Blocked Eustachian Tube
Join Date: Feb 2007
Location: uk
Posts: 75
Likes: 0
Received 0 Likes
on
0 Posts
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!!
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!!
Join Date: Feb 2008
Location: dc
Posts: 3
Likes: 0
Received 0 Likes
on
0 Posts
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
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
Join Date: Dec 2003
Location: UK
Posts: 211
Likes: 0
Received 0 Likes
on
0 Posts
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…
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…
Join Date: Aug 2002
Location: UK
Posts: 438
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Join Date: Feb 2008
Location: dc
Posts: 3
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Join Date: Dec 2003
Location: UK
Posts: 211
Likes: 0
Received 0 Likes
on
0 Posts
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.
i read a few things that say guaifenesin may not be actually mucolytic, but somehow reduces surface tension and adhesiveness of the mucous.
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?
Join Date: Feb 2008
Location: dc
Posts: 3
Likes: 0
Received 0 Likes
on
0 Posts
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?
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.)
Join Date: Feb 2006
Location: United Kingdom
Age: 39
Posts: 19
Likes: 0
Received 0 Likes
on
0 Posts
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?
Join Date: Aug 2002
Location: UK
Posts: 438
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Join Date: Dec 2003
Location: UK
Posts: 211
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Plastic PPRuNer
".....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....
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....
Join Date: Jan 2007
Location: UK
Posts: 433
Likes: 0
Received 0 Likes
on
0 Posts
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.
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Join Date: Aug 2002
Location: UK
Posts: 438
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
Join Date: Dec 2003
Location: UK
Posts: 211
Likes: 0
Received 0 Likes
on
0 Posts
".....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....
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....
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.
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
Join Date: Feb 2006
Location: United Kingdom
Age: 39
Posts: 19
Likes: 0
Received 0 Likes
on
0 Posts
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 
Plastic PPRuNer
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
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
Join Date: Apr 2000
Location: gone surfin'
Age: 58
Posts: 2,333
Likes: 0
Received 0 Likes
on
0 Posts
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.
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.
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.
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.