Blocked Eustachian Tube

[Ennie]

I've been suffering with a blocked Eustachian tube in my left ear for a month now, still not gone despite several trips to the Doctors and countless tablets and de congestants.

Has anyone ever had the same problem, if so how long were you off for, and have you any suggestions as to what may help clear it faster? I'm really wanting to get back to work, employer is fine with me being off with this problem, but I'm starting to miss the flying! :ugh:

[WaterMeths]

Hi Ennie

Sorry to hear of your discomfort.....do you have any other symptoms such as a long term cold, stuffy nose etc, or is it just the tube that is blocked?

If so it must surely be a persistant infection caused by some bacteria or other. I presume you have tried antibiotics ?

Hope you get flying again soon.....

[Tip tank]

Sympathies.....there are loads of threads on hear about blocked ears, problems equalising etc.

I have the same problem and it is looking like it will probably cost me my job. It just won't go away. It doesn't necessarily mean you have an infection either although you will probably have discussed that with your GP. Here are some of the things I tried, although I would suggest you get medical advice BEFORE tying anything else as I am not medically qualified!

Obviously try steam inhalation, that might shift the mucus.

Nasal sprays - Nasonex or Flixonase. Could try a good dose of Otrovine but can only use it for a week I think.

Also, expectorants (e.g. Benadryl) are designed to work on chesty coughs but can also loosen mucus elsewhere.

Drink LOADS of water - if you are well hydrated it can help it run out.

Ear Candles - bit crazy - didn't work for me but you never know.

Acupuncture.

Herbal remedies to open up the tubes - tried loads but can't remember the names...a good herbalist will help you.

Cut out dairy, alcohol, starchy foods and load up on fruit and veggies....all can create mucus (search for "mucus forming foods" on Google).

Get your GP to do allergy tests and food intolerance tests for the same reason.

A last resort is getting grommets in - ventilation tubes in your eardrum to equalise when your eustachain tube won't...can cause long term hearing loss though so you really need to think hard before embarking on this. Some specialists will say it doesn't but do your research...they will fall out and repeated re-insertion (especially if it is a longer tem grommet or a "t-tube") can leave a permanent hole (perforation) which leads to hearing loss and requires more surgery to repair. Not sure if this repair returns your hearing to normal though.

Your GP can't help - their training only goes as far as glue ear in children and dispensing antibiotics, nasal sprays etc. Go see an ENT specialist.

None of this stuff worked for me but I hope you will have more luck. I am of the opinion that once your tube is blocked, there is very little you can do to clear it. The gunk gets up there and just sits in the tube I'm afraid.

Keep us posted though - good luck. I hope you get back flying soon.

[WG774]

Ennie - how are you getting on?
I've been struggling with intermittently blocked eustachian tubes since childhood (I'm now 36).

BTW - to my knowledge, grommets are being pretty much phased out in the UK - there's a more effective treatment which is more invasive medically, but more effective.

When the blockage came back in 2002, my GP went spare with me and said he had no time for smokers, and that the issue would go if I quit cigarattes... I quit smoking (20-a-day) there and then, but the blockage hasn't gone away.

My reason for bumping this discussion is to see if anyone here has tried Endonasal Therapy (try a Google - I don't want to link to commercial sites).
Apparently, ET is common practice in the US, and has been very effective for some people, according to reports I've read.

Unfortunately, I can't find anyone in the UK who practices ET, and the US is a fair way to go just to try a 5-minute outpatient's procedure...

Anyone? Blocked tubes are a common issue for those who fly regularly - it could benefit the community here if we can share info and experiences with ET.

[Hufty]

I have tried Endonasal Therapy - like you I tried pretty much everybody I could think of in the UK but nobody had ever heard of it let alone practiced it! I tried my GP, an ENT specialist, chiropractors, naturopaths, cranial sacrotherapists......it just goes on and on.....

There is one clinic in the US that does this (in Pennsylvania) and I understand that some chiropractors do it too. The thinking is that you can get gunk building up at the ends of the tubes and it causes them to block. "Sweeping" this gunk away in theory causes the tubes to drain. However, I understand that it is unusual for people to have gunk there in the first place and a good ENT guy should be able to examine the ends of your tubes anyway with one of these long things with a light and camera on the end to check.

It is a very uncomfortable procedure (I read on the web that you can do it yourself but there is NO WAY I could) and involved the guy shoving his finger further back in your throat than you imagine it could ever go and really giving the ends of the tubes a good hammering with his finger.....not pleasant and a bit sore. :yuk:

It didn't do a thing for me (no gunk) but I suppose if you do have this build up it would be an effective treatment. They also give you peripheral natural treatments designed to improve the lining of your nose but none of it helped me. He also is big on allergy testing to will offer advice about that and food intolerances etc. on the assumption that your problem is to do with allergies (which of course it may not be). Still, it was good to have tried. My ear problem turned out to be to do with a wisdom tooth.

If you are planning to get it done please PM me...you will likely have read about it on the same web site I did and will likely visit the same clinic. I can recommend places to stay, eat etc.... and can give you a complete heads up before you go.....

Have you tried a good physio? I know you're thinking "what?" but there is a large nerve that runs into your head called the Trigeminal nerve - if you have problems with posture, slouching etc. this gets trapped and can cause problems with your tubes amongst other things...also it can give you problems if you have stiff neck muscles etc. for the same reason, all according to a chiropractor and physio I saw once. Also read up on TMJ - the disorder of the jaw joint - the jaw controls the muscles that open and close the ends of your tubes and any imbalances or muscles spasms due to incorrect bite or tension in the jaw muscles apparantly can give you tube problems too.....

Please note though that I'm not medically qualified - all this is just what I have been told and from things I've read...the problems is that there can be soooo many reasons for this condition, you just really need to try stuff to see if it works - it is impossible really to diagnose since your tubes are buried in your head!

[Loose rivets]

Remember that when you quit smoking, you will likely go through a period of troublesome thickening mucus.

This can take up to a year to normalise, and is one of the main excuses that people give for going back to the weed.

Just see it though...your life will change for the better in the long term.

[WG774]

Good stuff, Hufty - thanks for posting!
It does appear that Endonasal Therapy is popular amongst 'alternative therapists' and for this reason, I'm a tad dubious.

I did think there was a possibility of TMJD, but I asked the dentist last time I had x-rays taken (I had 2 upper wisdom teeth out in the summer - they came through years ago, but had gotten tatty and needed removing) and he gave me the impression my jaw was ok. Is a dentist the right person to ask?

The big irony for me is that I seem to have developed health issues since quitting smoking... The ear blockages have been infinitely worse and I get mild eczema during the winter (have seen top dermatologists about this - they seem to reckon it's not a big deal as it goes away when the weather improves... It's not UV-related btw)

The safest thing to do with smoking is never to start - a truly pointless, miserable and expensive habit.

For double irony, I reckon that if I do have TJMD, there's a good chance it was caused by my use of nicotine gum... I quit smoking overnight, as the doctor terrorised me into thinking I was going to need radical ENT surgery to correct the blockage issue... I recommend the inhalator btw.

[Hufty]

I asked my dentist about TMJD and while he had heard of it, he was only really able to recommend a bite guard to stop me grinding at night - a cause of TMJD too so I read. I think dentists are kind of like GPs, they have a broad understanding but not the level of expertise that you need to deal with it. I also spoke to the guy who removed my wisdom tooth (a maxillofacial surgeon) and he stated bluntly that there was no relationship whatsoever between the jaw and the ears!

However, I am seeing a physio (my long term wisdom tooth problem has left me with a painful jaw even though it has now been removed) and she is really big on TMD etc. She reckons it is all about posture - even though your bite and jaw joint might be physically OK, the jaw moves very differently depending on the position of your head (I guess as gravity comes into play). She made me tilt my head all the way to the left and right and bite down - the teeth made contact at different sides depending on the direction you tilt your head. Thus, according to her, the muscles get strained (both jaw and neck) if you're slouching and your head is in the wrong position. She reckons it is all about muscles and nerves. Nail biting, pen chewing etc. can all be factors behind it too plus all the unconscious things you do - I realised that I tended to bite my lower lip a bit - never knew I was doing it till she pointed it out. My jaw joint was fine, but the muscles were either very weak or incredibly tight. She said my swallow reflex was all wrong too and I'm working on that.

It is difficult as there are several disciplines who will claim to help. As far as I understand, a dentist can help with your bite (filing teeth down, removing protruding wisdom teeth etc.) and trying to stop you grinding. A maxillofacial surgeon can operate to rectify a damaged jaw joint. A "neuromuscular dentist" (whatever that is) can apparantly help you with laser alignment of your jaw etc. (bit dubious that I reckon) but a good physio can help your body move the way it was designed to do. I have a very different posture now and according to her use a different set (the correct set!) of muscles to move my head. I still find myself slouching and holding my head forward but at least I am aware of it now. I used to sit with the seat reclined at work which made me hold my head forward a bit, but now I sit upright like an elderly woman driving (!) and it is more comfortable. Playing havoc with the flare - my excuse - sticking to it ;)

I get a bit of tinnitus too - I always thought it was due to me going to concerts etc. as a student and noise on the ramp, but she reckons it is partly due to the jaw trouble as the joint is really close to your tubes.

I also get a bit of exczema - still there but better since I cut out dairy. I also drink more water now (being hydrated can help thin out the mucus a wee bit.)

Have you tried nasal and sinus irrigation with salt water? I know this sound a bit odd but it crops up time and time again when you're searching for this kind of advice. I guess it works by cleaning out the nasal passageways - important I suppose as the end of the ET is up there.

[Flyin'Dutch']

If you have ET problems, go and see your doctor.

He she can have a look up your nose and in your ears, do some tests to make sure there is nothing serious going on.

A lot of folks with ET dysfunction have an allergy; most often housedust mite. They can be easily treated with some topical steroids.

Candeling of ears? Endonasal Therapy? Whatever next! :rolleyes::rolleyes:

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[Hufty]

Flyin'Dutch' is correct that your doctor shuld be your first port of call but after a while they run out of ideas.

Your family GP, however well-meaning, will look in your ears to check for infection, damage to the drum etc. then suggest decongestants, steam inhalation, anti-inflammatories etc....perhaps antibiotics if he or she think there is an infection. They will also suggest allergy testing etc. but that's about it. "Sorry we can't help you, but if I think of anything I will give you a call." That's what I got.

They may send you to an ENT specialist who will go a bit further but if your ear trouble is a symptom of something else going on, in my experience they won't have the first idea how to treat you. Sorry if that sounds disrespectful to the medical fraternity (and I am sure I will get a response from somebody) but that is the way it is. I wasted months trying all kinds of nasal sprays, surgery etc. I saw several ENT specialists and while it was clear that they were all very highly skilled and knew a great deal about their subject; they all hit a brick wall when it came to treating my ear problem.

I did some reading about the other reasons why you may have trouble with your ears and I uncovered a whole host of additional analysis and treatment options they hadn't told me about. I even mentioned to one ENT guy that I had a sore wisdom tooth and asked if that might be causing it (it was on the same side)......"There is no link whatsoever between your wisdom teeth and your ear trouble" sic. I had it removed anyway and the problem began to clear up. Co-incidence? Of course it could be. I started receiving treatment for poor posture and a sore jaw around the same time so it might be that, but the long term discomfort from the tooth was causing me to grind in my sleep which in turn was putting pressure on the jaw joint. I'm only going by what I am being told but it all makes sense and I am seeing people with a track record of treating these kinds of complaints.

My point is that the medical profession will try and treat your ENT structures to solve an ENT problem. That isn't always the source. I'm not endorsing any methd of treatment (conventional or otherwise) but there can be more going on that you need to investigate for yourself when your doctors run out of ideas.

Warning though, every therapist, doctor etc. will tell you they can treat ear problems. But what they don't know is if they can treat YOUR ear problems.

[WG774]

This is all very good advice – much appreciated.

You could be onto something with the ‘dust mite’ theory. I personally think the eczema is caused by exposure to dust mites (I get it on parts of the skin that are exposed to bedding when I sleep – fortunately, it’s not too visible, quite mild, but annoying).

I wonder if this is a crock: I was told that smoking can ‘mask’ allergies… ??? It does seem odd that I could go for 30 years without skin irritations, and intermittent ET blockage, to quit smoking and find the symptoms virtually permanent…

My GP told me to try Loretadine to rule out allergies. However, I was weary of being on Loretadine long-term, particularly since I work around dangerous machinery, so to be honest, I don’t think I took it for long enough to make a difference to the ET situation (about a month). The GP is good as far as GPs go, but he admits this is not his speciality.

It’s funny that someone would suddenly develop a mite allergy after 30 years of no allergies…

BTW – Ear candling can be very dangerous! I’ve read reports of people getting burnt ear drums from it! I also believe it to be outright new-age quackery – for ET issues, it’s the wrong circuit anyway.

Thanks!

[Hufty]

There is quite a bit you can do to reduce your exposure to dust mites....

You can buy these mattress, pillow and quilt protectors that you zip around them to prevent the dust mites getting in. Also vacuuming your mattress and spraying soft furnishings with anti dist mite spray can help. I am told you need to wash things at a highish temperature in order to kill dust mites too.

I removed the carpet from my bedroom recently and even though it was vacuumed regularly and had been professionally cleaned not long ago, it was still bogging! :yuk:

[gingernut]

Your family GP, however well-meaning, will look in your ears to check for infection, damage to the drum etc. then suggest decongestants, steam inhalation, anti-inflammatories etc....

If you do find something better, please let us know!

Whilst I understand your frustrations, it does have to say that the "science" for ent interventions isn't always that robust, and I'm not sure an expert can offer that much more than your GP, although it's likely he'll have access to the scans and investigations required to rule out the nasties.

Try running a search, it's probably one of the most sought after solutions on this forum, and as, yet, I havn't really seen any magical solutions.

I'd be a little cautious consulting non-qualified folk about this very delicate, and important area of anatomy. Ask to see some evidence of effectiveness, other than anecdotal cases studies, and never trust anyone who offers solutions based on pathophysilogy alone- make sure it's tested on a thousand patients first. (A little tongue in cheek perhaps.):)

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[WG774]

Hi,

I saw the GP today. In my totally non-clinical opinion, I reckon he's a good GP.

He reckons there's no problem being on Loretadine long term, so I really should try it for longer than a month this time (he explained why Loretadine is different to other anti-allergy medicines, and it makes sense that it's safe long-term).

He confirmed that smoking *can* mask allergies in theory... Well, I never...

He also reckons it's safe to use nasal inhalers long-term as well. He explained that the steroids are flushed through the body, unlike other steroids (please excuse my vagueness there).

From scanning the forum here, it does appear that it can take a long time to clear a blocked ET. So, current plan is to take Loretadine and Nasal spray for at least 4 months and re-evaluate the situation.

The GP reckoned that blood results for allergies are notoriously vague and suggested to me that, if they were accurate, why is it that many people spend months / years finding out their specific allergy via process of elimination?

Quitting the cigs is for the best long term, but it appears to have made my tube issue worse!

I also intend to drink black coffee now and only use a dash of milk for morning cereal. The words 'straws' and 'clutching' spring to mind... Having said that, this discussion has been of definite assistance - thanks again!

BTW - the most useful treatment I know of is to go for a hard cross-country run -it's temporary, but seems to make a difference, although it could be placebo as a run generates endorphins.

[emoo]

The user above me hit on something at the end of the post, with the running...


I have had blocked eustachian tubes for a while now, and I have smoked up until recently. I also used to blow my nose (with quite a bit of force) until I started to realize what I was doing to myself. I have had a problem with "stones" coming from my tonsils and eustachian tubes, and recently learned that the problem also extended to my sinuses. (My troubles all date back to my one and only massive sinus infection)

Our (human) nasal passages and throat/eustachian tubes empty themselves using the venturi effect, like a carbuerator. They were never meant to be highly pressurized (no hard nose blowing). I have been told all my life to not "suck back" my mucous, but I have recently learned that it is the natural way for my body to cleanse the nose and throat area. As I draw air past the sinuses and eustachian tubes, the material inside of them is drawn out into the major passageways where the airflow is, using the venturi effect.

When I started doing this, I could feel large pieces of solid matter being sucked out of my sinus cavities into my nasal passages, and I could also feel the same occurring for my eustachian tubes in my throat. I could feel the debris as it came out of my nasal passages and eustachian tubes and went down my throat. It also left a slightly offensive taste in most cases.

I found that running and focusing on keeping the air flowing across the openings to my eustachian tubes would almost always cause large amounts of this matter to be flushed. After running I could feel significant liquid drainage from my eustachan tubes. After a while, I got to the point that my ears would tingle from the air flowing past the tubes, and I knew I was definitely on the right track.

I have sworn off nose blowing almost entirely. I have also sworn off anything that stops "runny nose." Why would I want to shut down a part of my immune system? That sounds stupid. In fact, the runny nose that my girlfriends cat gives me has actually helped relieve my ear pains once, while I was "sucking back" the mucous.

Chugging water also has a similar effect on the throat, I've found. I get a large quantity of water and drink, filling out my whole throat and continuously chug the water until I cannot continue any more and this usually also provides a similar type of relief on the eustachian tubes. It makes sense, considering the water is as good or better than air at providing the venturi effect.

I have only quit smoking for a few months, but figuring out how my sinuses and eustachian tubes work has massively expedited my recovery from years of ENT problems. So far, aerobic exercise like running and large mass of water while focusing on drawing past the eustachian tubes are the two largest tools I have found to eliminating my blockage problem.

I think, though, that the very root of my problem is an infection that creates these blockages. I get a feeling that this infection moves about my ENT area. If I have not fully recovered after a year of being cigarette free, I will probably try some antibiotics to help me out.

Who would have thought my interest in high performance engines would lead me to a (very simple) solution for my ENT problem. :ok:

[coxy]

I know its sad but its really encouraging to find people with the same sorts of issues....

I had my first sinus infection in April. I had pain in all my sinus's, but the main issue was pressure in my ears which did not shift... I tried blowing my nose for weeks, took thousands of sudafeds, nasal and ear drops and even a short course of antibiotics. Im 36, drink a bit too much and smoked up until about 29.

In the end my GP told me with respect, he didn't have a clue and reffered me to an ENT specialist. (I now have found a GP I respect!). I had a CT Scan which revealed a bent septum and nasal polyps. I had FESS (Functional Endoscopic Sinus Surgery) 2.5 weeks ago. He removed my septum and the offending Polyps. Im still bleeding now and again and get a minor headache from time to time... But it all seemed worth it.

Up until yesterday my ears and head where my own again.... It was bliss.

Im now sat here with full ear drums trying to blow my ear drums out, only making it worse....Its back.

However I agree with emoo, exercise definatley offers temporary respite. I too crave a runny nose, but only get it when I play football ? I also have not had a cold or flu since April... when all around me seem to have had it 2 or 3 times... It just doesnt seem to get past my sinus's ?

The steam room down the gym also takes the symptoms off for a couple of hours. Im told going on holiday to a warm moist climate is also beneficial. These sorts of issues are few and far between in the jungle apparently?

The other thing I've tried is cutting out sugar from my diet. This does seem to have a positive effect (although I didnt stick at it... its xmas and requires serious will power) but the weight loss is almost instanteanous! There seems an increasing argument about ear / sinus infection and links to candida (IBS and GUT Infection) which can breed fungal infections in the Ear and Nose... The GUT being a major force in your immune system....

I go back to my surgeon in the next couple of days, if nothing else works im removing the sugar (fruits included), taking up running, sleeping on the floor of an oxygen tent and moving to Thailand.....Im so narked off, i'll try anything...

[soggyboxers]

Ennie,

12 years ago, I suffered from this same problem. Visits to many doctors in Nigeria did nothing to help and finally my then-company flew me to Holland to see the company physician (a GP in Holland). he referred me to an ENT specialist who prescribed Nasonex which cured the blockage within minutes. I still have occasional blockage of my left Eustachian tube and always find that an application of Nasonex cures it very quickly

[skyloone]

Looks like I've joined the club....
Had an ear infection which appears to have cleared, but finding it impossible to unblock my eustachian tubes. Dr suggested that fluids should clear in 8-12 weeks....oopss... considering I've done just one day with my new employer and spent the next two weeks off sick. Not an impressive start but all have been understanding. Not sure if their goodwill stretches to 12 weeks?

[Hugh Spencer]

I have had this trouble from time to time but last time the doctor agreed to give me some antibiotic tablets but also suggested a nasal spray Beconase. He suggested spraying lying on my back so that it reaches ' parts other things don't reach '. Sleeping with extra pillows to keep your head higher helps. It can be a lengthy job. Beconase can be bought 'over the counter '.

[creativegent]

ahh taken me ages to find a decent place to talk about Eustacian Tube blockages...ill confess upfront im not a pilot, sorry, but have had eust,tube blockage for a solid 4 years now....3 trips to the ENT and countless complimentary therapies later, still blocked up. Actually am off to see the ENT again tommorow, to see what else they can help me with.
Just wondering if others with prolonged blockage get the same bloody horrible symtoms i get ; weird headaches,dizzy spells,the usual 'fullness' in the ears sensation?

[lovethesky]

count me in too!! had blocked ears for 15 months, had 2 sinus surgeries, tried chinese medicine , homeopathic tablets, nasonex, antibiotics ect ect ect
the surgey irritated my sinuses when now produce thick gunk!!!!
i se a neti pot to wash my sinuses daily, abd have spent thousands on potions and lotions.
ged v bad sinus headaches and fever!!
such a healthy job we have!!

[pazuzzu]

as a chronic ear problem sufferer...here's the only way i know of to clear blocked Eustachian tubes. high dose guaifenesin. i couldn't frickin believe after all the years of problems that no ENT told me this. i went to a specialist for adults with chronic otis media and he just casually said, "yeah, lets clear that crap out of your ears first. this will do it." worked like a charm!

guaifenesin is a potent "thinner" of mucous. the dose for clearing ears is quite high, so you need a prescription. do it in combination with an anti inflammatory agent...like flonase + ibuprofen. the cause many times is exacerbated by leftover adenoid tissue blocking drainage.

another one that's a pain for pilots...never blow your nose while holding one nostril to try to clear it. you may actually push dirty mucous into your ear.

hope it helps someone!

cheers

[WG774]

Hi,

What is likely to be better, Carbocisteine or Guaifenesin? How long before you see a result? How many times the normal dose should someone with a blocked ET take?

What I can’t get my head around is, if the mucous is trapped inside the ear and can’t get back down the Eustachian Tube, how can a drug thin it out? Surely, if the mucous is trapped, it’s trapped - how can a drug alter its composition?

I'm also struggling to get my head around the 'venturi' concept mentioned earlier. Is the fellow simply stating that he sniffs in a very hard manner, with long breaths?

I appreciate all the caveats stated previously – I’m in the care of trained pros. Unfortunately, it does appear that solving these kind of ENT problems is somewhat of a black art, even to those with letters after their names…

[Hufty]

creative agent you should see your doc.

There is a condition I read about called Meniere's disease which can cause the syptoms you are describing...especially the dizzy spells. I don't think it is that serious though but it is worth doing some research on.

WG774 I have just started taking Carbocisteine. 375mg tablets, two three times a day. I will let you know how I get on. I also just emailed my ENT specialist to see if has heard of Guaifenesin and asked him what the difference was between the two products (my GP had no idea) so I will let you know too.

I think the mucous only gets trapped as it becomes viscous and even then it will gradually ooze out but gets replaced by new mucous. Over time I think you just get an equilibrium level that sits there. The ET really isn't blocked AFAIK, it is just stuffed up with thick mucous, so thinning it helps the old stuff drain away and prevents the new stuff from getting too sticky so it too runs away rather that hanging about in your ear?? Tomato Ketchup bottle principle perhaps?

I think that is the way decongestants work....they help open up the passages so even though they don't alter the composition of the stuff, the wider pipe helps it drain.

[pazuzzu]

hufty has it right, the ketchup analogy is perfect....guaifenesin increases the volume of mucous and also decreases its viscosity allowing it to drain. combined with a NSAID or something like flonase gives you the double hit of reducing inflammation which reduces swelling in the eustachian tube and nasal passages. reduced swelling = increased diameter of the tube for better drainage.

i would still do it under the care of a physician; i remember the dosing being quite high for blocked ears. i think mine was 1600mg and it took like ~ 3 weeks before i saw the difference. if you're flying a lot you may see improvement a bit quicker since the pressure changes will move things around a bit.

both Carbocisteine and guaifensin are mucolytics, meaning they break down the bonds holding mucous together. i think Carbocisteine probably is a better choice. guaifenesin was just better known and over the counter.

i read a few things that say guaifenesin may not be actually mucolytic, but somehow reduces surface tension and adhesiveness of the mucous.

[WG774]

both Carbocisteine and guaifensin are mucolytics, meaning they break down the bonds holding mucous together. i think Carbocisteine probably is a better choice. guaifenesin was just better known and over the counter.

i read a few things that say guaifenesin may not be actually mucolytic, but somehow reduces surface tension and adhesiveness of the mucous.

Thanks both of you. I look forward to reading how you get on, Hufty.

If both drugs work on different principles (I like the sound of the surface tension principle, but then again, I like physics, so I probably would...), why not take both at the same time? Hedge your bets? :hmm:

[pazuzzu]

If both drugs work on different principles (I like the sound of the surface tension principle, but then again, I like physics, so I probably would...), why not take both at the same time? Hedge your bets? :hmm:definitely...but sometimes weird **** happens, so do it under a physician's care. :ok:

as annoying as it was for me when mine was totally clogged, i would have done anything. (considering i already had tried beating my head flat on a table covered with towel while holding my nose and swallowing.) :ugh:

[Vbells]

I'm nearing the end of the CTC Wings selection process and, if I pass the last stage in 2 weeks (fingers crossed) will be trying to get my first Class 1 medical soon after. However, I have had fluid in my ears for months and I'm really worried that I won't pass the medical because of it. I can still hear, although I imagine not as well as I should be able to, and its not painful. I have a Flixonase nasal spray but its not helping. I'm so worried that I might not get my Class 1 - does anyone know anything about it?

[Hufty]

Have a look a the rest of this thread - there are some good tips up there in relation to medication etc. Try steam inhalations, decongestant tablets etc. anything try an open up your tubes....

I don't think you will fail the Class 1 with fluid in your ears provided you can hear OK but I would check with the CAA first.

In extreme cases, you can get grommets in your ear drums which will allow the fluid to drain out....I wouldn't bother with that until you've exhausted all the medical options though!!!

If you do a search on Google for Otitis media, you will find lots of good information.

[WG774]

I wish I could remember exactly, but as I wrote earlier, I was told by a GP a few years back that there's another operation that can be performed that's less risky than grommets..??? Could it be the gruesome-looking procedure where they rebore the sinus passages? From what I understand, it's one of those operations that looks ghastly, but isn't too risky.

If you read reports on the 'web, it appears that grommets rarely work, and have a large risk of permanent hearing damage as they involve making a hole in the eardrum. I know that grommets would be the last port of call for me.

For what it'll cost you, and for what my opinion (and those of others in this thread) is worth, I would be inclined to visit a Physio for a few sessions to make sure your posture is good, particularly if you spend a lot of time behind a desk / computer.

[Mac the Knife]

".....it appears that grommets rarely work,..."

Nonsense. They work very well for most people.

and have a large risk of permanent hearing damage as they involve making a hole in the eardrum...."

More nonsense. Unless you get the local plumber to put 'em in....

:*

[99jolegg]

I had gromits put in by an ENT surgeon when I was 14. They fell out 14 months and 18 months later (quite late apparently). I've had no problems with hearing since that and have passed a Class 1 audiometry exam.

[gingernut]

The use of grommets in children is controversial, as there appears to be a lack of evidence supporting their benefit.

Latest guidance seems to support what proper doctors have suspected for years-watchful waiting can be more constructive than diving in with a scalpel.

I think NICE released something recently.

[Hufty]

According to my ENT guy, the problem is in keeping them in. They will fall out and if your problem is due to blocked tubes, allergies etc. the hole will (should) just heal up and you're back to square one. One insertion should be fine but it is the repeated insertion of new ones that can leave scar tissue on the drum and lead to hearing loss.

They make so-called "T tubes" which are larger and designed to stay in longer but if they come out they can so I'm told leave a fairly large hole behind them.:ouch:

[gingernut]

http://www.nice.org.uk/nicemedia/pdf/CG60quickrefguide.pdf

[WG774]

".....it appears that grommets rarely work,..."

Nonsense. They work very well for most people.

and have a large risk of permanent hearing damage as they involve making a hole in the eardrum...."

More nonsense. Unless you get the local plumber to put 'em in....

Note that I prefaced my statement with “according to what I’ve read on the ‘web” – I hope I made it clear that I wasn’t stating that grommets cause damage as a fact.

To be honest, I’d love to give grommets a try. Why is it that they get a bad reputation, and the vast majority of reports I find through newsgroups tend to be negative? Is this purely Sod’s Law, in that the people who’ve had them done successfully don’t contribute to newsgroups, so you only get reports from people who’ve been misdiagnosed / are in a minority?

Thanks for the link, Gingernut. Not that I’m under 12, but I’d *like to think* that NICE wouldn’t suggest treatment that endangers hearing.

[gingernut]

Welcome to the wonderful world of medicine, WG.

Whether something works or not isn't black and white I'm afraid.

In the old days, we relied on what "experts" thought would work, because it seemed logical-more often than not it didn't.

Thankfully most of these practices have now been overtaken by the science of evidence based practice.

We still get the odd dinosaur who thinks that his or her opinion is the best, because he can shout the loudest, but most health care commissioners are waking up to the fact that we really need robust evidence before we can subject our patients (and the people paying for health care), to unproven treatment.

Which is why we refer less and less patients for useless, or dangerous operative procedures.

[Vbells]

Ok, I tried the salt solution idea and now its trapped in one ear. Bugger. Ah well, I'll just keep trying stuff and hopefully something will work. I don't mind the fluid as much as the idea that I might not pass an Audiogram :rolleyes:

[Mac the Knife]

Sigh. Gingernut off again on his antitherapeutic hobbyhorse.

Lets try and get a few things straight.

"In the old days, we relied on what "experts" thought would work...."

The days of "I think it works" ended at least in the fifties. Since then scientific studies have been expected to show statistical significance in order to be accepted. Ol' Ginge is still hanging on.

"...we really need robust evidence before we can subject our patients (and the people paying for health care), to unproven treatment." is hardly new!

Note the use of parentheses for "experts". Ginge doesn't believe in "experts" - there are no "experts", even if they are multiply qualified specialists of many years experience. Evidently I'm not an expert, only an "expert" whose abilities and motives are not to be trusted. Remember that when you fly, your pilot is not an expert, only a soi-disant "expert" who is quite probably incompetent.

Medical tree-huggers like Ginge keep harping on about "evidence based medicine" as though it was something absolutely new that they had discovered. Of course it isn't - strict statistical evaluation of therapeutic manoeuvres has been around since before Ginge was born, though admittedly it hasn't always been applied.

The interesting thing is that the current evidence for the benefits of "evidence based medicine" is rather poor - empirical treatment by experts (OK, "experts") actually seems to do no worse and frequently better.

"Evidence based medicine" is a bureaucratic and construct rather than a scientific one and is designed more to save money than to optimise anyone's health.

But "revenons a nos moutons" as they say (or rather ears).

Otitis media is common in children and treatment is controversial. Allow me to quote:

"Because of a tradition of inappropriate prescribing of antibiotics for viral acute otitis media, their use has recently been condemned by many primary care practitioners for most cases of acute otitis media. Ear specialists tend to disagree with this philosophy and promote efforts to distinguish between viral and bacterial infection, so as to optimize treatment results by giving antibiotics only for bacterial infection. Acute bacterial otitis media can cause pain that leads to sleepless nights for both children and parents, can cause eardrum perforations, not all of which heal, and can spread to cause mastoiditis and/or meningitis, brain abscess, and even death if a severe infection goes untreated long enough. High fever can occur and can cause febrile seizures. Appropriate antibiotic administration prevents most such complications. On the other hand, it is generally agreed that acute otitis media that is purely viral will usually resolve without antibiotic treatment, although associated persistent middle ear effusions may require medical intervention"

Similarly, while the efficacy of grommets in the treatment of chronic secretory otitis media is undisputed, there is no doubt that too many grommets are inserted for rather nebulous reasons (pressure from parents and money for a start).

Probably the majority of cases of chronic secretory otitis media will eventually resolve as the child gets older and a case can certainly be made for waiting. The downside is that prolonged deafness in children may delay speech, communication may be difficult and education may suffer - behavioural disturbances may occur. Whether these are worth suffering in the defence of therapeutic correctitude is a matter for debate (except for the gingernuts of this world).

"....we refer less and less patients for useless, or dangerous operative procedures...."

This is an interesting statement.

Basically your GP knows best and that "experts" (like trained ENT specialists) are likely to employ useless or dangerous procedures. Evidently "experts" (specialists) are all either ignorant or venal (or both), in which case it would surely be better to get rid of them!

I do not consider myself to be either, but then perhaps I am an exception (if our resident medical nut permits such).

Mac

:ok:

[gingernut]

Ha Ha- I knew if I shook his cage hard enough. Interesting to note your view point on evidence based medicine.

Wading through all the personal abuse, it'd be interesting if Mac could source his assertions.

Ear specialists tend to disagree with this philosophy and promote efforts to distinguish between viral and bacterial infection, so as to optimize treatment results by giving antibiotics only for bacterial infection.

You see this is exactly the meaningless nonsense offered by "experts," who are often a little divorced from reality. I prefer facts myself, if your interested Mac, see Sharland et al eBMJ 20 June 2005 for a starting point.

If you know of a reliable and valid tool to distinguish viral from bacterial OM you'd be more than welcome to spend a day in my practice demonstrating it's use.

Twenty years experience doesn't count for much in my eye, 'specially if you've been doing it wrong each year, for all of those twenty years.:)

[Mac the Knife]

"If you know of a reliable and valid tool to distinguish viral from bacterial OM....."

Well there isn't one. A red drum and a child with viral type symptoms is probably viral. Stinky pus and a perf is bacterial. In between it's a best guess.

How reliable and how valid does it have to be for you to accept it? 100% or would a good "based on experience" guess do? Ooops, experience doesn't count!

Anyway, thank God, I at least get wiser as I get older and better at getting my guesses right.

:ok:

[gingernut]

I'm afraid a guess isn't good enough for my patients. Although to be fair, I'm often "managing risk." (Tree hugging term for guess:))

Funnily enough, as I get older, I'm realising I wasn't as wise as I once thought I was.:ok:

[WG774]

I've been reading a number of items on the 'web, citing that Trigeminal Pharyngioplasty was helpful for unblocking ETs. I have also seen reports claiming (possibly from practitioners of TP...) that it is suspected that many people with ET issues are incorrectly diagnosed with allergy / audiological problems and sent to audiologists, when in reality they had a TMD issue...

I wonder what you guys make of that? It would tally with the earlier comments about posture...

Is Trigeminal Pharyngioplasty simply the medical term for Endonasal Therapy?

Try a Google on Dr. Schames - he seems to be the most visible TP practitioner.

I'd love to hear what others think... Personally, and going purely on circumstantial evidence, I tend to think that there could well be some truth in the concept of people being misdiagnosed, when they needed TMD therapy...but what do I know, I'm just an engineer!

[Hufty]

This is interesting....

I had "Endonasal Therapy" and this looks kind of like the same thing although the 2 practicioners seem to be coming at it from different angles. The guy I saw called it "finger sweep" and said you could remove these "adhesions" by aggressively (and painfully) running a finger across this "Fossa of Rosenmuller" while this other guy seems to achieve the same thing by massaging the muscles. I have just started looking at the links so will read more although it looks very similar if not the same thing.

[mad_jock]

Just a question for MAC and ginger nut.

Being an engineer and a diver if folk have probs with stuff getting blown back in. How about blowing it out with 1 bar of pressure. ie stick them in a chamber and take them down slowly to 10m let them sit for a bit on 1.6 bar partial o2 and let the free radicals do there stuff then a reasonable sharpish accent?.

I was always amazed at the amount of snot, more than a mouth full, that could be held in ones head that was produced in the last 10m. I never got colds etc when diving 30m plus regularly. My sister who's job it is to research the green slime in sewage farms which eats poo reckoned we where making the bugs burn out with high PP of o2.

[Mac the Knife]

Interesting thought mad_jock. Hyperbaric oxygen for eustachian tube dysfunction. The volume of air in the middle ear is tiny (<1cc) so I don't know that it would work. Rather an expensive solution and, I suspect, rather painful.

Lets see what our surfing fount_of_all_wisdom says.

:ok:

[gingernut]

I'm a bit confused Jock, I think what your saying is, shall we reduce the outside pressure surrounding the middle ear, (by placing the patient in a decompression chamber), hence promoting expansion of the air in the middle ear, (Boyles law and all that), to try and expulse gunk out of the eustachian tube.

If you are, then I guess the risk is that we blow the delicate drum, instead of forcing out the gunk.

If your talking about hyperbaric oxygen acting as a bacteriacide, it may well kill the bugs, but we tend to find, in OM, other nasties tent to have a habit of taking over what we've killed.

It may be worth an experiment, if you can get Mac to volunteer, I'll gladly operate the chamber.:) (Only kiddin')

Any cheers all, talking of surfin' I'm off to Watergate in the morning. If anyone fancies a beer, I'm the sturdy one with a red bic and a black dog.

[mad_jock]

Remember that at pressure you don't actually need haemoglobin to transport oxygen to the cells so your not relying on just gaesous transport into the ear.

Gingernut you slowly compress the person in the chamber while they breath 100% O2. They then sit there for a bit and then the chamber gets the pressure let off at a comfy rate.

If say you were blown down to 50m you would have a 5 fold increase in the volume of gas in the ear on the way up. Usually just a doubling from 10m to 0 is more than enough for the ears to creak and all the muck to dribble into your throat. We are talking diving masks full to the brim with snot. One bloke even had a lump of lint come out and he had his sinuses scrapped or what ever you do to them 6 years before then.

It was just an ex engineers suggested solution to the problem.

Mac I don't know about exspense I recon a 2 week holiday to the maldives diving 3 times a day should cost less than a course of hyperbaric treament.

http://www.nationalhyperbariccentre.com/images/stories/medical1.jpg

Fancy operating at 600meters depth ;)

[RunwayBlueOne]

One diagnosis which most GP's and Most ENT's overlook is Patulous Eustation Tube (http://www.saxontheweb.net/vbulletin/showthread.php?t=58786)- The symptoms are very, very similiar to Otis Media/ Eu tube disorder- blocked tubes, dulled hearing, difficult to clear gunk etc. (This condition can sometimes be accompanied by acute tinnitinus) Unfortunately there is no foolproof cure at present but there's lots of research going on. The Eustation tube Institute in Geneva is one of two places which can possibly help. The other is in Boston, US.
It would be interesting to see what decompression does as it cannot blow the eardrum as the EU tube remains open with this disorder...

[WG774]

Whilst Googling 'Patulous ET', I came across a link that mentioned having catheters fitted to the ear... I assume this is just another term for grommets?

Has anyone got any comments on Trigeminal Pharyngioplasty? Do you think it appears genuine?

Hyperbaric treatment looks very interesting. How much would it cost to book a chamber for a 30-minute session?

Thanks to all contributors!

[mad_jock]

Depends where you live in the country.


Before you go any further with the try and blow it out option can I suggest you speak to a hyperbaric medic type person in case it really is bloody stupid.

http://www.nationalhyperbariccentre.com

As a suggestion.

If they arn't willing to help with advise they should be able to point you towards a consultant who does know. One of the chamber divers will proberly know someone to speak to or have an old sat divers trick of sorting it out.

but google threw up quite alot of hits in the UK. Seems to be quite the done thing these days.

[WG774]

Thanks, Jock.

From the diving sites I've checked, they all say that a diver needs perfect ET function or they shouldn't be diving...

Have a look at This Link (http://londondivingchamber.co.uk/index.php?id=advice&page=6&cat=12&sub_cat=76)

At the bottom of the item, it talks about Laser Eustachian tuboplasty, which appears to be an interesting option. Try Google.

Here's a couple of links I found: http://www.ncbi.nlm.nih.gov/pubmed/12671411

http://www.ncbi.nlm.nih.gov/pubmed/14724483

CONCLUSION: Laser eustachian tuboplasty is a new procedure that has demonstrated early promise in correcting intractable eustachian tube dysfunction with few complications. Further studies will be necessary to reproduce the results and establish the role of laser eustachian tuboplasty in the management of chronic intractable eustachian tube dysfunction

[mad_jock]

Yep I would agree with that but its a bit like you should never fly with a cold.

Your also not meant to drink heavily the night before either. I was part of the drinking research group which proved that it doesn't make a difference. :-)

I would call one of these diving medics you never know you GP might refer you if they say they can help

[WG774]

I'd love to hear an opinion from a medical pro on this: http://www.biolitec-us.com/filephotos/documents/eustachian.pdf

??????

[mad_jock]

To be honest mate looking at that site you posted you couldn't go far wrong contacting the London diving chamber for advise.

[Hufty]

WG has uncovered some interesting stuff here....Mac and ginge, you seem to have differing opinions but it would be very helpful for all of us if you could both offer an opinion on this and the Trigeminal Pharyngioplasty ...

My ENT surgeon was VERY dubious when I suggested any surgery of the ET itself....as far as he was concerned such things are rarely successful but I am encouraged by looking at the material that WG has uncovered.

BTW, I have been on Carbocisteine for a few days and it hasn't really done anything. It has definately made me produce more mucous :yuk: but the ears are still the same.

I am convinced that my ET issues are muscular. Whenever I swallow (say drinking a glass of water for example) my tubes block up and I go a bit deaf. It takes a bit of ear popping to restore the situation. I can't see why this would happen otherwise???? Anyone??

[WG774]

BTW, I have been on Carbocisteine for a few days and it hasn't really done anything. It has definately made me produce more mucous but the ears are still the same.

I am convinced that my ET issues are muscular. Whenever I swallow (say drinking a glass of water for example) my tubes block up and I go a bit deaf. It takes a bit of ear popping to restore the situation. I can't see why this would happen otherwise???? Anyone??

Your symptoms are identical to mine... I went for a run an hour-or-so ago, which seemed to clear the tubes somewhat. I've just had a large meal (with plenty of chilli) and it felt that, with every chewing action, I was pumping mucous back up the tube...

Just like you, I have been on Carbocisteine for about 8 days. It has thinned out the mucous, but the ear is still as blocked as ever. What worries me is that my current blockage is on the left, whereas my previous problems have been on the right...

BTW - I'm not totally convinced with Trigeminal Pharyngioplasty. If I could get it done locally and affordably, I'd jump at the chance. The only concern I have - and it may well be somewhat ill-founded - is that those who practice it *seem* - in my mind - to be a tad heavy in terms of marketing it... It might just be my perception / cynicism though.

Of all the treatments I've come across, the one that seems to offer most hope in my layman's eyes is the laser surgery. Look at it this way: many women have been able to conceive by having their fallopian tubes opened with a laser - if the treatment can translate to the ETs...

Ginger? Mac?

[Mac the Knife]

I can't be a fount of wisdom here because I only deal these days with CSOM and Eustachian tubes as part of the problem in my cleft-palate patients.

What I can say is that middle ear ventilation and eustachian tube dysfunction still isn't too well understood (that doesn't mean, BTW, that it isn't understood at all). Certainly cleft palate patients, where the tensor and levator palati are malinserted have faulty tubal opening and CSOM.

Quite why some folk who seem to be anatomically normal have tubal dysfunction is unclear. Perhaps the muscles just don't "work right". Incidentally, lysing muscle adhesions manually by "Trigeminal Pharyngioplasty" (which sounds like an operation but isn't) sounds odd to me - you don't usually see muscle "adhesions" and when you do, they need more than massage to take down. But if his patients are happy.......

I've no experience of laser surgery here - lots of people have these problems and if laser surgery is effective you can be sure that it will be in mainstream practice. Ask someone with an interest in tubal dysfunction whether it works or is just snake-oil.

I'm old enough to remember Politzerisation, so here are a few references.

http://en.wikipedia.org/wiki/Politzerization

http://journals.cambridge.org/action/displayAbstract;jsessionid=984A6587CD4608642FACE1CFB3FAA304. tomcat1?fromPage=online&aid=1103128

http://www.earpopper.com/

Just remember, for every ill in this world there's a little man with a pendulum or a potion who's the only one who really really understands it......................................

:ok:

[Hufty]

You mentioned Catheters in the ET....on doing some more reading it seems this is just shoving a tube up the ET into the middle ear in order to force ventilation.

If you have fluid in the ear then this might be a good technique....it would allow it all to drain out and fingers crossed it might not re-appear. A myringotomy could also help.

If you have patulous ET then you will get a bunch of additional symptoms...the tube is open all the time so you'll be able to hear your own voice loudly in your head when you're talking and will have great sensitivity to sounds so I'm told as there is an open path between the outside air and your middle ear.

My ENT specialist was very dubious about ET surgery....I'm aircrew so I need to make sure my tubes work as well as they can and I'm very reluctant to mess with nature. As I sit and type this, my jaw feels very tight and is aching quite a bit. I'm convinced that is is aTMJ issue for me at least...WG do you have any jaw tension??

[Hufty]

http://www.headaches.com/home.htm

This guy seems to crop up a lot too in searches....I don't know anything about him though and the website is suspiciously quiet on what the treatment options are (!) but you never know....

[WG774]

Hufty - I last had an X-ray at the dentist last August. I asked if I had TMD, and he responded 'no'. However, I remain open-minded and intend to get a second opinion. My physio doesn't want to say 100% because she's not a specialist, but she thinks my TM joint isn't equal from side-to-side; but she made it clear that she's a 'general physio' and not someone who specialises in TMD issues.

Do you have any links that go into detail regarding fitting a catheter? I can't seem to find any info beyond a one-paragraph summary. Does it involve a general anaesthetic? What are the risks? How often can you have it done?

There must be a risk with catheters, otherwise every man and his dog with ET issues would be queuing up to get their ETs drained, wouldn't they? It seems like an ideal treatment to me; you get a blockage, you drain it. If you have another blockage 12 months down the line, you get it drained again... It seems too good to be true; there must be a drawback somewhere...

I don't get random headaches. I get them if I've been stressed (morning after a heated argument), or if I've strained my eyes the night before (I sometimes get this after a session looking for road name signs in poorly-lit areas). Aside from these scenarios, headaches aren't too big a worry. I get one if I have to spend a day in front of a PC (rare, but necessary once in a while).

I think Jock's onto something regarding speaking to the diving clinic linked to earlier. From what I can gather, divers put exponentially more strain on their ETs than frequent flyers.

I will admit that stress could well be a factor in my ET problems. The first time I had a serious glue ear as an adult was back in '93 (aged 22), when I was living in rented accommodation and undergoing massive turmoil in my personal life. Running my own company and doing ten different jobs doesn't help.

[mad_jock]

Speaking to one of the Aberdeen medics the hospital has a pretty good reputation and the tame ENT consultant ( Mr Neil Tolley ) has a very good reputation.

[WG774]

Unless anyone wants to correct me, from what I can make out, the trouble with having a myringotomy and a tube fitted is that it will drain the ear (good), but long term, it does nothing about ETD and you're back to square one.

[Hufty]

True, but according to my ENT geezer he has seen patients with fluid in the ear who have had it done then the fluid doesn't return. He was at a loss to explain why though when I asked!

With the TMJ stuff, my physio told me that my jaw joint was fine but my muscles were messed up.....so I guess that you can have the symptoms without being diagnosed with TMD??

I couldn't find much on the catheters really.....seems like it has fallen out of favour as a method of treatment....it does seem like a suspiciously good idea though?!

Personally, I've been around in circles with all this....still no nearer a solution despite all the research and doctors.

I am going to call that guy in the US this week from the headaches.com site....I don't get headaches either but he seems to talk about jaw, muscle and ligament stuff associated with ear "fullness" etc... I reckon it is worth a call. I have been seeing a chiropractor (a good one) too. I saw one last year and she managed to make my symptoms worse...they also moved from the right side to the left. Under this new guy they have moved back! My GP gets frustrated when I tell him this as he maintains there is no link but this is the same guy who told me "...you know more about ENT issues than I do."

[WG774]

For what it's worth - and I may well be totally wrong - but the more I think about it, the more I think I have a TMD / muscular / joint issue.

It's a tad odd that my ETD became worst after quitting smoking... Stress perhaps?

When my ETD flaired up for the first time since '93 back in 2002, I was going through the tail end of a truly ghastly court case (they all are - the only winners are the lawyers).

The problem gets worse as the day progresses and appears to be best when I get out of bed first thing.

The current bout of glue ear was not brought on by a cold or 'flu - it seems to have come out of the blue, and I'm not a hayfever sufferer.

At this moment, my non-clinician's opinion is that the disorder is brought about by tension in the muscles around the jaw and ET. The blockage *seems* to be worse after eating.

Regardless, it does appear that both our (Hufty and my) symptoms are very similar...

I wonder if the constant swallowing and popping, i.e. muscle attempts to clear the blockage, is causing problems due to some kind of fatigue? Maybe the best policy for me would be to focus on de-stressing (take up Yoga..), and the ET issue could go away in its own time... It does appear that my ET issues have reared their head during stressful periods in my life.

[gingernut]

WG has uncovered some interesting stuff here....Mac and ginge, you seem to have differing opinions but it would be very helpful for all of us if you could both offer an opinion on this and the Trigeminal Pharyngioplasty ...


Sorry mate, not really my area of expertise, may be worth searching something like "Medline" for further studies.

[Hufty]

I also find that my symptoms get worse as the day goes on.....on a 4 sector day by the time I'm finished I've got a pretty sore jaw from repeated swallowing to pop my ears. Also, I find (and I have no idea why) that if I eat or drink while in the climb or descent my ears block up! I also seem to lose a bit of hearing as the day goes on too while it seems to return the next day. I've tried relaxing too and really tried to de-focus on the symptoms but it doesn't work for me anyway..the tubes just ain't popping on their own!!

It is unbelievably frustrating when you sit in front of doctors and they just stare at you like you're some kind of nutter when you describe symptoms that they can't reconcile!!

[WG774]

I am waiting to get an appointment with a fellow who appears to be one of the top ENT surgeons in London. Somewhat worryingly, his assistant has referred to my issues as 'complex'... Hopefully that's because all ET issues are such, not just mine...

Anyway, I will post back here as soon as I've had the appointment.

[WG774]

The plot thickens...

Having got back from the GP, he is suggesting that I could have a problem relating to Acid Reflux, whereby acid is getting into my Eustachian Tubes...

This is the best link I've found so far in terms of explaining the issue, albeit targeted at kids: http://www.marci-kids.com/eerpharynx.html If you find a better link, do post it.

My visit to the GP has reminded me just how complex the diagnosis process is, and just how little an amateur like me really knows :rolleyes:

Anyway, I do have one or two symptoms associated with the disorder, such as occasional gurgling noises emanating from my neck. I also suspect that my unconventional lifestyle with regards to rarely adhering to regular mealtimes could be an issue.

Anyway...no doubt there are a hundred and one other illnesses that can cause ET problems... Acid reflux is about as plausible as any diagnosis I've found, so I'm now on antacid pills and will see what happens...

I feel sorry for anyone finding this thread - there's no magic bullet - you'll probably have to try a hundred and one treatments to find a solution :ugh:

[windowjob]

Sorry to be a wet blanket guys, but been there and done it all, TMJ investigation, MRI, septoplasty (twice), 3 grommets, on my second T tube plus mastoidectomy. And still have the blocked feeling and loss of hearing. I can also figure on one of the other medical forums in so far as I have hearing aids and thanks to some more enlightened medical attitudes and a helpful AME also hold a Class 1 medical!
The main problem is my right ear (funny that it's the same with others) but my audiologist said I would benefit from hearing aids in both ears - and he was right. I have small digital "in the ear" aids as I wear a headset but he reckons I could get better results with a behind the ear model.
Mine first started one day when I got a blocked ear and just couldn't clear it by swallowing and the hearing then went with it. The T tube definitely keeps it clear as I can actually hear the air escape when I blow my nose!
Good luck but I get the feeling you have to live with it - I've virtually stopped looking for a "cure" and accept it, reluctantly as otherwise it can take over your life always hoping for something new and being disappointed.

[pool777]

I am happy or unhappy (whichever way you want to look at it?!) to have found this thread. Ive recently changed airlines and 3wks ago on the descent experienced pain and couldn't equalise. Then, my ears popped but i was left with this blocked feeling in my left ear, i decided to go back flying and didn't experience pain but enough crackling and popping to warrant a trip to the docs who advised me to take ibuprofen and not to fly. Ive now been put on a weeks course of amoxycillin to prevent infection, ive tried nasal sprays and inhalants and its just not getting any better. Due to go back to my GP after my antibiotics are finished but from what im learning this may be something that i will just have to live with?... but what i really want to know is can i fly like this even though the GP (who i don't really think has a clue to be honest) is saying i can't. Im terrified that ill never be able to fly again.

[gingernut]

Ah yes, the acid reflux link. Surprising how many ent/breathing problems can be caused by this.

A coupleof things you could try- don't eat late at night, lose weight if needed, elevate the head of your bed by about a bricks height, eat smaler meals, stop coffeee and stop smoking. Your doc may trial an antacid.

Worth a try at least.

[WG774]

Another mucolytic to try is Erdosteine. I've been on Carbocisteine for around 10 days now - if I don't get a result in another 10 days I think I'll try Erdosteine.

Ginge - you've been really helpful, old chap - much appreciated. I am concerned that my GP has run out of patience and intends to leave me in the hands of specialists now - I get the impression his suggestion of Acid Reflux was a last-ditch attempt to help (although he could well have a point - I live on very hot food and invariably eat late at night...). If you can find a minute, would you be able to post a link regarding which foods are good / bad? I've been using Google, but there's so much conflicting info out there regarding foods...the amount of quack websites is shocking :rolleyes:

BTW - Bricks placed under bed - thanks!

[WG774]

One thing we haven't covered yet in the thread is the sheer variety of exercises that can be performed to open the ETs.

I have never felt comfortable with the Valsalva btw. The list below is copied from a Scuba Diving website: One problem with the Valsalva manoeuvre is that it doesn't activate muscles that open the eustachian tubes, so it may not work if the tubes are already locked by a pressure differential (see illustrations). It's also easy to blow hard enough to damage something. Instead of using the Valsalva next time, try one of these:

* The Toynbee Manoeuvre. With your nostrils pinched, swallow. Swallowing pulls open your eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them.

* The Lowry Technique. A combination of Valsalva and Toynbee: While closing your nostrils, blow and swallow at the same time.

* The Edmonds Technique. While tensing the soft palate (the soft tissue at the back of the roof of your mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva manoeuvre.

* The Frenzel Manoeuvre. Close your nostrils, and close the back of your throat as if straining to lift a weight. Then make the sound of the letter "K." This forces the back of your tongue upward, compressing air against the openings of your eustachian tubes.

* Voluntary Tubal Opening. Tense the muscles of the soft palate and the throat while pushing your jaw forward and down as if starting to yawn. These muscles pull the eustachian tubes open. This requires a lot of practice, but some divers can learn to control those muscles and hold their tubes open for continuous equalization.

If someone practiced the above techniques regularly over a period of months, is there a chance that the ETs will improve, in the same way that muscles improve with physiotherapy? Why shouldn't this be the case?

What I have learnt so far:

Cut out mucus-forming foods / drinks - the less mucus in your system, the less there is to get into your ETs.

Cut out foods / drinks that can cause excess acidity - excess acid is a known irritant to the ETs in people with an acid reflux tendency.

Get into the routine of performing ET exercises several times daily.

[WG774]

BTW - There have been many studies conducted over the years into the ET function in air personnel. If it interests you, put this string into Google: "Eustachian tube function in selection of airmen" - the Pubmed website has numerous studies; you get the abstract, but you have to pay for the full article.

[speedsalive]

Guys..I ve been having this for somtime. I fly non pressurized upto 10K abt 4 to 6 times a day and eversince i stated this, I ve been having EU problems.

Would it make anydifference if i Go into pressurized aircrafts? The other thing is, What if u get the junk behind the eardrum drained out by surgery and not putting the tubesa afterwards???

My doctor says that should be fine and when i asked abt hearing loss due to scars and hardening of the eardrum, he says i dont have to worry a sigle bit abt it.

and last, If this does not work out, What if i get them permanant tubes in? I know the tubes will keep the PE tube open from outside and u wont have to worry about the pressure difference and mucus getting into the EU tube.
The problem with ther permanant tubes are that it leaves perforations. but as long as it is there, wont it b OK??

[Hufty]

I'm not sure about ET muscle exercises....AFAIK there are four muscles that control the tubes so is there a risk that if exercise one, perhaps the others will work less effectively? Kind of like having poor posture and the jaw muscles developing oddly as the chew with your head in an odd position?

I have seen that list of tube opening techniques and for flying the best one I reckon is "Voluntary tubal opening"...I can keep them open for a few seconds at a time but it does hurt my jaw which might in instelf be contributing to my ETD...ironic really

There was a post right at the beginning of this thread with some useful "what have I learnt" stuff...(sorry dont' know how to do quotes so have just pasted it in!)

--------------------------------------------------------------

Obviously try steam inhalation, that might shift the mucus.

Nasal sprays - Nasonex or Flixonase. Could try a good dose of Otrovine but can only use it for a week I think.

Also, expectorants (e.g. Benadryl) are designed to work on chesty coughs but can also loosen mucus elsewhere.

Drink LOADS of water - if you are well hydrated it can help it run out.

Ear Candles - bit crazy - didn't work for me but you never know.

Acupuncture.

Herbal remedies to open up the tubes - tried loads but can't remember the names...a good herbalist will help you.

Cut out dairy, alcohol, starchy foods and load up on fruit and veggies....all can create mucus (search for "mucus forming foods" on Google).

Get your GP to do allergy tests and food intolerance tests for the same reason.

---------------------------------------------------------------

I find that drinking a lot of water does help as does going to the gym. These decongestants work (as far as I am told) by stimulating a kind of adrenalin response which causes the tubes to open up....fight or flight response I guess. Working hard at the gym generates the same kind of response and it kind of clears my head as does drinking a lot of water.

Interestingly (and nobody believes me) I suffer less when I am flying as HP not NHP. Perhaps because I am busy operatng the plane rather than sitting doing the paperwork there is a higher level of adrenalin release (esp. on take off etc.) Perhaps it is just that I am thinking more (descent planning etc.) that my mind isn't on it?? Who knows..

WG have you been to a chiropractor?

[WG774]

To be honest, I think most people (I know I do) are less aware of any kind of ailment if their mind is diverted elsewhere.

As I’ve posted many times in other discussions, Ear Candles are the WRONG circuit for ET issues. Not only that, but they’re illegal in Canada and I know people who’ve burnt their eardrums with them. One of the most comprehensive ENT sites on the ‘web (http://www.entusa.com/) has a warning about them on EVERY page… (BTW – that link has videos of myringotomies and the like – not for the squeamish, but worth checking out if you want to know about that kind of thing).

I tried acupuncture a few years back for stress. It worked, but to be honest, I think it was the meditative aspect – not the treatment itself. Maybe I should try it again. What worries me is that I’ve become fervently cynical about alternative therapies since then, and if you don’t believe, it’s unlikely to work…

I now take a 30-minute cross-country run every week day – so far it hasn’t done a lot apart from temporary relief, which I suspect is due to general endorphin production from exercise.

I drink an average of 3 litres of water a day, more if it’s hot.

The chiropractor is a good suggestion. I definitely am guilty of poor posture and I suspect that years of abuse could have taken its toll.

One thing I will say is that I have found that the valsalva manoeuvre is lacking in 3 ways:

You risk ear drum damage if you blow too hard
It can push crud / infected tissue further into the ear
It doesn’t do anything to exercise the muscles around the ETs

Considering divers put more stress on their ETs than pilots, I’m inclined to think they’re a good source of advice for ET exercises and the like. Having said that, only an idiot takes everything they read on the Internet on face value – caveat emptor and all that. Do thorough research before trying anything, preferably with the advice of a pro before attempting any scheme.

Interestingly, my MRI report says I have “marked mucosal thickening in the maxillary antra – and minor mucosal thickening in the anterior and posterior ethmoid cells”. The plan is to eliminate dairy and wheat (very difficult in the latter case) and use an inhaler for hot water / eucalyptus oil once or twice a day.

BTW – The link between acid reflux and ETD is conclusive. It’s uncommon, but there’s no doubt of the connection – worth investigating if you have any kind of heartburn / excess acid issues.

[WG774]

Speedsalive – I don’t think it’ll make much of a difference whether you’re in a pressurised AC or not – either way, your ET function will be tested.

I have performed hours and hours of research into myringotomy complications and the like. Your concern is due to scarring, which can perforate the drum and affect its performance. Providing (as Mac said) you don’t get the tubes put in by your local plumber, you should be ok. Perforations are reversible, but you don’t really want to be in that position.

I understand your temptation just to have a standard myringotomy first without tubes (the visual appearance of grommets concerns me somewhat…will they freak out children if they see them?), and feel the same way myself. However, from what I can make out, you will increase your chances of getting out the gunk if you have tubes fitted… There are myringotomy studies that contradict each other… Some say that laser myringtomy (no general anaesthetic) leaves less scarring / perforations, whereas others say that conventional micro-scalpel leaves less scaring. One thing most studies confirm is that the grommets will stay in longer with conventional surgery.

BTW – there’s likely to be more bacteria in the air of a pressurised AC (from what I understand – I don’t want to incur the wrath of Mac again), so I would look into whether there’s likely to be a higher chance of something undesirable getting into the ear in a pressurised AC. Having said that, if all is healed, I’m not sure if you’d have a problem. You’re better off asking Ginge or Mac on that one.

[windowjob]

Standard grommetts can't be seen, they're very small and a long way down the ear canal. The downside of them is they are actually designed to be forced out of the eardrum naturally after a period when the hole then heals up. Mine lasted about 8 months each time which is why I had a "T" tube fitted. This acts exactly the same way but is designed to be more or less permanent -only problem was the first got totally blocked by ear wax and had to be replaced but still effective over a year later.
I still think that one day I will wake up, swallow and find the blocked feeling has gone and I can hear normally again, but realise it's almost certainly not going to happen after 4 years.
Hope exercise/drugs/chiro etc do work but I've yet to find anyone who has got back completely - sorry but you ought to know.

[WG774]

Your prognosis is definitely not one of the more optimistic ones I have seen posted, Windowjob. For the benefit of others, can you please give us more info?

You say you had a mastoidectomy. Were the cells removed due to infection? Was it an infection that triggered the whole saga? You say you had no ET issues before - correct? Have you never been prone to ear infections?

Are you prone to allergies? Have you been a smoker? What was your age range when the problem started?

Did you consider Laser Eustachian Tuboplasty? You still have the blocked feeling with T-tubes fitted? Have you ever had balance issues? Did you suffer from general stress prior to the problem flairing up?

Your reply would be most helpful - Thanks in advance.

[WG774]

BTW - one anomaly with my own condition is that I can still hear 16KHz in the affected ear...odd.

The ear that's currently affected has been gradually bunging up over a period of time, to the point where it's at now which is driving me mad. It feels as if something has gradually 'grown' in the ear, but an MRI has ruled out a nasty such as a neuroma.

The other ear is the one I've traditionally had blockages with, and it's been fine for ages and is now better than the other...

[WG774]

I just got back from seeing one of the UK's top ENT surgeons and have been told that my ETs are fine and I do not have a blockage / glue ear. He reckons that my issue is an inner-ear problem. He was pretty adamant about the ETs - and it didn't take him long to decide.

So, it appears that my time as a "Google Doctor" has not paid dividends...back to square one...

Anyway, I doubt I'll be contributing much more to this thread - I do hope the links I've provided help someone.

BTW - The ENT surgeon told me that "Laser Eustachian Tuboplasty" was pretty much a scam in his opinion - unlikely to do anything except drain your bank account (I had a quote - think 5-figures Sterling...)

Take care y'all.

[mad_jock]

I wouldn't say your back to square one. Sounds like your talking to someone who knows what they are doing.

As a matter of interest did the london chamber get you in touch with the ENT person?

Its just good to know where to point mates in future if they have a problem.

[WG774]

It was the London Chamber who referred me to their man. He runs a private clinic in St John's Wood, London - and also does NHS work, although I'm not sure where. I wanted to get in there ASAP, so I went private.

To be honest, unless you really are in a hurry, I'd suggest getting an appointment via the NHS. The NHS has a scheme whereby you can choose your consultant. If you're in the flying game, you are within your rights to insist on being referred to the Top Noggin, on the grounds that your career depends on it.

BTW - Aside from the wait, which can be pretty arduous, I don't think going private has any benefits really. If you want the TN though, I guess you could be talking about 2 weeks versus 2-6 months though, depending on where you are. No doubt, as with anything public service-related, waiting lists are shorter in Bonnie Scotland!

BTW - Jock, I have sent you a PM.

Oh yeah, before I forget - the consultant was optimistic about the prognosis for ET problems in general when I discussed it with him - he didn't paint a doomsday scenario whatsoever. Cheap he is not though...

[speedsalive]

Guys....I want you all to have a look at the link below...

http://www.eardoc.info/

I ve already ordered one of this.

cheers

[speedsalive]

anycomments on the eardoc?

[Hufty]

WG I wouldn't abandon your search quite yet - my ETs are also "working" although they don't work well enough. The traditional pass/fail test for ET function is the valsava manouvre (AFAIK) and even though you may be able to pop your ears using this technique it doesn't necessarily mean they will work on their own as they should. So they can tell you there is nothing wrong with your tubes and you "pass" the "test". Also my guy failed to daignose fluid in the ear when it was diagnosed by the nurse at my GP practice when I had my ears syringed....I went totally deaf in one ear and she said she saw bubbles behind the drum. ENT man didn't spot that.

[AMEandPPL]

anycomments on the eardoc?

Faced with anxious parents with a screaming child of three in the early hours, if I had a choice of getting a hefty dose of amoxycillin started straight away or giving them one of these things . . . . . . .

. . . . . . . . I know which I'd choose, and I think the MDU would back my decision 100%

[WG774]

Hufty - thanks for the encouraging comments. I don't even want to get started on what the issue really is... I have theories, but I've been proven wrong so many times now...

I ordered an "Eardoc" a few weeks back, before I saw Mr Specialist. I have a strong suspicion it will find its way onto Ebay without having the packet opened...

The diagnosis treadmill is not a nice one for these kinds of conditions - ear function isn't a simple area of medicine :ugh::ugh::ugh::ugh::ugh::ugh:

edit - before I get my hide tanned, I'd like to remark that no area is simple - it's just that inner-ear conditions can be particularly awkward to diagnose.

[speedsalive]

www.eustachian-tube.net

any comments ?

cheers

[WG774]

I saw one of the UK's most respected ENT Surgeons and he said the laser treatment didn't make sense and he felt it was definitely a scam.

As (Mac?) said, if a miracle treatment appears, only one person is qualified to to carry it out, and it's expensive...it's probably a ripoff...

If it's such a miracle cure, why don't they offer it at the Royal ENT Hospital in London?

I got a quote for the laser treatment btw. See quote below.

If you're a millionaire and you reckon the risks are worth it (not sure what the risks are), go for it - keep us posted!

For information, the cost for a surgery is Euro € 9’000,- to 13’000,- or Swiss Francs 15'000.- to 20'000.-, depending from what kind of surgery must be provided.

You must do a deposit of about Euro € 13’000,- or Swiss Francs 20'000.- before the surgery. All payments can be done in cash or through a previous bank transfer.

We don’t accept credit cards or checks.



BTW - Every other surgeon in the building is in the cosmetic field... It's not like they're based above a world-class oncology consultant and below a famous neurosurgeon...

Having said that, I don't 100% know it's a scam, I'm just repeating what I've been told... Good luck to you!

[speedsalive]

Is there anyone whos got the tubes in..and whos got good or bad experinces with them.. and if you have a medical chekup coming soon.. will it be ok if you already have the tubes in ur ear?

cheers

[WG774]

Seeing as I've spent over 20 years having numerous (probably nearing 10) GPs wrongly telling me I have an ET problem, I'm in a prime position to say what I'm about to. Check out this link: http://www.tinnitus.org/home/frame/Things%20that%20go%20bump.pdf

Middle ear blockage, not always what it seems

Behind the eardrum is an air-filled space
where three little bones conduct the sound to the cochlear or inner ear, when the eardrum vibrates. The air is replenished through the Eustachian tube every time we swallow or yawn, something most people have experienced on air flight. Many
patients come to us with a conviction that they have Eustachian tube blockage, and this will have been reinforced by professional diagnosis in the absence of any investigation. It is very easy these days to measure Eustachian function with impedance audiometry. A soft earplug placed in the outer ear connects with a device which measures the pressure behind eardrum. In over 97% of our tinnitus patients this proves to be the same as atmospheric pressure, indicating that the Eustachian tube is functioning normally. Nevertheless many patients have been
treated for Eustachian dysfunction even
though they didn't have it. Do not accept a diagnosis of persistent blocked Eustachian tube without this test.
Eustachian blockage no longer such a
common problem.

Concepts about Eustachian tube blockage, particularly in complimentary medicine, are generally very out of date, and reflect the common clinical findings in pre-antibiotic days, when chronic infection of the throat and sinuses was commonplace. In those societies where children are given regular courses of antibiotics, and live in good housing, such chronic infections are now a rarity, compared with the high prevalence of these symptoms. Consequently Eustachian dysfunction after childhood (when glue ear is common) is now rarely seen. In any case, impedance audiometry, taking some 30
seconds to perform, gives the answer

The crux is, if you have a middle ear condition relating to tension in the various tendons (if you have a stressful or noisy lifestyle, it's not uncommon), you will get discomfort that feels very similar to an ET problem (the 2 are very close to each other) when going through pressure changes.

If you think you have an ET problem, don't take the GP's word for it: GET A TYMPANOGRAM ASAP, preferably at a time when the discomfort is recent.

(Don't be put off by the tinnitus reference - the analogy about ET issues is relevant, and you WILL get a feeling of pressure, similar to ET dysfunction, if you have a middle ear issue. Also note that a middle ear problem isn't the end of the world - early diagnosis is the key)

[KindolFaret]

I've just recovered this very interesting thread from the archive... I'd like to share with you my experience and specially WG774 tell u about my theory... that seems pretty similar to yours...

I've been flying since 2003 and this year first time in comercial ops / pressurized. I've never had problems with my ears before, even being allergic to many things. After a period very high emotional stress... i've begun to suffer from blocked ears both during climb and descent but worse during the last 5000ft of the approach... due to the bigger pressure difference, i guess.

Every ENT doctor talks about otitis media, rhinitis, sinus problem etc... but my experience is that medicines for that doesn't solve the problem. I'm in the same situation as you... but one day I started thinking about the possible relationship between tension and blocked ears. There's a lot of stuff on the internet about that but not very clear though.

One morning, when sympthoms were better (as you say), while still on the bed I started thinking about a problem I had which created me stress.. one minute later my ear was blocked. On my last days off i went to the beach... no problem with the ears... i was relaxed, but the day before starting flying my ears went blocked again.

I'm convinced there's a direct relationship between my blocked ears and tension / stress... and also because after a back and neck massage session I feel my ears unblocked sometimes inmediatelly.

Any comments on that? WG774 can you update us on your current status? I'm very interested and supporting 100% your theory about muscular relationship.

Cheers!

[Horizons59]

Note that I am NOT a pilot and I am only posting here on the off chance that someone will be helped.

I have experienced it all with my ears. Born with a cleft palate, multiple mastoid operations and recently a total replacement of the middle ear bones with a titanium unit. I was lucky enough to have the finest ear Dr. in the world (Dr. Brackmann, House Ear Institute, LA, USA).

To make a lifelong (49 years) story short, after all of the above, my Dr. recently prescribed the earpopper device ($200 USD). This simple device has made a world of difference for my hearing and has greatly reduced the uneven pressure in my middle ear. That fullness in the ears is gone. He prescribed this because the titanium unit was not fully functional due to the inward pressure on my eardrum.

(Not a shill for the company, just a happy customer).

EarPopper - Earache, Ear pain, and Ear Pressure Relief Device (http://www.earpopper.com/)

I hope it helps some of you.

[WG774]

KF - You and I have very similar symptoms by the sound of it. I'm no nearer a conclusive diagnosis, and am resigned to the prospect of seeing many more ENT specialists. I suspect that issues of this nature (and indeed those witnessed in other threads such as Stilton's) are fantastically difficult to diagnose, and doctors often feel that investigation causes more damage than good.

Sorry to sound pessimistic, but I suspect you *may* need to see a lot of specialists to get a conclusive diagnosis. My tip is to trust your instincts; nobody knows your body better than you. Get a holiday and see what that does.

Also, try a Google on 'TMS'. I'm not totally convinced, but I believe Sarno's theories have some truth to them in a common sense kind of way.

I'm away for a couple of weeks, so don't think I'm rude if I can't reply. Excuse typos as this is written in a hurry.

(Not Test Match Special btw)

[Hugh Spencer]

Can I just say that I have suffered with blocked eustachian tubes for years. The consultant wanted to insert a grommet , which would have been only a temporary remedy if at all. I refused but later my GP suggested a Beconase type of nasal spray, using it while lying on my back. I had this trouble for about 4 months last winter but I have been using an Eardoc for the last two weeks, before a severe blockage occurs and I must say the signs are hopeful. I think it is going to work for me.

[agirlwithaguitar]

I have ETD which started after I took azithromycin for a sinus infection (an antibiotic). I've been getting the same line as everyone else from the ENT - do nasal steroids and decongestants and hope it goes away eventually.

I started wondering if it could be related to some sort of yeast infection caused by the antibiotics? IF so, what if I did my nasal cleansing with a warm water solution containing some live acidophilus cultures? Has anyone thought of this? Anyone tried it? Can anyone think of a reason not to try it? The same approach has worked wonders for me for yeast infections in other areas of the body, so that's why I thought of it.

However, I'm going to try the guaifenesin first, since several of you suggested it here.

Thanks, this is a lively forum!

[WG774]

Bearing in mind that my ETD issues have been misdiagnosed for many years by serial GPs, and that I have nothing of the sort, being told I had ETD has made me learn to exercise my ETs with various techniques. The upshot of this is that I've spent tens of hours flying in the last few weeks, without a hint of a problem or pain. My tip is to 'pop' your ears every few hundred feet in descent. I can't quite describe the technique, but I manipulate the jaw and muscles around the TM joint, without swallowing, which pops my ears. It's magic and I get no pain in the middle ear at all.

I strongly suspect there are many people with unrelated ENT conditions that are told they have ET issues... Over 5 doctors said I had ETD... Whilst others in the cabin have their faces contorted in pain, I have no discomfort at all... I guess the benefit of misdiagnosis has been learning to open my tubes at will. :ugh:

[mattford51]

Good evening.

I rarely post on here, however I have a distressing problem that is slowly driving me insane, so any advice is greatly appreciated.

A few weeks ago, I had a fairly heavy cold, didn't think much of it, apart from my ears didn't seem to clear. 3 weeks later, after the cold has cleared, my ears are still blocked.

Last week, I visited the GP three times, and the out of hours doctor at my local hospital, two said it was just the cold that was causing it and that it would clear in a few days along with the cold (3 weeks after I actually had the cold), and the other two diagnosed this as middle ear fluid, which can take absolutely forever to heal. We're looking into the region of 4 - 8 weeks, apparantly. Since i've had the problem, I haven't felt ANY improvement whatsoever.

I work for an airline that flies many sectors in a usual working day, so I have to carry out several descents a day. This is where the problem really starts, as the pressure builds up, I keep doing the valsalva maneouver, but every so often I'm unable to clear the pressure, it keeps building up, causes me a severe amount of pain, and the A/C is now flying single pilot.

I've had a seven day antibiotic course, tried every decongestant in the book, nasal sprays, cold tablets, Vics etc, but nothing has improved.

I'm going to a specialist about this ASAP, but for any treatment to be carried out will take a long time.

My question now is, where do I go now? I'm not technically employed by my airline (have a guess which one), so being self employed they can quite easily cancel my contract with them. Is it worth trying to go to work again, knowing what happened the last time I tried with this illness could easily happen again? Has anyone else had a similar experience, and found a way to keep the ears clear during a descent?

Thanks for any help, I really will appreciate it.

[Loose rivets]

I've posted on the use of warm (sterile) saline water, and a lot of hanging upside down over the bath.

Search me, medical, up to a year ago. A key search word might be salt, but I've had quite a lot to say about that, so be patient.

It has saved my bacon on more than one occasion.

Just repeat the same method of clearing your ears as you would on the decent while being upside down and having a good reserve of the mix in your nasal cavity.

Do a lot of extreme sniffing, then run the procedure again.

Very messy, but very affective. Eventually you will hear the progress, but remember the sniffing, or holding your nose and sucking as hard as you can, is a vital part. There's a limit to just how much air you can pump into your head!

[gingernut]

Unfortunately, I don't know of any medical interventions which will get you better, quicker. Pseudoephadrine helps some, (consult with your AME etc,) but beware the "rebound" effect, which could delay your symptoms.

(You will eventually recover whatever you do.)

Rule out other causes, such as reflux oesophagitis.:)

[C172 Hawk XP]

Pseudoephedrine helps some, (consult with your AME etc)

Very true, but my favourite decongestant is ACTIFED.

Everyone knows of Sudafed (pseudoephedrine) which is openly on display in chemists, and even advertised on TV. ACTIFED has an extra ingedient (pseudoephedrine plus triprolidine), and works much better in colds, catarrh, snuffles, etc etc. It's not on open display, not advertised, and needs to be specifically asked for. Packets of 12 tablets. One tab x 3-4 times daily for most adults.

Still best to ask your AME advice though, 'cos in a very few people might just produce a little temporary drowsiness. Mind you, if you've got that bad a cold . . . . . should you be flying at all ?

[WG774]

Make sure to read this thread: http://www.pprune.org/medical-health/294662-blocked-eustachian-tube.html

Make sure to get a tympanogram ASAP. Considering this affects you in a professional context, I would be inclined to obtain a full battery of tests at a specialist audiological / ENT facility.

Oh yeah - as you'll see in the link, there are drugs known as 'mucolytics' which thin one's mucous - could be helpful in your case.

[BYALPHAINDIA]

Cod Liver Oil x 2 a day, I have not had any colds or flu for 3 years now.

Cod Liver Oil, Has an ingredient in it that kills the build up.

[KindolFaret]

Hello guys,

just 3 weeks now from my septoplasty and turbinates surgery. After seeing many many ENT doctors one pilot from the Israel AF who runs a clinic in Vietnam told me to get the septoplasty done... so I went to Europe and got it done. He says it's physics... if you open the door, you ventilate the ETs then they open easily.

My ears are basically the same as before the surgery. The post-surgery was **** during 7 days... with totally blocked ears, blocked nose, etc. My doctor says it takes time for the ET to work properly. I took 3 flights in one day to return to my base to start working again... and I felt the pressure but every 10sec as WG774 said I discovered a way to pop my ears (moving my jaw in a certain way) and it works. The problem is to do it every 10 secs flying at 1000 km/h during a VORDME app in IMC... it's pretty challenging but... at least is a temporal relief.

Now I'm seeing a Chiropractic. He says there could be a relationship between my tight neck and back and blocked ears. After only one session I'm still the same, but confident,... no choice! I also wanna try a dentist for the TMJ thing and have a look at the trigeminal or so nerve.

I'm still convinced there's a muscular influence in this. Periods of tension and stress seem to trigger my ET problems. Also when I sleep (100% laydown position) my ears unblock. Funny...

I've been having same symptoms as you all... and I think for being pilots we are exposed to certain not normal environmental situations and agents that for some reason are not taken into account by the majority of ENT specialists. My conclusion is that our problem is yet to be diagnosed officially.

If it continues the same maybe I need to stop flying / working / earning money / living basically... so this is a great issue for me.

Any suggestions / comments?

[lpman]

I'm still convinced there's a muscular influence in this. Periods of tension and stress seem to trigger my ET problems. Also when I sleep (100% laydown position) my ears unblock. Funny...

-----------------------------------------------------------------------------------

Hello, i find it sorta surprising that you seem surprised that there is a correlation between laydown sleeping & unblocking your ears if you have eustachian tube disorder. I have been diagnosed with ETD for 4 years now. Possibly misdiagnosed from what i'm reading on this board... Like a lot of people posting i'm convinced it will never go away. I first got the symptoms right after a bad flu, which i've read on here by others is a way it sometimes starts. Before i even went to a doctor the way i found the most relief was when my ears got really blocked painful in my forehead got major headaches i took a decongestant & then lied down with my left ear ( which is the problem ear ) face down or on my back with my head tilted to the left). I always do so on a couch which has been my new bed for the past 4 years. With my head elevated & tilted to the left i can feel liquid flow down my ear/ET & down the back of my throat. I also can feel liquid drip down from the top of my head & if i put my head straight up can feel liquid flowing down my eyeball on the inside. Am i the only ETD person that feels the liquid running down right after taking a decongestant ? everytime i pop my ear i feel that cold slushy stuff flowing. I've always just assumed that people with ETD have a problem with there eustachian tube balancing out during the day with your head in various upright positions & that it only drains good from lying down with your head elevated & tilted where the eustachian tube is sorta forced into an open draining position. I always have noticed the more i sleep the less ETD problems i have the next day, and the less i sleep the more. So when i dont get much sleep i try to make time for 10 minute naps where i layback with my head elevated & tilted.

I read one person on here talk about impacted teeth & the jawbone grinding on them as a possible cause of ETD. I hope that is correct as i'm scheduled soon to have my 4 wisdom teeth removed. That would be great if that solved my eustachian tube problems.

[blueflightynurse]

Hi, sounds like you have tried the usual things, what I find really good are those menthol strips, put one on your tongue and it blows your head off, clearing your sinuses at the same time, You will find going up may be a problem but coming down is going to be the worst, Vicks Sinex sniffer is as good as any but you can't beat those strong menthol and eucalyptos strips - cant think who makes them though. Drinking lots and keeping the swallowing going, warm oil ear drops paracetamol, decongestant tablets 1/2 hour before landing, tried them all personally, they do work most of the time. If there is fluid in the ear then you will have less problem- it is the gas expansion you need to worry about, also if anyone has a burst ear drum then there is no where for pressure to build so no more pain, no problem.

[Mickey Kaye]

I think your being a foolish flying. If you shaft you ears its career over. And I do know of one pilot who 15 hours into his first job post fatpl did just that and never flew again.

Be carefull.

[Hufty]

Look at the threads that WG (and I) have contributed to....

It is a tough one right enough....the good news for you (IMHO) is that there probably isn't anything structural wrong with your tubes...you've just had the misfortune to get some liquid stuck up there that won't clear.

I reckon (non medical opinion but somebody who has suffered as you are suffering) you should try getting some steam up your nose......get your head over a bowl of hot water with eucalyptus oil and steam a couple of times a day. Saline wash is a good idea too....take a look at the NEILMED site...they sell bottles that you can use to blast some saline solution up there to wash past the opening of the ET and clean out any crap there. I looked at Loose Rivets' posts and I have spent a lot of time trying to do what he suggests but so far have only managed to spray salty water over the bathroom and myself! It is good advice though if you can make it work!

Try to keep hydrated too....it helps thin the mucous and may help it drain.

Excercise may help too I reckon...if you do it hard it can open up your passageways and get some air around there...

I sympathise....if you need anything PM me...

[Dick_Dasterdly]

Pop your ears every occasion you can think of, while on the ground, sitting watching TV, I got this advice when i had fluid in my middle ear after a bad head cold, it took about 2 weeks to fully clear and now my ear is fine, its was a horrible feeling though, be careful flying as the pressure could rupture your drum...

[Hufty]

I had another diagnosis recently...(another ENT surgeon) the guy said that I had some large areas of swollen flesh around the entrance to my ETs on both sides. The right ear has always been worse and he said that the right hand side was the biggest. It seems that this swells up and blocks the end of the tube.

He said it was to do with long term allergies and sinus issues.....the fluid that drains out of my sinuses and down the back of my throat is quite sticky and doesn't drain very fast. As such, it gets infected with bacteria and when it eventually does drain out, the persistent mild infection causes the whole area to swell up.

I have been trying saline washes for ages but he recommended something I hadn't seen before....basically just a plastic bottle you can fill with solution and get up your hooter. It seems to get a greater volume of water up there and because it is under a bit of pressure, it might be more effective than just using one of these neti pots.

Neilmed sinus rinse kit.

Maybe getting the infection out will reduce the swelling?

He suggested operating to reduce the size of these swollen areas....I am planning to try aggressive saline washing first to see if that works!!

[blockedrightearahhhh]

Hi all:)

It sux big time that we're all having to deal with this nightmare...My sympathies... I had a bad cold back in Jan and gradually i had a water moving type sensation in my ear if i bent down etc, that would come and go...Now my hearing is going and my ear feels full and pressurised and won't pop like most of you..And it is driving me crazy!! ahhh :)..A lot of the threads have been quite interesting..I don't remember who brought it up first, but , the theory of wisdom teeth affecting the tube seems like a possibility to me...I googled "Can wisdom teeth affect ET's?" and all i got was another thread discussion and a lot of the people on it said that after getting their wisdom teeth out they no longer suffered the ear problem..I have my top wisdom teeth and have noticed they have started to moving down and sideways in the last few years (i'm 38)

I was wondering does everyone here still have their top wisdom teeth??

Worth asking i guess....

Good luck to you all being able to fix this crap

:)

[The Right Stuff]

I've had all my wisdom teeth removed and all my sinus problems (along with eustacion tube symptoms) have happened and continued years later, so no connection in my case.

When my sinuses are bad I can feel aching in the teeth roots of my upper jaw though.

In the last couple of weeks I've been worse than usual which I hope is down to spring and pollen counts, and as such will settle down again soon.

[teresa green]

This problem nearly cost me my career, in the eighties, not only did I have a blockage, but bled from one ear when reaching a certain altitude, (which was very offputting to my First Officer to say the least) after many visits to ENT and brain specialists with no result, it was a humble surburban dentist who found my problem, a piece of mercury from a back tooth (filling) had broken loose and had somehow found its way into the tube between the ears and under the eyes and when the aircraft reached a certain altitude the tube became swollen, and the mercury rolled around causing friction within the tube, hence the bleeding, needless to say the specialists were amazed, and I think I made it into the "crash comics" (the mag put out by the Civil Aviation Auth) as a one off case, so check your fillings, if one is missing, or half missing you could be in the same boat I was. Good Luck.

[jetjockey737]

Hi everyone

5 years ago I was really struggling with my ears at work and was having to have time off on a regular basis.

I saw my GP and told them I wanted to see an ENT specialist. I opted to have the consultation done privately (approx.£100 )....THE NEXT DAY...I saw said ENT consultant and we discussed my options.

I had the choice of having my nose broken to straighten it and having the entry to my sinuses widened or grommits and some steroid based drops. He advised me that the grommits were probably the best option for me and I had tham done on the NHS 3 weeks later.

I was also told to stop smoking, Lose weight and cut down on dairy....touch wood I have had literally 2 instances of blocked sinuses since then.

The last time I had them I was going on holiday to barbados. I went snorkelling to some depth and a couple of hours later had water literally pouring from my nose. The bajuns that saw it said that my sinuses had been flushed out with salt water.....since then no problems!!!

I must say knocking the fags on the head was the best thing I did....but the grommits really worked for me.

Be careful what you shove up your nose as some products actually make the problem worse. They decongest but then the problem reappears in a thicker and more problematic form!! Go and see an ENT consultant and they will prescribe you the good stuff!!

Good luck!!

[PPRuNeUser0161]

Try this for two weeks with no excursions or it won't work.

No dairy
No simple carbs
No processed foods of any kind
No bread
Strictly no deep fried foods
Yes pack your lunch every day.
No beer or wine
Limited spirits with mineral water or diet mixers are OK if you must drink.
Cut out sugar
No marinades.

In other words eat steak, salad, veggies, fish, eggs, chicken and any meat without sauces that are not freshly prepared.
Its a cave man diet, if it wasn't commonly eaten 150 years ago don't eat it. Do this for two weeks to allow time for your body to get rid of toxins and allergens. If you feel relief as I did you have either an allergy, a food disorder or you could be insulin resistant which creates inflamation in the sinuses and eustations. Give it a go it worked for me. Oh yes and go to the gym or do some sort of resistance exercise if you can.

After two years I now control any problems by controlling how much processed food I eat. The less the better. This two weeks will be bad but if you want to get better you have to give it a go!
SN

[Yayan]

Hello, I've been experiencing this problem for about two weeks, research came up with this:

Eustachian tube blockage may be the sign of a more serious problem such as nasal polyps.

[blue up]

Family history of Tinitus.
10,000+ hours on 757/767. Diet high in milk, salt and bread. I guess I'm doing all the wrong things!

After noticing a decline in my hearing over the last few years I decided to buy one of those Bose X headset since I found that I was missing lots of radio calls. It seems to have made my ears a bit more sweaty and I had to come off flying this week after I couldn't clear my right ear. Lots of pain and distraction during the descent. I've also noticed occasional rapid "nose dives" whilst sat down either in the flightdeck or at the table in the dining room. Very unpleasant! Probably associated with the ear problems.

Doc said that the drum wasn't perforated but was full of fluid. Beconase and Otrivine plus a week off. I'm going to try the diet change and I'll report back.

[lloydstephens]

Keen to have news of the Eardoc and the other treatments. I've been wearing hearing aids for 23 years. I get the clicking noise in my ears and only one doctor has ever placed the light thing in my ear and said 'you've got some fluid behind your ear drums'

All others have just said (paraphrasing here) 'You're deaf, get on with it'

[Crew]

Hi everyone, I guess I have the same problem....after my flight I can not equalize the pressure, I am taking Nasonex and antibiotics, Xylolin nasal spray didn't help, I do steam inhalation 3x a day and no results, I was at ETN specialist yesterday, audiogram + ear pressure normal.....DR. said I can fly in 5 days when I finish antibiotics....(he thinks sinuses are not well yet)...even though the ear will still be blocked..I have already used one box of other antibiotics and it didn't help.
I really want to fly again, I miss it but I am scared to hell to go for a flight - I am cabin crew, what if something happens up there?? and I will be grounded forever.
Do you think I can go for a flight with my ear blocked......?????

It has been almost 2 weeks - home

NEED ADVICE THANK YOU

Jane :ugh::confused::{

[100hours]

Tried EARDOC with no improvement. "Glue ear" still the same.

[mrskytec]

Dear All,

Writing on behalf of my fiancee who has been suffering with a blocked ET (or so the recent diagnosis said) for around 8 months. All started after being off sick, but being pressured by the airline to go into work. A couple of times later she got an ear infection, and one offload in Paris later she was back with ear pain which has been the case ever since.

She has now been off work for a few weeks, and finally got her ENT appointment a couple of weeks ago. It was pretty much what we've read on here already- no real understanding of the problem, let alone appreciation of the work/earning a living situation.

Without having any sympathy from the doctors, and no supportive diagnosis from the ENT clinic, it's very difficult getting cover to take further time off work.

I'm convinced that some of the treatments talked about on here will work- especially as she has never suffered with any sort of ear trouble before in her life. She just needs some time off work.
The airline concerned will agree a new shift pattern, IF it is backed up by a doctor's letter; but even then, it's too soon for her to go back.

How do you communicate this to a doctor though?! They seem to shrug off the problem- "stop flying" is the general advice.

Does any one have any practical suggestions for clearing the way for time off work, with a doctors support, for an ET problem- allowing for some rest, treatment, and then a gradual return to work?

Appreciate any advice!

All the best

[BillClymer]

Hello
Not pilot, models only.
Former Scuba.
Alergy to Juniper trees, first time this year.
1. Drink lots of hot water or hot tea.
2. immerse in hot bath or spa, dunk head, rotate head to fill ears- repeat.
3. Reverse Valsalva Maneuver: shut mouth, hold nose, Inhale.
Works for me

[FlyingCath]

Hi Ennie,

Sympathies ... this is not a pleasant issue. I had a bout of it earlier on in the year. My GP said my ear drums were 'dull' (instead of shiny) ... so mucus in the middle ear ... I had antibiotics, nasal sprays, decongestants and in the end I got some nasal balloons ... Otovent ... available on Amazon for about £10 ... problem sorted out in less than a week. I do however use my balloons once a day to keep my ears clear and once a week or so I use NeilMed nasal rinse (I'd been using this 3 times a day) .. I've been grand ever since and all this stuff is natural ... no medication so you can fly with ease!

Hope this helps!

Kind Regards,
Cath

[serious]

I’m not a pilot but I do have a similar problem. I have lived with it on-and-off for 25 years and I must admit it’s a horrible thing as it can really drive you nuts. From what I can make out from this forum is that it has various triggers and can last for as long you mange to kill the infection or drain the excess fluid.

Triggers as stated on forum

Allergies: dust, food, pets, pollen…the usual suspects

Reflux: IBS or reflux sufferers may get it from complications between ear and throat

Water: Swimming, Bathing

Altitude: Air travel

Tips

If reflux sufferer – seek to control the condition with diet - ask GP

Lower your shower head – to below ear height – this can stop you getting it regularly - works for me

Give up Swimming – be carful of water in the ears even in the bath - only if water triggers yours

Antibiotics – If you’re lucky enough to get them will kill the infection and it will go fast but it will come back some other day - by GP perscription only

Clean ear carefully – get a lucky family member or friend to scoop out any goo or dry flakes in your ear but they have to make sure they just clear the outer ear not going too deep. Use a metal or plastic scoop – no ear buds and NOT to deep as they could make it worse - - ask GP if this is suitable for you

Drink lots of water – Make mucus thinner then It’s easier to drain and swallow

Paracetamol – can reduce ear swelling - ask GP if this is suitable for you

Reverse Valsalva Maneuver – hold your nose, cover your good ear, shut your mouth and breath in until you get that reverse popping sensation then swallow the gunk to drain ear - ask GP if this is suitable for you

Unfortunately you may have to utilise all methods to control it.


There are various posts of advice - good and bad. Get expert medical advice from your Doctor before trying anything you read online.

[Bad medicine]

serious - I think you are getting a little confused between middle ear problems caused by eustachian tube dysfunction; and ear canal problems which may be contributed to by a wet ear canal.

Always best to have it properly diagnosed by a health professional who can properly visualise your eardrum.

Cheers,

BM

[serious]

Maybe not confused - I have read pages 1-6 of this thread and there are a wide range of people on here looking for answers. Not just pilots and some with differing conditions and symptoms.

There are various posts of advice - good and bad. Get expert medical advice before trying anything you read online.

Your right, have it checked by a GP or ENT.

I'm guessing most of you have and that's why your looking for answers online!

This is just an example of what works for me... and you should only do if your GP is in agreement.

My ear was caused by blowing my nose to hard, too much pressure caused my ear to become damaged inside. Now my ear is damaged all kinds of things irritate it and becomes trapped inside causing fluid to build up.

It may be just a theory but could too much high altitude flying cause a similar problem due to the frequent poping of the ear?

[Matt1980]

@ serious
My ear was caused by blowing my nose to hard, too much pressure caused my ear to become damaged inside.

What exactly was damaged? Was it easy for the ENT specialist to see what was damaged?

[hannahbhannah]

I am not a pilot but I thought you may know about this problem:

I did have sinus problems but everything gone (once a day steriod nasal spray) they only thing left is my eustachian tubes have not recovered. In a non-heated environment they are fine, but within minutes of walking into a centrally heated room, or an air-con car, my ears feel full and I cannot unblock them. The only thing that works if that happens is oral sudofed and hours later (and much fresh air) they recover.

I am flying in 2 days and terrified as to what will happen to the tubes then? Please help! Wilol the change in air pressure have the same effect? Is taking sudofed before boarding enough, or should it be actifed? (bear in mind there is no mucus) ? many thanks

[Loose rivets]

The problem about flying commercially is you can't turn back . . . well, not without a lot of interviews. You really need to know if you will be able to tolerate the pressure changes. I assume c 8,000ft cabin.

Even when in good condition, the tube is something of a one way valve. Your real problems may occur on the way down.

I can get salty water (sterilized and about the mixture of sea water.) into my tubes, and have found it helpful in the past, but it takes a lot of messing about over the bath with head upside down, nasal cavity full of the brew and GENTLE nose-holding and blowing. Then not very gentle sniffing.

When it works, the noises leave you in no doubt about the flow.

[beachbumflyer]

I wouldn't fly. I would look for a doctor who really knows.

[piton]

Sudafed should probably do the trick - how long is your flight? You may need to take a second dose during the flight. You should keep equalizing your ears by yawning during ascent/descent. Also you should be able to find saline solution nose sprays at the chemist/drug store - this will have a calming effect on the mucous membranes.

If you can speak to your ENT doctor before flying that would certainly be a good idea.

For the long term google neti pot. This is something used historically by yogis to rinse nose and sinus/eustachian tube. You put lukewarm salt water in it and pour through one nostril letting it come out the other. This similarly has a calming effect on the mucous membranes.Pretty much doing what Loose Rivets suggests without the mess :-)

[lozhuni]

has anyone on here still got eustacian tube probs and has anyone found anyway of getting rid of the fullness??? iv had it for over a year and not found anything to help. tried antihisamines, nasal sprays, had ct scans, seen a chiropractor...still nothing...really getting me down duno what to dowith myself!!!! HELP any advice welcomed!!!!!!

[Bearcat]

I had a blocked eustacian tube.....very frightening with horrible tinnitus and going deaf with a fullness in my ear. Ended up getting an MRI which confirmed same......surgeon has me on Avamys 27.5 micrograms spray ( fluticasone furoate).......since taking the spray, two shots every morning, all my symptons have disappeared.

[Squawk 2650]

Hi Everyone,

Been having ear probs the last three days unable to clear one side. It clears on the ground and fine during the climb but on the way down I cant seem to clear it. Day 2 I took some decongestant and it was fine. Went to see the GP today who looked in my ears and throat and said all looked normal. I could clear them on the ground went to work and had same problem with the right ear not clearing. Have a few days off now anyone have any advise or old remedies that could help. I'm gonna give my AME a ring tomorrow but any help from here would be great.

Thanks in advance

S
:cool:

[Barbara428]

Hi. I had a cold and had to fly home last week = blocked eustachian tubes. ugh. I have been on a decongestant as well as taking an antihistimine for the cold. The cold seems to be gone, but my ears were still blocked. I have a mini trampoline for exercise (awesome way to work out btw), and voile'..... my ears starting popping while I tried to yawn and it has unblocked my tubes. Try it, you have nothing to lose and the bonus is a good work out. Research rebounding for health. ;)

[frankboase2]

Hi Hugh,
My own experience is actually exactly the opposite, if I lay with my head over the edge of the bed, this forces the throat, (and I hope the Eustacian tubes) open.
Still have the problem though :-((( I combine this with gargling salt water.

[hopeneeded]

Hi Guys

This is my first post here am I really hoping someone out there can help me please!

Basically I want to be cabin crew on long haul flights.

However, I have problems with my ears. I have seen an ENT consultant this week and have been diagnosed with allergic rhinitis which is causing problems equilbrilizing.

When I fly for holidays I get mild pain on descent and my ears will 'pop'.

The consultant is aware of my plans to enter the airline industry and has prescribed a nasal spray for 4 months to see if this helps. I am trying to eliminate dairy, wheat and use nasal rinses.

If this does not work I may need grommets to help.

I am so worried the airlines will not issue a medical certificate and deny my intended career.

Has anyone had allergic rhinitis and was cleared medically wise to allow a cabin crew career? Am I wasting my time applying?

Any answers and feedback is most welcome and appreciated. Thank you

[Company-man]

Hi all,

Recently since flying (with a head cold) I've been having painful ears and had trouble popping my ears on descent,

I've been diagnosed with Eustachian Tube Dysfunction and have a deviated septum according to the nice pics my ENT surgeon recently took, he mentioned I need a septoplasty and turbine reduction etc...and on top of that having grommets inserted.



-Does anyone have any experience on septoplasty surgery and turbine reduction? Did it help your Eustachian tube dysfunction/painfull ears,or we're grommets more helpful. Or maybe it's all due to the time of year ie: winter & head colds, summer & hay fever?

I've recently started with Avamys 27.5 micrograms nose spray, which seems to be rather helpfull, but not jumping too conclusions just yet...
Has anyone else had any good experiences with Avamys?

Ta

Company-man

[ChipMBW]

I found My Solution:

To start I am not a pilot or a Doctor. I am actually a pro Audio Engineer, my main gig is mixing the news, along with recording and mixing records for all kinds of music artists. So Obviously, my ears are directly related to my well-being and career. So when during the middle of my return flight to Miami, the pilot did some manuver that must have gained and lost quite a bit of altitude (like i said I'm no pilot) and my ears popped and clogged up I got extremely uncomfortable. Right then I couldn't hear anything from my left ear, and barely anything from my right. My girlfriend would have to talk in my ear (like at a concert) for me to understand. Then a few minutes into it, it became very painful, like a 6.5 out of 10.

Luckily for me, we were only another 30 minutes out from our destination. Upon descent my hearing did not improve at all. Only once I was on the ground and performing light Valsalva manuver did my right ear pop open. BUT my left ear would not budge, not even a little bit. Naturally I got very worried and started my google doctor routine, which lead me here.

48 hours later I am very, very pleased to report I was able to work out the blockage without any trips to an ENT doc.

During my trip I got Bronchitis, and when i got on my return flight it was at it's end but definitely not gone. I am sure that my bronchitis exacerbated the effects of the quick pressure chages onboard the plane.
I was chewing gum virtually the entire flight, I did not know however, that It could be so extreme as to block my ET's and subsequently ruin my hearing.

There is a wealth of good advice on here which I followed. Heres what worked for me.

Drinking LOTS of water (5-7 full cups)
Heavy doseage of Nasal Steroids, (I had flonase from my prior upper respitory problems)
Doseage of Nasal Decongestants
followed by an extremely hot shower (including inhaling steam vapor)
followed by running (Yes. running) around my block twice.

At this point I sat down (ear still totally clogged) and started drinking more water. I heard the tell-tale pops of the pressure finally starting to sink away. I got freaking estatic, and tried to finish the cup of water but to no avail, it did not equalize. However I knew I was on the right path.

I literally repeated the entire process.

It didnt clear up then either. I continued reading this forum and eventually read about the different types of valsalva manuevers so to speak. The one where you hold your nose but just swallow worked really well, as well as the voluntary opening one. But they would only work intermittently and wouldn't actually open my ET but I could feel them working.

Then I took one last hot shower before heading into the tv station, held my head at some awkward left up position and did the valsalva manuver, and bam. Pop crackle pop, a little bit of pain and all of a sudden my hearing was back to atleast 95%

One note, the entire time during my process I would breathe heavily through the nose and out the mouth, aiding in draining the ET's the way they are naturally supposed to be drained.

I also believe that keeping my body hot, and running in 98 degree heat, aided in the process.

For those of you who have had this for years, If you havent tried vigorous cardio-oriented excercise then you may have been tricked by our own lifesytles.

I, much like a pilot, have a sedentary job. I haven't ran around my block in YEARS. Your ears may be just one small part of your body, but your overall health can DEFINITELY affect your ears. Thats why avoiding all these foods and smoking and drinking is definitely good advice.

I'm writing this post because reading your stories of having blockage that lasts years or more was extremely upsetting as that would mean essentially leaving behind what gives my life meaning.

So there is hope, but don't look at your doctor like he is supposed to have that one magic bullet that is just going to make you right, It doesnt exist. If we were all healthy like we are supposed to be we probably wouldn't have gotten into this situation in the first place.

But for those that do have a deeper issue that clearing your ETs either cannot be done, or has no affect. I wish you the best of luck and toughness when it comes to dealing with the effects.

Hope something here clicks.
Thanks :ok:

[ohmit89]

Hi guys,

I have spent the last month looking at remedies on blocked ears on various websites, had a myringotomy done. but nothing really worked for my left ear it was stuck fast. Until yesterday. I read somewhere - wait for it - it sounds ridiculous, that if you hum like bee it will help. Being desperate and willing to try anything to help my condition. I went home to try this and I think I have had some success! I have glue ear for a whole month and this low pitched hum seems to shake off the gunk in my ear - it began to feel wet again inside the drum. and the fullness is wearing off. It soon got addictive I was humming at home whenever I had a spare moment.

More about the technique. I found the vibrations got to the ear easier if you pinch your nose.

I dont know whether it is time that is helping my issue or this weird technique but I am over the moon.

I also started using Benadryl last night as well so I dont know if it is that as well. but the improvements over the last day has been far greater/speedier than I have experienced since my problem started from a flight a month ago. Never flying with a cold again!

I signed up to this forum just to share this with you guys, ear fullness drove me crazy! Hope this helps!

[mad_jock]

Try sticking an electric shaver on the bone behind your ear

[figjam]

Google the following:

menthol effect on eustation tubes

I had this problem for many years but always carried a small bottle of menthol crystals (easily obtainable for the chemist) and when required, inhaled the vapour from one crystal dropped into warm water (usually the remains of a cup of tea) before descent.

[KylesMom]

I've read several posts here about eustachion tube blockage and disorder... but I haven't seen anyone mention that they are also experiencing a high pitched non stop ringing/buzzing.. I've had it in 1 ear for 4 days now.. can't hear anything out of that ear except the ringing/buzzing noise.. I read that some of you have had it for months...or years.. I am about to go nuts from this constant ringing! I cannot imagine anyone could live with it for any extended amount of time! Doc ordered me off work for 3 more days.. Does anyone else have this high pitched non stop noise going on with the blockage?

[Captain Slackbladder]

I don't fly much anymore, particularly because of ear problems.

As a passenger on a military aircraft in 1998, a fast decent left me bleeding from my ear which became infected. I still regularly flew and suffered deafness and pain, it all became too much and I vowed to never climb on an aircraft again.

I still suffered and eventually the ENT surgeon found a condition called colesteatoma. I needed surgery through the mastoid bone, there were complications but after ten hours surgery I woke to find the damaged hearing bones were replaced by a synthetic implant and I could hear again.

This year I decided to be taken to the skies once (or twice) more for a family holiday. I can't describe the searing pain the pressure caused, it felt like the prosthetic hearing bone was ripped from inside my ear and after continually performing the valsalva manoeuvre it felt like I swallowed it. I returned to ENT and am still being checked out, talking to the doc (a PPL hobby pilot) he thinks that if I had been seen by a surgeon very early on I would not have the problems I have today, and I wouldn't have had to have a severe mastoidectomy. I will no doubt lose more and more hearing as time passes, until it is all gone.

My point is, especially to those who need to be in the air to put bread on the table, please look after your inner ears. Blocked ET's rarely clear up never to return own their own.

One of the main damage points of one of my ear drums was caused by the ET blocking, and the gunge gelling the ear drum closed, as the pressure increased the eardrum sucked backwards and eventually burst.

If you can perform the valsalva manoeuvre, you are more likely to keep the ET clear and dry, my surgeon tells me he has learned to equalise the pressure like this without physically pinching his nose, and he does it when he flies regular on every trip.:ok:

[TotalBeginner]

I've always been able to voluntarily dilate my eustachian tubes in order to equalise pressure, without the need to chew, swallow, pinch my nose or make strange expressions. :)

However, when talking to a couple of friends who are also pilots, they had no idea what I was talking about. Both of them reported that their ears 'pop' when the pressure difference gets too high, but they have no control over when this happens.

I tried to explain that it's possible to open the e-tube on demand, but obviously without being able to point to a specific muscle, it's almost impossible to describe.

The reason I 'manually' equalise pressure is, not just because of the discomfort but also because I notice a significant loss of hearing when a pressure difference exists.

Is it normal to have to regularly equalise ear pressure in order to maintain satisfactory hearing?

[mad_jock]

For me it is.

[NW_Pilot]

I also have a blocked Eustachian Tube.

My sinus was Frost bitten in Iqualiat and got a Sinus Infection from Iqualiat - Guatemala took about 2 weeks to recover but 1 week later I got a fluid feeling in my ear that would not go away.

Took some amoxicillin and antihistamines it cleared up for about a week and a half. a week later it was blocked again was given Cipro went away for about a week then came back, now on another antibiotic and an anti-inflammatory waiting on the pharm to fill Nasonex see if that helps.

It is not painful just annoying.

ENT on monday if Nasonex don't work.

[monaaeysha]

Hi....I got fluid in my ears too.....and I took your advice seriously.....still recovering....but I thank you for posting here. Thanks

[Radgirl]

Popping your ears isnt a great idea. It can perforate an eardrum.

Reading this thread now it has been reactivated is interesting. The diagnosis of fluid behind the eardrum, known to doctors as chronic otitis media, is simple - you look in the ears with an auroscope and see the eardrum is dull. you dont need an audiogram!

The medical treatment is decongestants such as actifed, antibiotics possibly and painkillers if necessary. Unfortunately the key is the decongestant which you cant fly on. This treatment also takes time, and meanwhile depressurisation carries a risk of perforation of the eardrum - this doesnt kill your career, but may need an operation to repair is so you are grounded for months

Hot water, oil or anything else outside the eardrum is a waste of time - the problem isnt the drum but the drainage tube which is miles away.

The other treatment is to drain the fluid by a small nick in the eardrum. A washer or grommet is often left in so the ear can drain and you are soon fit to fly. In many countries this is done with some local anaesthetic in an office and takes perhaps 5 minutes! Whilst I agree the NHS doesnst usually consider this an emergency, if your career or health are at risk - ie you cant fly or you fly and perforate your eardrum - they probably will. If your ear is painful it is also urgent. So the morale of the tale is if it doesnt settle rapidly and you fly for a living, make a fuss, demand to see an ENT surgeon, and demand some grommets.

[hopefulone]

Going to give a try. Nothing to lose. Maybe it is the vibration caused by the running that helps?;)

[Peter-RB]

I used to do daily runs on the road, round about 5/8miles after work I would be about 28yrs old, played Rugby and cricket and generaly thought I was mega fit, one day whilst driving my world went haywire, I managed to stop on the side of the road got out of the car and walked about a little bit and after about 10/15 mins all started to get better, I felt immensly sick and went as pale as death, but the weired dizzy feeling went and after about 30 mins I continued my journey, I discovered I was not hearing to well in my left ear and had the feeling of a blocked ear, my ordinary GP put it down to a head cold, however five year later it was still affecting me every two to three months, my wife ( a Nurse) did some reading up on this and informed me that I would not get better, and that I needed to see a person who really was just an Ear Doctor, in other words a Specialist, I paid to see a Surgeon at Manchester Royal Hospital UK who diagnosed what was wrong and he suggested an operation to place a drain from my ETube into my Neck, he said the liquid in the E Tube had thickened up and by fitting a small drain it would alleviate the problem by always allowing a supply of fresh liquid produced in the head area to be in the E Tube which acts as a sort of spirit level for your body, I was in Hospital for one and a half days, the operation was about 9/10 hours, it cost me about £7k in 1988 and I have not had any trouble since, as soon as I came round from the operation I knew it had worked , for I could hear crystal clear and had lost the feeling of fullness in that left ear along with losing the high pitched clicking and whistling sounds.
even now in 2013 I cannot thank that Surgeon enough for his diagnosis and operational skills. He still runs the ENT side at MRH but now has a dedicated team of equally skilled sugeons under his control.

Potions pills and medicines did not help ..the knife did!

Peter R-B
Lancashire

[Mooneyboy]

Hello,

I m a full time pilot for a uk airline in my late 20`s.

I was on holiday with my family when i got a pretty straight forward standard cold. Flew back home as a pax a little congested which I did feel in descent but it wasn't that painful just used standard methods to clear my ears which they did after a couple of hours on the ground.

The next few days spent trying to get over the cold. I've pretty much got rid of the cold still a little congestion but the one problem I seem to have is not been able to fully clear pressure from my left ear. The right is fine. Its not painful at all just a pressure which is there 75% of the time. Strangely when I get up in the morning it seems ok less so when I'm upright.

I went to see local gp who said I have a lot of build up of wax in that left ear. Could that be the cause of this pressure sensation or inability to clear that ear? I'm using olive oil to soften up the wax and was perscribed a steroid decongestion nose inhaler.

Does anyone have any advice or knowledge on this as I am concerned that the pax flight has caused damage that might stop me clearing pressure. I hope it is the wax that I can get cleared as I am already calling in sick and really need to get flying soon.

Best regards

Mooneyboy,

[RedBullGaveMeWings]

I went to see local gp who said I have a lot of build up of wax in that left ear. Could that be the cause of this pressure sensation or inability to clear that ear? I'm using olive oil to soften up the wax and was perscribed a steroid decongestion nose inhaler.
Just wondering why he/she could not pick ear wax out as it may keep obstructing your canal ear. Nothing dangerous in the first instance but it could be really annoying and in some cases painful later.

You could try to remove ear wax by slowly and gently injecting warm water (body temperature) in your ear canal by means of a syringe. Let you help by somebody.

[L'aviateur]

Glad I found this thread. In January I had a severe ear infection which caused loss of hearing, and eventually after months sort of recovered but when I swallow I can hear a clicking sound in my left ear (like mucus is still in there). In July I had an audio gram as part of a medical which identified a slight loss of hearing in the left ear, however with a history of perfect hearing in all previous annual audio gram it was assumed due to the flight. Again in August I had another audogram which said the same. I've tried cleaning the sinuses, but now going to see an ENT specialist for advice. However since I'm here in the sandpit I like to be armed with the right info before I see the local doctors.

[Captain Victor]

Hi guys,

On the last 8 years I've been flying Boeing 737 for Gol Brazilian airlines.

It has been chalenging to keep flying all those years due to somes issues on my Eustachian tube.

Every year I need to get some days out of duty because of sinus and otitis media.
So I take some antibiotics and corticoids to get better and continue flying.

Comparing my health with other crewman I believe that I suffer more from sinus and otitis than the average. (I have one to two cases per year).

Do you guys think I'm in the normal range?

Can someone give some tips or treatment?

I'm really open minded guy and have already tried a lot of different options of treatments like homeopathy, take some clarintin (loratadina), allergy vaccine, etc.

It seems that a simple cold on myself improves to sinus and afterwards to otitis due to pressurization change that I'm exposed all the time.

I also realized that always when I have a cold my Eustachian tube doesn't work well causing hurt and pain.

On the other hand, some pilots never feels that discomfort even if they have a cold.

I always have a hard time for take off and land even if I don't have a cold.

An important information is that I don't have continuing sinus, it's alergic. So an surgery is not the case. My xrays are fine.

Another important information is that I've inserted "PE tubes" a few years ago and it was fine. It helped me and last for 6 months. (I consider doing it again if necessary).

Does someone here has ever user a product called earpopper? It seems to work fine when your ET is blocked.

[reynoldsno1]

I have had Eustachian Tube Disorder for about a year now. It is actually a fluid build up in my left middle ear, and the tube is not blocked. It is not painful, or uncomfortable. I have seen a specialist who shoved a shuftiscope up my nose, but reported nothing untoward. I have no problem 'clearing' my ears ....

My hearing is dulled on one side, and I have had tinnitus in my right ear for years - but I have learnt to live with it. I had an audiology test, which showed that I had reduced LF perception, but that overall my hearing is not too bad for a 60+ yr old.

On occasion, the fluid seems to clear for short periods and I have to turn down the TV a bit. However, there seems to no 'cure' per se. The fluid can be drained, but grommets are not a long term solution, and there is no guarantee that the problem will not recur. I'm living with it...

[2lilian]

Your blogs are most useful to me, thanks for posting. My head, throat and chest infection has lasted more than 3 weeks now, but at last, there are signs the viruses are departing. I did sweat from time to time in week 1. My throat got tighter and I began to cough after week 1.

I have not had a fever. Sticky yellow globs of mucus come up when I cough or hack the back of my throat, more in the third week up to now. My GP put me on antibiotics for 1 week in the 2nd week to get rid of any bacteria piggy-backing on the virus damage to my lungs. This to forestall any Bronchitis developing, and I felt better except that the cough worsened. Into weeks 3 and 4 , as of now, I have coughed up so much yellow blobby mucus from my tight throat.

Cannot believe it. Wheezing breathing worries me. I went back to the GP and was given a ventilator....slight improvenment. The websites all say a cough can last for 3 - 4 weeks, surprised me.

Drinking lots of water, honey and lemon, aloe vera jiucxe [peachy bits], all flavoured teas without dairy, taking paracetamol to help sleep, but cough all night sometimes. ......Wondered about allergy to cat hair/ fleas, since cats sleep on the bed ! .....Wondered about bed-mite irritation. Tumble-dried all my pillows on high heat for 10 plus minutes to get rid of dust mites. Washed all bedding at 60 degrees plus for same reason. Feels better to me. ..........Took Sudafed = decongestant 3 times a day to dry up dripping nose - helped me to carry on life near-normal, but decongestant use can keep the dry cough going on longer, and make the mucus stickier so you cannot cough it up so well, to spit out. ... ....Now in 4th week, coughing less, but eustation tubes still blocked, hearing interrupted a bit, sometimes I feel dizzy [balance part of ear affected], voice annoyingly wheezy and sinuses still partially blocked. ......I want to try jogging a little as suggested by a blogger here - thanks. Exercise IS good, but you don't feel like it ! .....Thought the turkish steam bath a good idea too. Nasal inhaling over hot water with eucalyptus oil drops, head under a towel, is supposed to help - mind not to be scalded. ....Commercial inhaler of salt water I may try too. Finally coming out of the worst in week 4......I considered myself fit, but these new viruses are terrible, laid me really low ! Must boost the immune system to avoid same again. ....Exercise plus healthy eating, giving up the medications, drugs, ......all boring ! Good luck with yours !

[500 above]

2lilian

Maybe it's the dust in the atmosphere in Limassol?

We've had a lot of dust here for the last few weeks, near Coptic conditions. (google Cyprus Coptic gales)

I too have been suffering for about the same duration (Pafos based)

[dennis7]

Hello everyone,

I have been suffering from eustachian tube dysfunction for a few years. I have crackling sound in my both ears, when swallowing, eating or drinking. Has anyone had this problem before? And is it a problem for class-1? Sometimes when flying, it may give pain.

Thank you.

[NGFellow]

Here is some info:

http://www.medicinenet.com/eustachian_tube_problems/page2.htm


Go see an ENT specialist! You can worry about your medical later.

[dennis7]

I have read it. Nothing is concerned with flight and dysfunction issue. Ent specialists tried a few treatment ways. But those did not work at all. Any suggestion?

[Bullmiller59]

Has anyone used high doses guiafenesin and had success treating blocked eustation tubes?

[421dog]

Likely won't do much.

Hie thee to the local swimming pool, read a little about the Valsalva manuver, and practice it whilst swimming to progressively deeper depths.

It works both ways, that is, you can hold your nose and sniff too.

If you can't clear your ears once you're able to develop enough pressure in your nasopharnyx to make little bubbles come out your nasolacrimal ducts, you need to be on Afrin and Flonase.