5 Hours After ENT Visit My Ears Fill Up Again

[Hotaru]

After a week of not having any pressure behind the ears and seeing an ENT earlier today who told me I didn't have ETD, I get pressure again. Also, I might be going to an AM-101 screening. This is my third bout of possible ETD in two months. What should I do now? Should I get a scan? An operation?

 

[glynis]

Have you had a test with a tube up your nose as that is the best way to check for ETD ?....lots of love glynis

 

[Hotaru]

Have you had a test with a tube up your nose as that is the best way to check for ETD ?....lots of love glynis

No, none of my doctors have ever ordered any tests to make sure I'm okay, no scans, no blood tests, no tubes, nothing.

 

[glynis]

I would defiantly try get your eustatian tubes checked properly .
My hubby had the test done today and said was painless just a little uncomfortable .

I'm not sure how easily it is for you if don't have NHS but would push for a routine MRI and nose test ......lots of love glynis

 

[just1morething]

I asked the ENT I last seen recently to look at my Eustachian tubes and see if there was inflammation and he said that was difficult. When I went to Paparella years ago the ENT there said I had a abnormal left E-tube so apparently only certain ENT's can do it.

 

[Hotaru]

But why wouldn't he or the other ENT I saw test me in the first place?

 

[Aaron123]

There really isn't a good test for ETD though I think basic tympanometry is part of a comprehensive hearing test (Quotes are from http://www.dizziness-and-balance.com/disorders/unilat/etd.htm)

Diagnosis
Smith and Tysome reviewed Tests of the ET in 2015 (Smith and Tysome, 2015). They concluded that "Currently, no single test could be considered a 'gold standard' for the diagnosis of ET dysfunction".

Practically, ETD is diagnosed by talking to the patient, and identifying symptoms that clear with manipulation of the ET, such as by "popping" the ear.

A ETD questionnaire was developed in 2014 called the EDTQ-7 (Schroder et al, 2014). We are dubious that a questionnaire is needed for this simple diagnosis. Van Roeyen et al (2015) reported that the ETDQ-7 was unable to distriminate between obstructive ET dysfunction and patulous ET. The questionnaire had good discriminant validity for ETD vs. healthy controls.

Formal measurement of ET function
Eustachian tube function can be evaluated formally by the process of measuring pressure in the ear using tympanometry, documenting that it is different than 0, then having the person attempt to open up their ET, and then measuring it again. If pressure changes, then the ET opened. If it didn't, either the pressure was normal to start with, or the tube didn't open.

Nor is there particularly good treatment:

Treatment:
Treatment of ETD is not very sophisticated or effective.

For the usual type of ETD (closed), medications for allergy such as decongestants, systemic or local antihistamines and nasal topical steroids are commonly tried. We are particularly fond of using "Astelin", which is a prescription antihistamine nasal spray, as well as kits that involve irrigation of the nose with salt water.

Closed ET

Occasionally, people with severe symptoms due to ET dysfunction may have a ventilation tube placed in their ear drum. This relieves the symptoms of ET dysfunction but creates a perforation in the eardrum which reduces hearing to a small extent as well as provides a potential entry point for infection. However, in most cases, it is worth it to find out if symptoms respond to ventilation of the ear.

Recently Balloon Eustachian Tuboplasty (BET) has been used as a method of treating chronic obstructive ETD. Schroder et al (2015) reported success in "more than 70%". Similar results are reported by Tisch et al (2013), and Maier et al (2015).

If you are using a nasal spray, you might look here http://www.fauquierent.net/etd2.htm for information on how to maximize its effectiveness for ET issues.

 

[Hotaru]

There really isn't a good test for ETD though I think basic tympanometry is part of a comprehensive hearing test (Quotes are from http://www.dizziness-and-balance.com/disorders/unilat/etd.htm)



Nor is there particularly good treatment:


If you are using a nasal spray, you might look here http://www.fauquierent.net/etd2.htm for information on how to maximize its effectiveness for ET issues.

So you're saying that not even an MRI can determine this?

 

[just1morething]

You might want to see if you can see a ENT that specializes in ETD like I'm seeing on 2-15. Probably best to forget about your past ENT's visits and possibly get a referral. Many of us hindsight, but it does no good, only makes you angry if you think something was not done properly.

 

[Hotaru]

You might want to see if you can see a ENT that specializes in ETD like I'm seeing on 2-15. Probably best to forget about your past ENT's visits and possibly get a referral.

What about urgent care or a hospital? That'll be faster.

 

[Aaron123]

So you're saying that not even an MRI can determine this?

(Keeping in mind that I am not a Doctor.) I would assume that an MRI could see something, but I don't think it is used as a diagnostic tool for ETD. Moreover, even if you found an ENT willing to do the test, I think you would be hard pressed to find an insurance company willing to pay for an MRI to look for ETD.

What about urgent care or a hospital? That'll be faster.

In my opinion going to an urgent care or an ER with a complaint of ETD and hoping to get better testing than at an ENT would be a waste of time and money.

 

[just1morething]

What about urgent care or a hospital? That'll be faster.

You could do that. Some ER docs are not very sympathetic to people with tinnitus, but if you have other symptoms yeah. I learned that the hard way. If you have a primary care Dr. he/she could order a head/brain MRI. I had one done last year in regard to tinnitus, but it was their idea. It was actually a spine Dr. that took interest in my tinnitus. That was nice of her.

 

[Atlantis]

Hotaru have you tried NETIPOT treatment?

 

[Hotaru]

Hotaru have you tried NETIPOT treatment?

Netipots make my T worse and cause pain in my nose and ears. Steaming just puts more fluid inside my head. Hilariously, when the pressure stops, (every 10 days) the T is worse.

 

[Alue]

In my opinion going to an urgent care or an ER with a complaint of ETD and hoping to get better testing than at an ENT would be a waste of time and money.

Agreed, I've found urgent cares to be pretty useless unless it's something obvious like a broken bone.