I am a 61-year-old male. For the past 3 years I have been dealing with extended periods of fullness, tinnitus, distorted hearing, and hyperacusis/recruitment in the left ear sometimes accompanied by short episodes (a few hours) of dizziness and nausea. Various nystagmus, caloric, tracking, and brainstem tests were all normal. Blood test was normal except for slightly low globulin (2.5). Sinuses and nasal passages are consistently clear. Eustachian tubes are apparently a target for allergic reaction, and examination shows the left tube to be more susceptible to blockage due to residual scar tissue (possibly from childhood adenoid surgery).
Treatment has involved trial of various decongestants, antihistamines, and nasal steroids until positive results were obtained. The first successful medication was Vancenase, which provided complete relief for about 2 months and then became ineffective. After another period of trials, good results were obtained with Deconamine. This was alternated with Poly-Histine-D at intervals of 2 or 3 months and satisfactory (but not total) relief was maintained for about a year with this routine.
During the trial periods, when the fullness and other ear symptoms were present, I could generally prevent dizziness episodes by frequently (sometimes several times a minute) popping/inflating the ears and, if I seemed to be "on the verge," taking a meclizine.
At the present time I've been in a trial mode for about 2 months and currently am using Astelin nasal spray along with guaifenesin/pseudoephedrine capsules with little if any effect on the ear congestion (but nasal passages feel as open as a wind tunnel). I'm averaging 2 meclizine tablets a day and recently had my first nausea episode in over a year because I waited too long to take one.
The eustachian tube blockage and resultant effects, while not necessarily more severe than 2 or 3 years ago, are apparently becoming harder and harder to control with antihistamines/decongestants. Neither my ENT or family physician has mentioned a tympanostomy tube as a possible option, but I'm starting to wonder if it might be getting down to that. Would you suggest that I inquire about this procedure? Are there any adverse side effects such as increased tinnitus or sound sensitivity?
Thank you in advance for your response.
Reply: -----------------------
I would have to defer to your treating otolaryngologist as to whether or not it is appropriate to consider tympanostomy tubes at this juncture. I suspect however, based on what you have described, that it would be a reasonable consideration. It is a very low risk procedure that is done under local anesthesia in an office setting.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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