Hi,

Thank you for your query.

1. If your doctor can see fluid behind the ear drum, it is an XXXXXXX (Secretory Otitis Media). If you can upload any endoscopic images of your ear drums, I will be able to give you an accurate assessment. If there is no fluid, it may be Meniere's Disease.

1. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus (abnormal sounds in the ear)
d. Fullness in the ear
There is usually nausea (feeling sick) or vomiting, the hearing usually worsens during an attack and the tinnitus also worsens.

2. You should get a PTA (Pure Tone Audiogram) done to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially ( Audiogram sloping to left).

3. Get a Tympanogram done to check middle ear pressures and Eustachian Tube function. If this Impedance Audiogram is normal, it may be Meniere's Disease as it does not affect the middle ear.

4. Meniere's disease should normally respond to a salt restricted diet, acetazolamide (Diamox) and betahistine (Vertin).

5. If fluid or negative pressure detected in the middle ear by a Tympanogram ('B' or 'C' type graph), the initial treatment will include anti-allergic, decongestant medication and steam inhalation.

6. The fuzzy / disoriented feeling is common in dizziness. Unsteadiness must be differentiated from true spinning vertigo. Positional Vertigo must be ruled out by direct examination. Is there any nystagmus (abnormal movements of the eyes) noted by your doctor? Is there any headache or are there any visual disturbances?

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

1. Use an OTC nasal decongestant drop containing Xylometazoline 0.1 % (such as Otrivin).

2. There may be a slight congestion around the inner (nasal) opening of the Eustachian Tube which connects the ear to the nose, though you do not feel nasal congestion.

3. Your current treatment will help to clear the fluid in the ears (from the middle ear and not from the inner ear), however it may take several weeks.

4. Use the nasal drops in a dependent position (head low by either kneeling forwards with the head touching the ground or by lying on your back on the bed with a pillow under your shoulders and the head thrown back).

5. Take regular steam inhalation.

6. It is better to follow the guidelines for testing as suggested in my previous answer rather than guessing whether there is fluid in the middle ear or not.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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Hi,

Thank you for writing back.

Hope you have some early relief with the above treatment. You may follow up directly at bit.ly/Dr-Sumit-Bhatti

Wishing you a speedy recovery,

Regards.

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