitus and decreased hearing) will also improve. For now, there is no need to take any steroid injections.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello doctor,
I have tried all the recommended treatments over the past three weeks, but the problem has not improved.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Have you tried the above-mentioned medicines? If there is no improvement, then you can start taking oral steroids (corticosteroids). It usually takes around ten to fourteen days for eustachian tube catarrh (inflammation or blockage of the eustachian tube) to resolve. Sometimes, it can take more than a month. This happens after the nasal inflammation has settled down.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello doctor,
I did. I was using a tablet from here called Paracetamol and a nasal spray called Xylometazoline, according to my doctor’s suggestion. I had really bad phlegm before, and now I do not have any, but this ear issue has not resolved yet.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
It usually takes around 10 to 14 days for the eustachian tube catarrh to resolve, although sometimes it can take over a month or so. This typically happens after the nasal inflammation has settled down.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello doctor,
It might take eight months to see an ENT here. My sinus is completely clear now after taking the medicines, doctor. I am not sure about the condition of the eustachian tube.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
What is the primary trouble now?
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello Doctor,
I am still experiencing hearing loss and tinnitus (ringing in the ear). The earache is still there, but manageable.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Is it a feeling of fullness with muffled hearing, tinnitus (ringing in the ear), or both?
Kindly get back with the answer for a detailed treatment plan. I hope this helps.
Thank you.
Patient's Query
Hello Doctor,
The muffled hearing and tinnitus are felt in both ears.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Are you using steroid nasal sprays? If not, you should start using a nasal spray containing Fluticasone and Azelastine, two puffs in each nostril, two times a day, for the next two months.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello Doctor,
Yes, I am using Fluticasone. My nose is completely clear now, but the hearing loss is still present.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
Please understand that even if you do not have nasal symptoms, there may still be some internal inflammation preventing the eustachian tube from functioning properly. This stops pressure from equalising in your middle ear, causing decreased hearing, a feeling of fullness, and some tinnitus (ringing in the ear). Injecting steroids is not the correct solution in this case.
You need to continue using a nasal spray containing steroids (corticosteroids) for a long period and wait for at least two months. In addition, you can start a tapering dose of oral steroids (corticosteroids) as well. However, I am not sure if you will be able to buy this over the counter there.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Patient's Query
Hello doctor,
Okay doctor.
Kindly help.
Hello,
Welcome back to icliniq.com.
I understand your concern.
I am not sure if you can buy oral steroids (corticosteroids) over the counter where you reside.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
Was this conversation helpful?
Answered byDr. Bhadragiri Vageesh Padiyar
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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