I am a 40 year old male, 5' 11-3/4"m, 200 lbs.
I have been traveling to Denmark on a regular basis for the last two years, and had been commuting to Kazakhstan for 1 year prior to that. Air travel always effected my ears, but I wonder if the problems I am having could be brought on by the dry air and pressure changes in the airline cabin. My left ear had felt uncomfortable over the last 6 months, not to the point of pain, just slightly congested. I had a sinus Infection on my way back to Michigan 4 months ago, and started taking antibiotics as soon as arrived. The infection returned an I got back on the same antibiotic, this time it cleared up completely, but my throat continued to be sore with difficulty swallowing. I went back to Denmark and two months later still have occasional difficultly swallowing, and my left ear continues to feel congested. I had about a week with no difficulty swallowing, but right now I am having problems swallowing again and it seems like the saliva is packing up somewhere in my throat just below the Adam's apple. After a week without any problems, I thought it was finally gone when about 30 minutes after eating a bag of "Light" Microwave Popcorn yesterday, the pain came back with a vengeance. I took some aspirin and gargled with both salt water and hydrogen peroxide with little relief. I haven't kept up with the gargling.
What can I do to avoid these health problems, I don't get colds or flu, but do seem to have problems with sinus infections that are treated with antibiotics about 2 to 4 times a year?
I had tonsillitis when I was 16 years old which was treated with antibiotics and gargling with hydrogen peroxide and salt water.
Finally, I have started to snore, could this be caused by the Melatonin I'm taking for the jet lag?
Answer ------------------------
If I understand your post correctly, the basic problem is one of difficulty swallowing that seems to be related to a somewhat prolonged bout of upper respiratory infection that coincided with airline travel. The bothersome symptoms include difficulty swallowing and some discomfort that is located in the lower part of the throat. There is no mention of voice disturbance or cough. There has also been ear congestion worse in the left ear. There is no mention of ear pain nor hearing loss.
First of all, it is conceivable that a low-grade persistent infection such as chronic tonsillitis or chronic sinusitis might explain such symptomatology. Chronic sinusitis is usually accompanied by symptoms more localized to the sinuses including facial pressure, diminished sense of smell, nasal congestion, dental discomfort, and post-nasal drainage. Mild chronic soreness of the throat might also occur. Ear pressure can also be related to sinusitis. Physical findings would typically include some degree of swelling of the nasal membranes, possibly tenacious secretions in the nose and throat, mild diffuse redness of the back of the throat, tenderness of the skull over the affected sinuses, amongst other signs. The symptoms of chronic sinusitis might temporarily respond to short term antibiotics 7-10 days but typically they will recur shortly after completion of the medication or they will fail to completely resolve. Ear pressure occurs because of extension of nasal swelling to involve the eustachian tube. Ear congestion due to eustachian tube dysfunction is frequently exacerbated by airplane flight due to the pressure changes that occur. The diagnosis of chronic sinusitis might require nasal endoscopy and/or X-rays such as a CT scan. The treatment may require long term antibiotics (3-6 weeks) combined with nasal steroid spray and mucous-thinning agents. If these measures fail and CT scan confirms the diagnosis, surgical drainage may be required.
Chronic tonsillitis is typically a condition of adulthood and is related to vegetation or debris that accumulates in the small crevices of the tonsil tissue. The usual symptoms of chronic tonsillitis include frequent but mild sore throats and feeling of swelling or accumulation of thick secretions in the back of the throat. Physical findings generally include evidence of deep crevices in the tonsils and mild generalized redness. Occasionally actual debris can be seen in the tonsils. Daily vigorous gargling with antiseptic solutions or a baking soda-salt mixture can be helpful for this condition. When such measure fail to help, tonsillectomy might be done as last result. Tonsil inflammation is often associated with some reference of discomfort to the ear because of shared nerve endings.
Another common cause of the symptoms you describe is known as gastro-esophageal reflux which involves the reflux of acidic secretions from the stomach into the esophagus occasionally reaching as high as the throat and voice box. Common symptoms of this condition include a sensation of fullness or a lump in the lower throat, mild soreness of the throat, episodic or mild hoarseness, accumulation of thick saliva or "phlegm", etc. Physical examination typically reveals swelling and mild redness of the back part of the voice box and few other findings. Management includes certain dietary modifications such as avoidance of meals within 2 hours of going to bed, elevation of the head of bed 30 degrees (2-3 pillows), and the use of antacids or prescription medications designed to reduce the acidity. Increasing one's intake of plain water also is very helpful as are mucous-thinning agents.
It is doubtful that the airplane travel is primarily responsible for these symptoms you describe, but certainly such travel might have aggravated them.
Such symptoms as you describe, warrant a careful examination of your throat by a physician given the length of time they have been present.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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