I've had plugged up ears for about 3 years now, accompanied from time to time with low grade fevers and head pain. It has been diagnosed as a eustachian tube disfunction, and I have used vasenase steroid nasal spray, entes, antihistimines, to no avail. Recently for the last 2 months I have experienced some mild to moderate pain in the jaw, and pain centralized in the bridge of my nose, often so severe that i can't sleep. I also always have a feeling of fullness in my throat--it doesn't hurt, just feels like a lump. I have had a tmj xray series done, which my doctor said was inconslusive, and also a sinus ct scan. That showed a pollup in one of the sinuses on the right side of my face, which my doctor said could not be responsible for both of my ears being plugged up. The scan also showed evidence of sinusitus, and more mucous than usual. My doctor said none of this was important, and prescribed nothing. Meanwhile, I'm close to going nuts from this head pain, and the occassional pain in my ears which comes and goes, not to mention the constant sensation of fullness. Do you think these symptoms I have described indicate a eustachian tube disfunction that can be helped by the insertion of tubes?
Reply: ------------------------------
You are describing a variety of symptoms which may not be entirely related. Eustachian tube dysfunction is usually not associated with significant pain unless there is a rapid change in ambient air pressures such as that which might occur during airplane flight or scuba diving. A sensation of chronic fullness in the ears could certainly be associated with eustachian tube dysfunction. Placement of tympanostomy tubes is done usually only as a last resort in the treatment of an adult with eustachian tube dysfunction. This is because adults are more capable of autoinflating ("popping") there ears by plugging their noses and gently blowing as opposed to children. When eustachian tube dysfunction is prolonged, frequent autoinflation combined with intranasal steroid sprays (used daily over extended time periods) and perhaps decongestant medication is a commonly recommended treatment regimen. Tubes may be recommended if such treatment fails after a few months and if the diagnosis is fairly certain (supported by audiometric and tympanogram findings). However, you shouldn't anticipate tube insertion would be helpful for any of the other (non-ear) symptoms you have described.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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