Ear congestion is a subjective unpleasant sensation in the form of a feeling of pressure in the ear, “fullness” of the ear canal, hearing loss. The symptom is observed with pressure drops, inflammatory diseases of the auditory analyzer and nasopharynx, taking certain medications. To determine the cause of congestion, otoscopy, audiometry, X-ray examination of the skull bones, laboratory tests are performed, and the patency of the Eustachian tube is assessed. Medications are prescribed only after determining the disease that has disrupted the functioning of the hearing organ.
General characteristics
With ear congestion, patients note a feeling of discomfort, swelling in the external auditory canal, hearing loss, accompanied by a constant hum or ringing. Some people compare the sensation to filling the ear canal with water. With short-term physiological congestion, bilateral symptoms are more often detected, inflammation and other pathological causes can cause unilateral manifestations. Congestion can persist from a few minutes to several weeks.
Patients often notice the connection of discomfort in the ear with acute bacterial or viral infections, injuries of the auricle or head in the temporal region. If the congestion is constantly bothering or occurs periodically for several days, this serves as an indication for a visit to a specialist. It is also necessary to visit a doctor when the symptom is combined with other manifestations — headaches or soreness in the ear canal, dizziness, an increase in body temperature.
Causes of ear congestion
Atmospheric pressure drops
Stuffiness of both ears is a typical symptom that appears in most people during air travel. Unpleasant sensations are associated with the difference in pressure inside the middle ear and outside. A person feels pressure on the eardrums, which is accompanied by hearing loss, noise or ringing in the ears. The same symptoms are observed when jumping into the water and quickly diving to a great depth (swimmer’s ear). Usually, unpleasant sensations disappear after the pressure indicators are equalized, if the congestion persists for a long time, you should visit a doctor.
Otitis media
The most common causes of congestion are inflammatory processes of bacterial or viral etiology. Patients feel pressure in the ear, which is combined with unilateral hearing loss and increased perception of their own voice (autophony). The symptom worries constantly, sometimes an unpleasant feeling in the area of the external auditory canal causes intense headaches. With external otitis, there is a sharp soreness when pressing on the auricle, purulent or serous discharge from the ear canal is possible.
Severe ear congestion occurs with inflammation in the tympanic cavity — otitis media. Patients complain of a feeling of bursting and pressure, hearing on the affected side decreases sharply. In addition to the blocked ear, the patient is concerned about sharp pains in the temples. The pathological discharge is uncharacteristic. When the process is running, congestion often turns into temporary hearing loss, which is associated with damage to the eardrum. Self-treatment of otitis is fraught with neurological complications, so you should seek medical help as soon as possible.
Lesion of the auditory tube
Normally, the Eustachian (auditory) tube provides communication between the oropharynx and the middle ear cavity, which is necessary to equalize external and internal pressure. Some causes provoke swelling and closure of the lumen of the organ, while patients feel stuffiness, swelling and discomfort. In inflammatory processes, the lesion is more often bilateral. Depending on the etiological factor, eustachiitis is accompanied by a runny nose, sore throat, headache, fever. Closure of the lumen of the auditory tube is caused by:
- ARVI: influenza, rhinovirus and adenovirus infection.
- Diseases of the nasopharynx: chronic rhinitis and sinusitis, curvature of the nasal septum, hoan atresia.
- Childhood infections: measles, scarlet fever, whooping cough.
- Allergic pathology, pollinosis.
- Complications after nasal tamponade.
Sulfur plug
With the accumulation of sulfur in the external ear canal, congestion develops gradually. At first, a feeling of discomfort and a feeling of a foreign body in the ear bothers, then hearing progressively worsens on the side of the lesion. Patients note constant swelling and pressure in the auditory canal. Some patients, in order to eliminate unpleasant sensations, try to rinse the ear themselves, which causes deterioration, since upon contact with water, the sulfur plug swells and completely closes the lumen of the external ear canal.
Diseases of the inner ear
Ear congestion, which is combined with severe dizziness, can be caused by labyrinthitis. Patients associate the onset of discomfort in the ear canal with a viral or bacterial infection, head injury. With moderate severity of the disease, pressure and ringing in the ears occur periodically, as the condition worsens, the symptoms become permanent. Hearing loss is progressing against the background of congestion. Typical complaints of balance disorders, staggering when walking, nausea and vomiting, which are caused by damage to the vestibular apparatus.
Complications of pharmacotherapy
Most often, pressure and discomfort in the outer ear area appear after taking medications for the treatment of bacterial infections for 2 weeks or more. Along with congestion, patients report progressive unilateral or bilateral hearing impairment. After the termination of the cause, unpleasant manifestations may disappear on their own, but with the defeat of the sensorineural cells responsible for the perception and recognition of sounds, persistent hearing loss is observed. An unpleasant feeling of pressure and bursting in the ear provokes:
- Aminoglycoside antibiotics: gentamicin, kanamycin, amikacin.
- Loop diuretics: furosemide, ethacric acid.
- NSAIDs in high doses: aspirin, indomethacin, diclofenac sodium.
- Psychotropic drugs: amitriptyline, phenazepam, carbazepine.
- Cytostatics: cisplatin, vincristine, methotrexate.
- Anti-tuberculosis drugs: streptomycin, florimycin, capreomycin.
Rare reasons
- Autoimmune diseases: systemic lupus erythematosus (SLE), scleroderma.
- Congenital diseases: aplasia of the cochlea of the inner ear, cholesteatoma, fetal alcohol syndrome.
- Oncological pathology: tumors of the tympanic cavity, neoplasms of the nasopharynx.
- Otosclerosis.
- Occupational hazards: prolonged vibration and noise exposure.
Diagnostics
Ear congestion is an indication for visiting an otolaryngologist, who conducts a full examination of the auditory analyzer in order to determine the cause of unpleasant symptoms. Laboratory and instrumental studies are aimed at studying the degree of hearing impairment and morphofunctional changes in various parts of the ear. The greatest diagnostic value have:
- Instrumental examination of the outer ear. During otoscopy, inflammatory changes, pathological discharge, cracks or ruptures of the eardrum are detected. To clarify the cause of congestion, microtoscopy is additionally prescribed.
- Audiometry. The degree of impairment of the function of the auditory analyzer is assessed using a special device that emits sounds of different frequencies and loudness. To detect damage to the middle and inner ear, impedance audiometry and tuning fork tests are used.
- Assessment of the patency of the auditory tube. The exclusion of eustachiitis involves special tests: with an empty sip, Toynbee or Valsalva samples. For an objective study of the patency of the Eustachian tube, it is purged with subsequent otoscopy or audiometry.
- Laboratory methods. The discharge from the external auditory canal is collected for bacteriological seeding and determination of pathogenic microorganisms. A general blood test is indicative for detecting signs of inflammation. In the presence of a general infectious syndrome, serological diagnostics (ELISA, PCR) can be used.
Dopplerography and rheoencephalography are recommended for suspected vascular disorders in the hearing organ. The presence of neurological symptoms serves as the basis for CT of the skull, MRI of the head, electroencephalography. If the allergic nature of the disorder is suspected, allergy tests are performed. Patients are also referred for a comprehensive examination to a neurologist, for consultations with other specialists.
Treatment
Help before diagnosis
The stuffiness of the ear that has arisen during the change of pressure can be eliminated independently – for this it is necessary to make several swallowing movements, blow your nose. To open the lumen of the Eustachian tube, you need to close your nose and try to make an intense exhalation. If the unpleasant sensations are caused by a runny nose, it is recommended to drip vasoconstrictive nasal drops into the nostril on the side where congestion is felt, then lie on your side. To identify the cause of unpleasant sensations in the ear and the selection of a treatment regimen, you should contact a specialized specialist.
Drug therapy
Therapeutic measures for a blocked ear are primarily aimed at eliminating the cause of the symptom. To increase the effectiveness of therapy, several drugs are combined that affect different parts of the mechanism of development of the disorder. Etiotropic and pathogenetic therapy involves the use of the following groups of drugs:
- Antibiotics. Medications are prescribed for purulent processes in the middle and inner ear. An otolaryngologist selects medications that do not have ototoxic properties. For mycoses, specific antifungal agents are used.
- Anti-inflammatory drugs. Usually, medications from the NSAID group are recommended, which effectively relieve swelling of the mucosa, eliminate congestion. The drugs have an analgesic effect, therefore they are also indicated as symptomatic therapy for severe pain.
- Antihistamines. They are prescribed for a proven allergic cause of discomfort in the outer ear. In addition, antihistamines that relieve swelling and restore the patency of the auditory tube are included in the treatment regimen for eustachiitis.
- Immunomodulators. They are used to enhance the local and general protective functions of the body, accelerate regenerative processes in the epithelial cells of the hearing organ. Immunostimulants are especially effective for bacterial and viral otitis media.
Physical therapy
As a rule, physiotherapy techniques are included in the treatment plan for congestion and other unpleasant symptoms from the hearing organ. Effectively blowing the auditory tube by Politzer, aimed at improving the outflow of exudate from the tympanic cavity, reducing unpleasant sensations in the patient. To stimulate blood circulation and reparative processes, a pneumatic massage of the eardrum is performed. Complex treatment involves the use of UHF, laser effects, microwave therapy.
Surgical treatment
In some situations, effective therapy of ear congestion is possible only after prompt elimination of the cause. With massive purulent otitis media, drainage operations are shown, which facilitate the outflow of pus and accelerate the recovery period. With significant growths of adenoids, a tonsillectomy is performed. According to the indications, correction of nasopharyngeal pathologies is prescribed – septoplasty, removal of polyps, other benign tumors, conchotomy for hypertrophic rhinitis. In some cases, reconstructive interventions on the inner and middle ear are required.
