Plugged ears

Obstructed ear

Plugged ears are simply the sensation that the ears are obstructed.

The patient may say that he feels a sensation of fullness in the ears. It can be a real mechanical obstruction, such as in a case of a plug made plugged earof cerumen (ear wax), fluids in the middle ear, infection or cholesteatoma in the middle ear, poor functioning of the Eustachian tube, or a retro-cochlear cause.

Plugged Ears and Meniere's disease

In patients who have Meniere's disease, Plugged ears are one of the 4 major symptoms. The sensation can come and go, it can be bi-lateral or uni-lateral, and repeated Otoscopy shows normal tympanic membrane (ear drum).

There is absence of the typical picture that can be found in infected ear (bacterial otitis media), fluids behind the tympanic membrane (serous otitis media), white matter behind the ear drum (cholesteatoma) or retracted membrane (tympanic membrane in non functioning Eustachian tube).

Hay fever, other types of allergy, and barotraumas may be causes of plugged ears.

Mr. Backman Amir, the musician, tells about his tinnitus after he suffered from barotrauma (see video clip).

Plugged Ears and Non-functioning Eustachian tube

This complaint may direct the Otolaryngologist to diagnose a Non-functioning Eustachian tube. The sufferer may push the expert to perforate the tympanic membrane, or even insert a fine tube to the middle ear via the tympanic membrane, in order to achieve equilibrium between the atmospheric pressure and the air in the middle ear.

See the video clip of Dr. Arie Yagoda who had surgery for insertion of a tube to his ears.

Audiogram left acoustic neuromaWhen the sensation of Plugged ear is retrocochlear, there is no indication for perforating the ear drum.

Typical complaints of plugged ears

The sensation of plugged ears can be unilateral (only right ear or only left ear), and it can be bi-lateral. the senstion may come and go for hours, days and weeks. The level of hearing is modified.

The change may be in the quality of sounds, the ability to discriminate between words, or general hearing impairement.

The patient becomes scared because he never knows if the quality and loudness of the sound that he is hearing will stay the same or he will recover. It is a real fear suffering from incapacity and not just anxiety.

Many times the sensation of plugged ears is acompanied by louder tinnitus. Such a tinnitus is very annoying and frightening. The sufferer complains that he does not have any way to modify the two symptoms.

Chewing gum does not help to open the plugged ear (in most of the patients), and masking sound does not help to ignore the tinnitus (in Audiogram noise induced hearing lossmany of the patients).

Retro-cochlear disease, such as acoustic neuroma, may cause a senstion of plugged ear.

Nomeclature of patients

Patients may say plugged ears, fulness in the ears, clogged ears, obstructed ears, blockade of ears, pain in the ear, lock in the ear, barricade in the ear, mass in the ear, obstacle in the ear, occulsion in the ear, ear arrest, ear shut off, closure of the ear.

Order of symptoms: monosymptomatic plugged ear versus part of a tetrad

Plugged ears are not the first symptom in a typical patient.

When a patient is coming with a single complaint, the Ear Nose and Throat expert should rule out other possibilities for the complaint of the patient. Tests for the vestibular system may help to decide where is the main location of the disease, even when there is no attacks of vertigo. When the ear is plugged on one side, the probability of bacterial otitis media, viral otitis media, serous otitis media, cholesteatoma or acoustic neuroms should be considered.

Meniere's disease comes in the last place because it does not carry any immediate risk when the diagnosis is not done in real time. When the plugged ear is bi-lateral, hay fever, other types of allergy, auto-immune disease and meniere's disease have higher priority in the differential diagnosis.







































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