ETD - Blocked Ear? Tinnitus?

These are classic symptoms of Eustachian Tube Dysfunction (ETD)  If you are reading this, then you are probably suffering from some of these issues?  I am written this because I have had to suffer this nasty condition for 2 years on and off.  Hopefully my experience will help you in some way to deal with this problem.  I have spent hours during my many sleepless nights looking up Google entries on this subject in the hope that there is some magic instant cure for this.  Unfortunately there is no such thing.  However there are a number of things that you can do which may help to speed up your recovery and get back to normal as quickly as possible.  I have also included a few links to help you find some of the things that I found useful.

If you lose your hearing in one or even both ears, perhaps in the middle of the night, it comes as quite a shock and can cause great distress.  You may also have a pressured blocked feeling in your ear and a loud noise such as a roaring sound or ringing sound or both.  It is very unpleasant!  Whatever you do, please don't panic.  Stay calm and try to keep in mind that in the vast majority of these cases it will go eventually!  It just might take some time.  I have suffered two bouts of ETD, one after the flu in 2010 lasting 6 weeks before it finally passed and secondly for a 6 month period again following a virus from January until July 2011. During that time it came and went, usually in cycles of 3-5 days with severe disorder followed by the same period of easing off, before starting again.  I visited my GP a number of times and was finally referred to the ENT after 3 months, however this was only as a routine case, meaning a further wait of 2 months before I could be seen by someone who might know what they are talking about.  I had an MRI which showed no abnormailties.  By this time it had eased off and my hearing had returned to normal.  However even to this date now (9 months after it started)  I am left with creaking and popping ear tubes and worse still an intermittent low level humming in the affected ear.

ETD is caused by fluid (mucus) building up in the middle ear under your ear drum.   It does this because your Eustachian tube is obstructed either by an allergy, an infection, a virus or sometimes a change in shape or function.  Often this will follow a cold or throat infection, but can also occur in isolation. Your Eustachian tubes connect your throat to your middle ear and provide the only air into the space behind your eardrum.  These tubes open when you swallow, yawn or during eating.  When they open, they let air in to maintain the pressure indie the ear and also let out any mucus originating from the ear and tube, therefore it is essential that they operate properly. Common symptoms include:

• Painful pressure or fullness feeling felt inside the ear (like being underwater)
• Hearing reduced, soft, muffled or even tinny.
• Tinnitus heard at various levels.  This can be a roar, whooshing and or a 'tuning fork' type ringing sound.

Most adults will suffer Eustachian Tube Dysfunction to some extent during their lives.  Thankfully most will only get this in a mild form and the symptoms will be minor. The unlucky ones (me for one!) can get this in a severe form and cause absolute misery for days, weeks and sometimes months.  Children also get this with the condition known as 'Glue Ear'.  This will often involve grommets being fitted in the eardrum to release the fluid.  This advice is aimed at adults dealing with this condition.

The cavity to the right of the ear drum fills with fluid.
Click to enlarge.



So what can and should be done?  Firstly see your doctor.  This because the cause of this could be an infection.  Your doctor will examine your ear drum to see if it inflamed or push inwards because of reduced inner ear pressure. If that is the case, you may be prescribed anti-biotic, although often these can have limited effect with inner ear problems.  You may be prescribed nasal spray or decongestants (see below)  Initially you will not be referred to an ENT.

Described below are some self help measures which you may want to consider.  In themselves these are not a cure, but collectively may help your body deal with this problem and eventually clear your middle ear of the fluid that is causing the problem. I tried all of these things and to be perfectly honest I am unsure if anything was particularly effective or totally useless.  There is nothing that will instantly relieve these symptoms.  If anything will work it takes time, days even weeks to finally start to get things moving again.  Patience is required unfortunately, which is little comfort when your ear is blocked, you feel inner ear pressure, loud noise and you cannot sleep!

Get those tubes open again.  You need to open your Eustachian tubes as often as you can to get air into the middle ear cavity and also allow excess mucus to find it's way out. When you achieve this you will hear and feel them pop or crack (this is good!) You can do this by swallowing hard or falsely yawning, pushing your jaw forward hard.  Use the 'Valsalva movement', which is done by pinching your nose and blowing quite hard with your mouth closed, filling your cheeks until both tubes pop open. It can take a while, but keep going. Hold them open for a few seconds, release and then swallow.  Do this 4 or 5 times a day at least.

Anti-inflamatories.  I believe that these drugs can help.  A common cause of the ET not working is inflammation in or around the ET's and by reducing this you can help things to get back to normal. It's worth a try, but keep going as it can take days to take effect.

Chew gum. Do this as much as you can and preferably use a menthol gum.  The chewing action will help the tubes to open naturally and the menthol will assist as well.

Use steam and lots of it. Using steam will help to free up mucus and open the tubes up. Do this as often as you can.  If you have access to a steam room, then use this and sit in there for an hour.  Using Olbas Oil with a steamer is very good.  A facial sauna machine is a good substitute as this will keep the steam hot for longer than a normal fill inhaler. This is a good one to consider HERE  Whilst breathing in, open the ET's by yawning. Using a bowl with a towel over your head is OK as well. I buy my Olbas mail order HERE

Heat pad.  Use a hot water bottle wrapped in a thin towel and hold it tight against your ear as hot as  you can stand it.  The heat will radiate through to the middle ear and will help to free up that stubborn mucus.

Nasal sprays.  These can be useful to start to free up the sinuses and ET's.  Saline spray is safe and some say quite effective.  Others include decongestant and steroid sprays, however take care not to over use these as this can cause a re-bound affect and end up prolonging the problem and not helping it. In other words your tubes get so dry that they will not be allowed to function and more mucus is produced to deal with that problem.

Sleep upright.  Don't lay flat because the fluid will shift into places that will not help.  Prop yourself as high as you can, which will naturally allow the fluid to drain. The problem ear should be upper most.

Use a distraction to relieve the tinnitus. If you need to spend the night sat in front of the TV to drop off to sleep then do whatever it takes.  Relaxing music through headphones or a pillow speaker can work, as can 'white noise' which can cancel out the ringing or loud hissing sounds often suffered with this.  You can download these files or purchase them.  Experiment with various tones as some will work and others will not.  Try this site http://www.simplynoise.com/  For not a lot of money you can get a small sound machine to take your mind off the noise and mask the sound.  This one is sold by Homedics.  There is a good MP3 download here of tinnitus distraction sound and music HERE

Avoid alcohol and caffeine.  These are stimulants and will enhance any tinnitus that you have. The  temptation may be to lose yourself with drink. This will not be productive. Now is a good time to try herbal and green teas.  Drink other hot fluids such as diluted fruit juices with honey which can act as natuaral decongestants and help with keeping your body hydrated.

Oral decongestants - you decide? The jury is out on these.  Some advice will say use them.  My doctor said treatments such as Sudafed are a complete waste of time to deal with this.  Yes they may dry up mucus but don't forget that we actually want this stuff to clear by running out, not drying to hard deposits in the ear. This can cause the ear to produce yet more mucus to shift the dried up deposits in what is referred to as a 'rebound affect'.  I did use them initially, however I will not the next time if this comes back as I am convinced that prolonged use of these did me more harm than good.  Piriton I found very good at drying up the mucus, however this caused my ear to block again and also caused the tinnitus to worsen.

Nasal irrigation - Many will suggest this as being helpful.  The Neti Pot is the most popular.  I used the SinusRinse system by Neilmed  which is easier than a Netipot and did seem to help. I would say for a small outlay it is worth a try, particularly if your sinuses are blocked as well. Amazon sell this HERE

Look after yourself.  Eat well and ensure you are getting what you need to stay strong.  High dose vitamin C is viewed by many as good to help battle this.  Dairy food is thought by many to be one of the biggest causes of excess mucus.  No evidence exists to say that it is, but for me avoiding this when your body is trying to shift it is probably a sensible sacrifice to make.  Certain food groups are thought to be inflammatory which may be triggering this problem.  Look at these foods and restrict inflammatory foods. Fresh garlic, ginger and fresh pineapple are excellent natural decongestants.  Gentle exercise may help, particularly in the fresh air, but avoid strenuous aerobic activity as again this creates more of the stuff you are trying to shift. Keep well hydrated by drinking you daily consumption.  Use this consumption calculator HERE

Devices may help.  There are a number of devices available aimed at relieving this problem.  The Earpopper may help if you are unable to open your tubes up yourself.  Earpopper  The Eardoc produces high level vibrations through the ear which is claimed will open up the tubes and allow the fluid to drain. Eardoc  Any other device which can produce vibrations to the ear may help to get things moving.  I have used both of these devices and found neither to be effective, but they might work for you.

Clean Air.  I noticed that going out in the fresh air would often help relieve symptoms, so you might conclude that being able to live indoors and particularly sleep with clean air free of dust and other allergens may help you deal with this.  I obtained an air purifier Ioniser which I left on before before going to bed and kept running through the night. The air certainly felt fresher and with the added bonus that the fan noise would take my mind off the tinnitus.  This is a good model to consider at a reasonable price. HERE

Homeopathy.  There are some natural medicines available that may help.  Just search 'Ear Problem Homeopathic' to see what is recommended.  Kali Bich is thought to be particularly effective at helping with ear, nose and throat disorders. Echinnacia is worth considering also.

Think positive.  It is very easy at 3am with no sleep and an ear that feels like it's going to explode, to feel that the world is ending and that you will be cursed with this forever.  You must keep positive and believe that will go.  Virtually all cases of this will clear up, unless you have a rare complication which will not allow this.  If you have this for a prolonged period, you must pester your doctor and demand to see a specialist.  This is because he/she is the only person to see if there is an underlying cause which needs other measures. Medical interventions are limited to solve this and the exact causes of this illness are still unknown.  As a last resort grommet's can be installed in the ear drum, but for many reasons this should be carefully considered.

In summary, what I suspect helped me the most was regular inhalation using Olbas Oil, taking Ibuprofen and getting air into the middle ear.  I cant be sure, but these remedies appeared to relieve the symptoms.

I am not medically trained and these thoughts are only my own based purely on my experience of this horrible condition.   Please take time to add your comments and experince below.   Good luck.

Regards Dave.

Useful links

http://www.patient.co.uk/health/Eustachian-Tube-Dysfunction.htm

http://www.rnid.org.uk/community/forums/tinnitus/eustachian_tube_dysfunction_tinnitus/

http://www.nhs.uk/conditions/otitis-media/pages/causes.aspx
http://etd.myfreeforum.org/index.php 
http://etdtinnitushelp.forumcircle.com

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