Sunday, September 17, 2006

Tubes and adults don't always mix

Q: I had a bout of Mono last summer and one side effect was a viral infection in my middle ear . A drainage tube was inserted but results have been mixed. I have recovered my hearing in the affected ear for only about 6 weeks in the past 15 months and am about to have a new drainage tube installed.

I use an ear plug when bathing or swimming but it occasionally leaks. I have just been fitted for a molded plug.

My question is:

Could water seeping into the middle ear be the cause of my drainage tube being ineffective? If not, what could be causing my tube to be blocked?

P.S. I am -- years old and my ENT says that he has not seen my problem(s) other than in kids.

A: I'm intrigued by that PS. That must be an ENT who treats very few kids, since I am constantly seeing this sort of thing in adults.

There are several possibilities, and there's no way for me to know exactly what's happening with you. Here are the things which come to mind:

1. Yes, occasional water seepage into the middle ear could be enough to compromise tube function.

2. Even one episode of tube otorrhea (drainage of middle ear fluids through the tube) could be enough to clog the tube, making it nonfunctional.

3. Sometimes, the problem is neither middle ear fluid nor Eustachian tube dysfunction, but low frequency nerve deafness, which can masquerade as the other problems. This is something readily diagnosible by a hearing test.

4. Some middle ear mucosal diseases persist despite tube placement. In this case, you would continue to produce middle ear fluid and you would notice persistent leakage of fluid from the tube . . . unless the fluid is exceptionally thick. That's something your ENT should be able to notice when he examines your ear under the microscope.

5. Rarely, throat tumors can cause persistent Eustachian tube dysfunction. A fiberoptic examination of the throat is sometimes necessary.

6. Finally, and most troubling, I've found that some adults simply don't respond well to tubes even when all of our tests and exam findings indicate that the tube should work like a charm. They're simply unhappy with the tube and there's no good explanation for it.

Good luck!



At 12:00 PM, Anonymous Anonymous said...

I have a strange problem. It all started with an episode/viral thing. NOT sure what it was. Felt like crap, had upper resp. infection, and both eyes PINK EYE. then one week later I had this feeling of a hard ball just under my jaw between jaw and ear...then it got worse, pain, and ear feels pressure! Had ENT look he saw nothing, got cat scan of neck..nothing! NOW what? I get pain when I swallow on the left, feel a pressure on the left when I bend my neck I feel something on the Left!! Suggestions?

At 11:27 PM, Anonymous Anonymous said...

I love your blog.
I have nasal herpes. and when i get outbreaks, the pain is very hard to deal with. Raw areas of nasal tissue tend to stay moist and not heal for 7-10 days. Also, outbreaks tend to manifest themselves much like a cold, with a runny nose, and general irritablity.
In your experience, what can i do to shorten the duration of the outbreak? Most creams need to be rubbed directly on the sore to help. problem is i cant always get to the sore because its in the nasal cavity.

At 2:46 PM, Anonymous LC said...

In 2004 I was diagnosed with otitus media with effusion. I had tubes put in in Sept 2004. One tube has already fallen out and 1 tube remains. I take nasonex daily and Prolex pd (guiafenesin) but I still have creaking in the ear without the tube in it and I was fine until lately where I have to blow air to unplug my ears. Is this just trapped wax or fluid in my eustacian tube and how can I get rid of it and eliminate the need to blow air to unplug my ears.

At 10:53 AM, Anonymous Anonymous said...

I am seeing a ENT Dr. that is trying to clear up my ear. I have some deafness in both ears, but I woke up one morning and it felt like I had swimmers ear in the right ear. they cant figure out what exactly happened.I had a loud noise in it through the night that would wake me up for about 2 hours a night.and then ever sincethen when I talk on the phone I am hearing some distortion in that ear. Any suggestions????? Barb


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