Long term possible ETD, Sinus and Head pressure issues

Ears, nose and throat
1

I've had chronic tinnitus, ear popping and blocked feeling in my ears over the past 3 years (mainly inmy left ear). Alongside the discomfort, I've had with this issue, I've had various sinus pain and extreme facial pain for 3 weeks once when I literally thought I was having a hammer smashed against my head. also seen ENT and been on nasal steroids and sprays which didn't help in the long term.

The problem originally flared up when I had a bad head cold 3 years ago and that's when my ear ringing and popping started. I was on high dosage of inflammatory s for my head pain and it instantly disappeared almost immediately and never returned upto now.

I've now had a cold which seems to have lasted for 2 weeks. And my god its been a misery. I've had buffered hearing, difficultly popping my ears, head, facial, eye pressure and pain. My sinusus feel like they are going to pop out of my skull and I feel like I've been banged over the head whilst asleep. I've also had trouble sleeping for the past few weeks which doesn't help whatsoever.

From what I'm aware I've not got any allergies, I'm going back to ENT over the next few weeks so we'll see whats said. However last time I had a camera put into my sinuses and it was all clear the only thing suggested by ENT was possible tubes in my ears?

Wondering if anybody else has similar problems and any advice for me. I'm only 21 and looking to start my career over summer when I finish university and this has almost controlled my life for years.

2

You clearly have sinusitis.

Viral infections can cause sinusitis, but it sounds as if yours is a bacteriological one. You can find the symptoms on the web.

I would advise you to consult a pharmacist immediately about your problem.

b?ut it could be. They can arise as a consequence of viral infection.

3

Eustachian Tube problems are normally secondary reactions to infections or allergies arising in the nose and sinuses. Unless the primary causes are brought under control or cleared then your E.T problems will continue.

This is why you have been prescribed nasal spray steroids. You should take them even if it does not appear to you it is having a longer term effect. They are difficult to administer, take properly. You should also be taking an anti-histamine.

The main difference between viral infections and allergies in terms of the reaction is that allergic ones tend to be chronic. Some allergies are seasonal, others are not. It depends upon what is causing the allergy.

The 'popping' you refer to is your E.T. functioning. This suggests your E.T. is not blocked.

Your pains in the face are a symptom of a maxillary sinus problem. It is similar to the tooth pain that is also a symptom. It relates to how the head nerves function. These are referred 'pains' because they do not arise in the places where the problems are.

Your tinnitus is probably mucus in your ears. This what an E.N.T. consultant said to me once.

I have had allergic based sinusitis and associated Eustachian Tube problems all my life. I have developed a profound understanding of my condition because of the advice I have been offered by my consultant and what I have researched in the literature.

The answer to you question depends upon what is causing your problem. You may never be able to clear your Eustachian Tube problem, but you should be able to exercise better control of that condition. You sinusitis should respond to treatment. I am unclear of whether tinnitus ever clears.

Suffering E.T. problems is not pleasant. I experience severe pain at times. There are no simple answers to such problem. But I do not believe your E.T. is the source of your problem.

I am offering you this because I have an empathy with other suffers.

I would advise you and anyone else experiencing such problems to research reliable websites. I.e. not just forums.

I advise you to read my other contributions on this discussion topic.

4

Thank you for your detailed reply. I've read around this topic plenty as I've been suffering with these problems for years now and not only does it make me feel depressed, and out of it but it prevents me sleeping proper for weeks sometimes and then I feel exhausted and nobody understands!

I was told by the ENT I saw that the extreme one sided sinus/migraine type headache I had was caused by inflammation (possibly my Eustachian tube) which was therefore touching a nerve in my face and causing severe pain, disabling pain in fact. I do question why my ENT said a last resort would be tubes, because surely she knew that the popping means it is working correctly? However I've read on many sites that this can still be a result of it not functioning correctly therefore it's always inflamed therefore causing long term issues? Also the my discomfort started when I had a cold, and my ear makes all kinds of crazy noises when I've got a cold. Or does this mean anything?

Either way I'll fight to get to the bottom of my issue however my main concern is having pointless treatment/surgery. I've also read about TMJ etc.

Thanks again

5

I was also wondering if anybody would recommend using a netipot/nasal irrigation to see if this helps my problem? I've been reluctant to try this because I was worried it could damage my ears if they are blocked etc.

6

Hi, I don't normally post in these forums but I have exactly what you describe. Narrow airways and eustachian dysfunction. Whenever I get a cold it becomes terrible agony in my sinuses but my entire head feels as though it is subject to a vacuum, as well as the well-documented fatigue, pulsating feelings, spaced-out feeling and headaches. The last twice I've had a terrible cold this has not resolved easily and I am currently on co-amoxiclav, day 10, with little improvement. Taking fluticasone nasal spray (12 months), which reduced the number of colds but I wonder if it is now not working as well as I am now really ill again. I suggested a short course of prednisone to my GP, who said it's not 'normally' given. However, I feel there is so much inflammation that anything to reduce it and help drain the air spaces would be worth a try. ENT wants to perform sinus surgery on my nose, including bones and is not keen to insert ear tubes, which is a shame as any relief would be heaven!

Yes, used a neti-pot - tried saline and even manuca honey, but doesn't really help. Steam, hot water bottles pressed on different parts of the head, trying to lie in 100 positions to 'drain it'.

I wonder if it could be a primary or subclass antibody deficiency? Or even a form of vasculitis?

It's not much fun, is it? And it's rather frustrating that GPs and ENTs don't always come across as being investigative or interested that, in lieu of definitive evidence and a roadmap as to what to do, their patients feel as though they are about to die!

7

Hi Rachel, how long have you been suffering for? and did your symptoms come on after a cold or different circumstances? Mine started when I was about 18, I never had a single ear infection, or issues with colds whatsoever until then. I had a very bad head cold and since then I've had the constant tinnitus and popping ears... and the came the severe headaches etc about a year after.

It's funny really because I was on antibiotics a few weeks ago when I wrote the above post for a cold, and I was really struggling with headaches which seemed to be especially behind my eyes. Really bad pressure that almost pulsates in my head and above my eyes and severe sinus pressure. I took 1 single Dicolofenac 50mg (Strong anti-inflammatory) and believe it or not my discomfort sinus/head pressure wise has literally disappeared again. I've not had any issues for around 2 weeks again and I've started taking antihistamines also now.

I'm due to see my ENT in April.. only the second time I've seen one since December 2012 so it will be interesting for them to see that over a year later my issues are still identical. I also wonder the same question weather its literally the fact that we've had a bad virus that has just damaged our immue system to the sense of our ears etc?

And I totally agree with what your saying about doctors and ENT's. There seems to be an extreme lack of information, research regarding the issues we have. The amount of people, articles, forums etc. I've seen online who suffer from this or similar symptoms surely they should invest some time and money to give us a chance to stop suffering?

Thanks for your reply, any info that you may have please share, or any questions feel free to ask!

8

Dear Jacko,

Thank you for your reply. Perhaps rather that allowing yourself to become depressed you should start taking more decisive actions to solve your problems. You are clearly young. You must learn to listen more and learn from your experiences.

You should have read the information provided on the Health U.K. website on 'Sinusitis', which has been written by doctors which explains that viral infections can cause 'sinusitis' and, on E.T.D. which explains that viral infections can cause 'E.T.D'. It also refers to chronic problems.

They also advise on using nasal steriods spray. They also confirmed my advice that through reducing the inflammation in the back of the nose (It should have stated the nose and sinus) that the Eustachian Tube problem normally clears up. Your consultant has clearly given a reliable prognosis and advised you how to treat your condition.

There is no evidence you took any medication or sought suitable advice from what you said to me initially. If you are not going to take advice or your medication, then you can expect to suffer and not to resolve your problems. Until you resolve that problem it will impossible to determine whether you having any pain from your Eustachian Tube.

Inflammation is like a fire. It the body's defence system. Everyone experience inflammation when they have viral infections, including some degree of sinusitis and E.T. problems during them. Yours is simply more severe for some reason.

If anyone is experiencing chronic inflammation, then a viral infection will make the problem worse. Heat can also increase inflammation.

The maxillary sinus is like sump. It can contains a lot of mucus. It drains upwards. Very often during viral infections the very narrow sinus drainage channel will become blocked. This causes the sinusitis and the severest pain, because of the pressure building up inside it.

If it is not treated effectively, then the bacteria gets trapped by the mucus in your sinus and this will turn into even more painful bacteriological infection. Any pharmacist should be able to confirm this to you. This will allow you to be more informed when you see your consultant.

My reference to your Eustachian Tube working relates to the fact that 'popping' is your ear drum responding to changes in air pressure. Ironically I have just experienced one while writing this. This is exceedingly rare for me.

Your E.T. is not clogged. If was clogged, blocked for long periods, then this would create ear infections, because air would not be getting into your inner ear. I did not claim you did not have E.T. problems. You should be able to find a reference from some E.N.T. consultant on the web to confirm this.

In your own words you consultant explained your frontal sinus problem, which is either a sinus problem or a pure headache. Severe E.T. problems would have caused you earache. There is no evidence to suggest you have E.T.D. whatsoever.

In respect of your reference to an operation, a operation might be needed if you had deviated septum, which would make you more inclined to have sinus infections, but it is likely to cause you more problems that it will solve.

I would not read too much into your E.N.T. examination. The procedure would not look inside your maxillary sinus. I had a scan five years ago and I knew at the time that I would it would not show up my problem. Inflammation can vary during the day. Your sinus can be mildly inflamed without it being very painful.

You are too obsessed with your ears. The curse of the type of problem is that is very abstract, it cannot be clearly seen. I cannot say with absolutely certainty that I do not have some inflammation in my sinus today, for instance, and I know I had a mild problem with my frontal sinus over the years, but I have not had any symptoms there. The Eustachian Tube is a symptom that the only symptom that you can physically clearly recognise.

I would be interested in what steriod nasal spray you were given, but I will not be prepared to advise you on what to take. This would not be fair upon G.P. practises. Pharmacists can advise most people what to take.

You are lucky that I am retired and I chosen to respond to what I offered you, because I found your response dismissive. Very few E.N.T. consultants would have met someone like me, because my condition is so rare. I have enjoyed the support of very informed consultant.

I might offer you further advice if you advise me of the short and longer term outcome of your problems.

You will be aware that there are lot of people struggling with E.T. problem throughout the world because there is currently no validated, proved means of directing attacking the E.T. with medication. I would be advisable for you not to try to attack the problem.

Howard

9

Hi Howard, thanks for your very informative response. Do you have a medical background? I'm by no means blaming this all on my E.T as my overall problem, I completely understand that the issues I'm having with myears is more likely a result of inflammation somewhere e.g. my sinuses which you clearly just stated. However this doesn't change the fact that this is the main area of suffering for me which is why its the point of most discussion.

When I last visited the ENT I was presribed flusonase drops and spray which I took for months with no significant results. I was the person who spoke to my consultant who actually told me after putting a camera up my nose that the problems I have was not a result of my sinuses? Therefore its very reasonable for me to scrutinise the information I was given. At no point have I been asked about allergies, TMJ etc. The symptoms I have could be a result of various problems that are hidden by nerve pain due to inflammation and this should be the starting point for doctors. I was also diagosed with cluster headaches before I saw me ENT and then I was told by various doctors this is extremely unlikely and this has been proven over time. I completely understand what your saying regarding my sinuses because the severe pain and pressure I get is always on my left hand side mainly which is the same side as the problematic ear. I really appreciate the time you've taken to respond. Any additional information would be great, I'm seeing my ENT on the 23rd of April.

I'm still struggling as I honestly don't know what the ENT will say when I go next time so I'm a little nervous.

Thanks again,

Jack

10

Dear Jacko,

I have explained my background in related discussion posts. I am someone who had chronic asthma, sinusitis and E.T.D dysfunction all my life because of allergic hyper-sensitivity.This means that I will suffer far more severely from these problems than most people.

My problems have been chronic. I have learnt a considerable about about my health problem through my consultations with my consultant and through personal experience.

I cleared my asthma out about ten years ago. I cleared my sinus problem five years ago and I am now on the boundary of clearing up my Eustachian Tube problems. It has taken me a tremendous amount of work to finally solve my nose/E.T. problem, which has only been possible because of the newer generation medication that I am on now.

A point I made to my consultant about four years ago is that there was a simple solution to my health problems then we would have found it. In such circumstances it is naive to believe that anyone one can magically offer patients a solution to such problems. E.N.T. consultants rarely see patients with the severity of problems I have.

It is very evident to me that you demonstrate an abject lack of understanding of everything that you claim to have read and I have explained to you. No G.P. or consultant has the time to explain in detail everything to you about any condition. I can assure you both nose and E.T. functions are not as simple as they appear.

I am unclear of whether you have taken the time to review what you said to me. You certainly do not appear to have thought it through it. If you were in such severe pain then I am at an utter loss to understand why you did not seek some professional support immediately by seeing a pharmacist. I gain the impression your problem is your cluster pain. They would have been able to advise you on this.

I do not intend to enter into further dialogue with you on this issue, because I do not believe that you are totally committed to solving your problems. It is possible I might reconsider this if you go and see a pharmacist. I am only posting this for the benefit of anyone else that should research this discussion.

11

Hi Howard,

Responding to what you said regarding your an utter loss to understand why I didn't seek professional support immediately. It's hard for me to understand your response because you seem to think you know everything about my personal circumstances which is far from the case, clearly. If your going to use these forums you need to approach how you speak to people differently because it comes across quite rude. You may have much more experience and knowledge in this area and maybe my frustration is part of the issue. I saw three doctors, I spoke to two different doctors on the phone (on call) and saw a doctor when I actually went to A&E with severe pain last December when I had the severe sinus/headache pain. It was only until then that I was given an appointment to visit my ENT. I then visited my ENT twice and also my mum is a fully qualified nurse who is extremely knowledgeable.

I understand my issues are due to inflammation somewhere which is what my ENT told me. I further understand that my E.T is most likely a secondary result of a different problem. I think you've been very informative and I understand how sinus's work, and viral infections also already. My pain isn't cluster pain because it's nothing like 'cluster headaches' are described. If I had cluster headaches I wouldn't be on here I'd be in hospital needing oxygen.

Cheers

12

Why did you not tell me all this sooner? I feel very sorry for you Jacko. I would not have been saying what I said to you when I was your age. I had seriously debilitating health problem which was undiagnosed until I was thirty. I have just read what you just said and it is clear to me that your E.N.T. consultant does not know what your problem is.

If you E.N.T. consultant does not know where you problems are, then you cannot expect your G.P., out of hours and casualty doctors to know. It is unlikely to be the kind of problem they will have expertise in and regularly experience.

I agree with dealing with anyone on website is impersonal. I cannot say what I would like to say to you because everything I say is in the public domain. This is why I have repeatedly asked you to see a pharmacist. I have been just be talking to mine. He is very knowledgable.

I would expect pharmacists to understand everything I have advised you. I know because I was talking about my E.T. problem with one today. All consultants are dedicated to diagnosis and they are not very good a communicating things to patients other than diagnosis. Nurses/phramacists do a much better job of that.

I am prepared to help you, but I am not prepared to spend hours working on this when you should be able to learn a lot from pharmacists. I spoke my mind to you to make you see sense

I am confident that I have worked out what your problem is. I am 95% sure.

It would not be helping you by telling you now. You must be more legalistic and keep an 'open mind' about all possibilities. I may not respond to any response from you until the middle of next week.

13

Hello Howard,

Sorry for my late response I've had a busy week with university and work. I agree, the GP's I saw regarding my issue told me it was cluster headaches and then the doctor in A&E referred me to ENT because she saw how much pain I was in and how this was controlling my life. I didn't for one minute believe that my GP or any other doctor I spoke to on the phone etc. knew really what my problem was. A few said it was migraines, and I'm not by any means knowledgeable about these things but I know my body and I knew it wasn't.

Now ill share a few specific symptoms with you Howard to see if this can shed any light on my problems.

I get the stuffy nose times at night and when I wake up, I get pressure pain behind my eyes in the morning sometimes also. I have the heavy sinus's (left side mainly), left ear popping constantly, tinnitus and stuffy feeling ears. The ear problems are continuous however the sinus problems come and go, generally when I've had a cold. I sometimes feel groggy and like I'm coming down with a cold.

Head pressure or severe pain (feels like bad sinus blockage only on left hand side eyebrow also in the corner above my nose. This has only occurred once or twice since I was seeing my ENT a year last December. This comes on when I sneeze? About 1 month ago I had my cold... when I made this original post. I had gotten over the cold and had a day where I felt fine, after getting rid of the sinus pressure etc and suddenly a sneeze from nowhere and this pressure, pushing, sharp sinus pain came on. The only painkillers that seem to work as mentioned earlier are only strong anti inflammatory tablets. After taking 1 tablet the pain went and its not come back. I wonder if the fact its when I sneeze the head pain comes if that means anything? It's only ever on the left hand side which is the same side as my ear problems.

Not long now until I'm back to see the specialist.

Thanks for your support

Jack

14

You are missing the point and the question, there are many more reason for developing sinusitis and the camera it's not enough. Dismissing after a quick camera examination is typical behaviour of NHS specialist, It did happen the same to me the specialist saw examination me with the camera and tried to dismiss me, I suggested an allergy test and it came out extremely positive, thanks that useless was so convince I had nothing and did not ask to see me back. I am continental an went straight abroad as I was not impressed with allergy specialist in here but my Gp could arrange another ENT who happened to care and order a CT scan, still waiting results bug that gives you an Idea, I you cannot just accept the decision of a practician if sorts no problem. And this us not easy I know, myself I changed gp, ENT and partially went private but if the NHS doesn't care about this condition, like doesn't card about almost anything is not life threatening, guy it is your duty to react.

Good luck with the Ent

Just wanna help

Dave

15

I did advise you to see a Pharmacist which you have no done. I am confident that they would have narrowed your problem down for you.

In respect of Dave's comments a practice nurse will be able to diagnose and treat sinusitis without the need of cameras. He was advised he had a positive allergy test. The problem with his type of problem is that the symptoms may not be present on the day of the E.N.T. consultants examination. E.N.T. are normally not allergists. There are clear recognised treatments for his problem. I advise him to see a pharmacist.

Please would you advise me of whether you smoke.

Howard

16

Dear Jacko,

You have admitted you suffer from depression.

These are your words that you said in your earlier post:- "I've read around this topic plenty as I've been suffering with these problems for years now and not only does it make me **feel depressed**, and out of it but it **prevents me sleeping proper** for weeks sometimes and then I feel exhausted and nobody understands!"

I understand. Your exhaustion is not related to your physical E.N.T. symptoms, but it related to the fact your not sleeping properly, you are run and you are clear depressed. This will account for your headaches which is clear symptom of anxiety/depression. A pharmacist would have told you that had you bothered to consult with one.

You posted on this site that you had "Chronic E.T.D.", but it is blatently obvious your symptoms are trivial and you have not referred to a critical symptom that should be currently associated with the state of your E.T.There is no evidence you have any significant maxillary sinus problems either.

The danger with reading forum website is that you can start imaging problems you do not have by exagerrating your symptoms, especially when you are run down and depressed. You are not the first in the world to suffer from depression. When you recover you will see things more clearly.

Unless you sort it out it will interfere with your college exams because you need your sleep. This is the main reason why I endeavored to help you.

No one can say with absolute certainty whether there is problem with your headache, it might be some neuralgia, but it highly unlikely that you have a problem there.

I would suggest you go and discuss you problems with a pharmacist and then see your G.P.

I should be very annoyed with you, but I understand depression and I feel sorry for you.

I view this discussion as closed.

Howard

17

Hi there, I'm really interested in your comments. I am a regular sufferer of sinus problems, which also cause problems with my chest, which the doctor feels is possibly asthma, but also related to tuberculosis, which I had around 20 years ago and has left my lungs scarred. I've had an outbreak of sinisitus since February which hasn't cleared up, I've got pressure in my ears which is currently driving me mad!the doctor has just given me some  momenta stone furoate along with an inhaler, which I've been using for about 4 days, but it just doesn't seem to be clearing up. I'm going for an asthma test on Thursday and been referred to chest clinic. I haven't read all your posts as yet, but if anyone has any advice then please write away, it would be very much appreciated sad

18

A Welshman - you clearly didn't read my post! I've had this bout of sinisitus since February which hasn't cleared,yes I have only been on this medication for 4 day but, it's not the first batch of medication I've had since February, so not expecting miracles! Just expecting it to clear up in a timely manner. 

I haven't read the information you refer to but will do - thx

19

Hi Jacko. I am very sorry about how bad you feel and hope it is better now. For what it is worth I have had similar experiences. The tubes are probably grommits which they insert to get rid of fluid in the ear.  But everything I have read up on points to how the fluid in the ear comes up as a result of acid from the stomach so you would need to get that stopped. Your stomach has a splincter in it - a bit like a cat flap - that should automatically stop acid from rising up into your head but if it has been weakened it can allow the acid to rise up where it should not, causing sinus, headaches, face pain and bad ear(s);. If this is the case  pp1 andpp2 would stop the acid rising but also cause other problems. It is better to think of eating less acidic foods and more alkaline foods, smaller meals, and not eating in the evening. As you are quite young you have a head start, it is far worse after many years.

20

p.s. Jacko.  I cannot see any point in people posting simply to tell you to go to hospital or a doctor or pharmacist, am sure you are not that stupid that you would need to be told such obvious things.