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Suggest Treatment For Eustachian Tube Dysfunction
Question: Have pulsatile tinitus, recently diagosed with hypothyroidism and taking 75 mcg of Levothyroxine. My opposite ear cannot equalize either. I've been to ENTs had every test possible, no signs of ear problems except enlarged artery behind the ear with the tinitus. Now my glands are swollen, been treated with anti initiatives, no change, except for ringing in both ears now. Still swollen neck and redness in throat. Doctor says not related to thyroid condition. Why are my glands swollen? Also recently back on birth control, needing more blood work soon to adjust thyroid meds possibly. Why isn't my ear still not equalizing? Also constipated one day and XXXXXXX stools another day. Why glands still swollen? Help!
Brief Answer:
You have Eustachian tube dysfunction...
Detailed Answer:
Hi
Thanks for posting the query. I have gone through the history and understood your problem. I'll try my best to help you with this problem.
1. The blocked tubes could be due to Eustachian tube dysfunction. This will require steroid and saline nasal spray to relieve the block followed by steam inhalation.
2. Tinnitus in the ear could be either due to Eustachian tube dysfunction or aberrant artery in the middle ear. This requires confirmation with angiography, to identify the aberrant vessel and blocking of the same if required.
3. Birth control pills may worsen tinnitus as it increases the viscosity of the blood.
4. Glands are the harmless lymph nodes, enlarged in response to the infection in the surrounding region. Appropriate antibiotics are required to treat the same if it is tender. And no intervention required if there is no pain in the lymph nodes.
Hope this answers your query; I'll be available for the follow-up queries.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
You have Eustachian tube dysfunction...
Detailed Answer:
Hi
Thanks for posting the query. I have gone through the history and understood your problem. I'll try my best to help you with this problem.
1. The blocked tubes could be due to Eustachian tube dysfunction. This will require steroid and saline nasal spray to relieve the block followed by steam inhalation.
2. Tinnitus in the ear could be either due to Eustachian tube dysfunction or aberrant artery in the middle ear. This requires confirmation with angiography, to identify the aberrant vessel and blocking of the same if required.
3. Birth control pills may worsen tinnitus as it increases the viscosity of the blood.
4. Glands are the harmless lymph nodes, enlarged in response to the infection in the surrounding region. Appropriate antibiotics are required to treat the same if it is tender. And no intervention required if there is no pain in the lymph nodes.
Hope this answers your query; I'll be available for the follow-up queries.
Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Prasad
I have been treated by my first ENT for Eustachian tube dysfunction and been given two trials of steroids on two consecutive visits which showed no results to improving my ability to equalize pressure in the ear. I also had a cranial angiogram which came back normal. I have been a very healthy person my whole life except for the last year when this all started with an episode of vertigo that made me almost incapacitated for a week due to nausea or unconsciousness from the meds given to me for vertigo. I'm concerned to take more antibiotics because the last time I was prescribed them by my GP for the same swollen glands I still have, I started getting pulsatile tinitus in my right ear too. My dentist also seems to think that I may have TMJ because my jaw clicks and grinds and sometimes I clench my jaw shut at night ( too much stress I guess). A mouth guard is not a great option because I am a mouth breather and have a bad gag reflex to boot. If I do not take antibiotics will it get worse or will my body eventually fight off whatever infection it may be? Perhaps if my thyroid meds get increased it will make my immune system stronger to address the swollen glands. It has been a frustrating year of going to every possible doctor and still not being properly diagnosed to feeling better. Prior to going on thyroid meds I was losing hair and always being cold in my extremities and being sluggish. I am very thin, so it surprises me that I'm diagnosed as hypothyroid when most who are diagnosed with this are overweight. Any advice would be helpful. Do you think my swollen glands are related to my thyroid condition? I don't remember ever having glands this swollen for this many weeks before. Thank you in advance for your medical advice and patience with my babbling :)
Brief Answer:
ETD, nasal steroids to be used for longer duration
Detailed Answer:
Hi
Thanks for writing back. I sincerely apologize for the delay in answering the query.
Intranasal steroids need to be used for a longer duration, minimum of 6 months, before expecting any improvement.
1. I feel you should not worry about the swollen glands unless you have pain. Sometimes, the swollen lymph nodes may not regress even after completing a course of appropriate antibiotics, and it is perfectly normal. Swollen lymph nodes are related to the thyroid gland if it is located in front of the neck, around the gland area.
2. If the nodes are located along the sides of the neck or below the jaw, it is not related to the thyroid gland. And, even for the lymph nodes associated with the thyroid gland to enlarge, there should be infection in the thyroid gland or any malignancy of the same. As, you do not have either of the above conditions, the swelling of the lymph nodes secondary to the thyroid problem is ruled out.
3. If you are really concerned about the nodes, you can get a fine needle aspiration cytology (FNAC) or excision biopsy of the same to identify the exact cause of enlargement. I would appreciate, if you can post the image of the affected region.
4. TMJ dysfunction can also cause pulsatile tinnitus in the ear. The Dysfunction requires simple measure such as rest for the jaw and topical, as well as, oral analgesics. Avoid chewing on the affected side, avoid chewing gums; eat soft food and chew on the affected side.
5. Other causes of tinnitus such as stapedial myoclonus, stress, vitamin B12 deficiency, sleep disturbances, etc. needs to be ruled out.
6. Yes, you are right; replacement of thyroid hormones will boost up the immunity and increases the ability to tackle the common health ailments.
7. Finally, it is not mandatory that hypothyroid individuals should be fat. Most of the times, hypothyroidism is seen in adolescents and young adults who will be lean.
8. My sincere advice to you is to avoid stress. The more you get stressed up, the life will become tougher for you and thus the tinnitus. Drink lots of warm water, eat plenty of fresh fruits and vegetables, you will be alright.
9. Please do not feel bad that you are posting a lengthy query. Actually, it has made my job easier in identifying the cause of your problems. Please feel free to ask any number questions which are bugging your mind. I will try my best to help you out.
I wish you good health and good luck.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck surgeon
ETD, nasal steroids to be used for longer duration
Detailed Answer:
Hi
Thanks for writing back. I sincerely apologize for the delay in answering the query.
Intranasal steroids need to be used for a longer duration, minimum of 6 months, before expecting any improvement.
1. I feel you should not worry about the swollen glands unless you have pain. Sometimes, the swollen lymph nodes may not regress even after completing a course of appropriate antibiotics, and it is perfectly normal. Swollen lymph nodes are related to the thyroid gland if it is located in front of the neck, around the gland area.
2. If the nodes are located along the sides of the neck or below the jaw, it is not related to the thyroid gland. And, even for the lymph nodes associated with the thyroid gland to enlarge, there should be infection in the thyroid gland or any malignancy of the same. As, you do not have either of the above conditions, the swelling of the lymph nodes secondary to the thyroid problem is ruled out.
3. If you are really concerned about the nodes, you can get a fine needle aspiration cytology (FNAC) or excision biopsy of the same to identify the exact cause of enlargement. I would appreciate, if you can post the image of the affected region.
4. TMJ dysfunction can also cause pulsatile tinnitus in the ear. The Dysfunction requires simple measure such as rest for the jaw and topical, as well as, oral analgesics. Avoid chewing on the affected side, avoid chewing gums; eat soft food and chew on the affected side.
5. Other causes of tinnitus such as stapedial myoclonus, stress, vitamin B12 deficiency, sleep disturbances, etc. needs to be ruled out.
6. Yes, you are right; replacement of thyroid hormones will boost up the immunity and increases the ability to tackle the common health ailments.
7. Finally, it is not mandatory that hypothyroid individuals should be fat. Most of the times, hypothyroidism is seen in adolescents and young adults who will be lean.
8. My sincere advice to you is to avoid stress. The more you get stressed up, the life will become tougher for you and thus the tinnitus. Drink lots of warm water, eat plenty of fresh fruits and vegetables, you will be alright.
9. Please do not feel bad that you are posting a lengthy query. Actually, it has made my job easier in identifying the cause of your problems. Please feel free to ask any number questions which are bugging your mind. I will try my best to help you out.
I wish you good health and good luck.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Dr. Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2543 Questions
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