What Causes Re-accumulation Of Fluid In Middle Ear Post Evacuation?

Posted on Wed, 5 Aug 2015

Question: after a terrible ten-day flu/cold, I ended up with fluid behind my eardrum. my ent drained the ear yesterday, but he did not put in a drainage tube, he said, since I "had no other history of issues with my ears". . today, the ear still feels full. I told the ent after the procedure "it still feels full". he said if it has fluid again in 10 days, he will drain it, but this time, he will put in a drainage tube. he said he will put an endoscopic up my nose to make sure I don't have a mass behind the nose, which can cause fluid. I called him today to ask him if it's normal for the ear to still feel full after draining. he didn't call me back. his staff person said this is normal, and I asked her how long it would take for it to feel cleared out..she said it could be weeks!!! i don't get it. i thought i would experience immediate relief. question 1) : is it "normal" for it to still feel full? question 2) how should I proceed? 3) what if anything should I be asking my doctor?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (4 hours later)

Brief Answer:
Need to address the blocked Eustachian tube...

Detailed Answer:
Hi

Thanks for posting the query

Re-accumulation of the middle ear fluid following evacuation is very common, unless a ventilating tube is inserted into the eardrum.

There is a tube connecting the nose and the ear known as Eustachian tube. This tube helps in maintaining the pressure between the middle ear and the nasopharynx (backside of the nose). When there is an attack of flu or nasal allergy or obstruction in the backside of the nose, the Eustachian tube gets blocked due to which there is pressure altered in the middle ear. This obstruction causes accumulation of the fluid in the middle ear.

Our aim should be addressing the cause of accumulation of fluid, i.e. the Eustachian tube. Unless, the tube doesn't open up, the ventilation will not happen and the fluid cannot drain out. Hence, I would recommend the following:
1. Do steam inhalation. Steam helps in opening up the nasal end of the Eustachian tube and equalizing the pressure.
2. Try using steroid nasal spray. Intra-nasal steroids such as Fluticasone or momentasone can be tried.
3. A mucolytic such as ambroxol or bromhexine helps in thinning out the secretions and easy drainage of the same.
4. Avoid chilled food & beverages and smoking.

Hope with these above measures you should be alright. Revert back to me if you have any follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (25 hours later)

i am not sure what to do. my doctor isn't going to see me until the 26th of july. my ear is ringing; the right ear feels full and feels like it's pulsing, although there is no pain. I am seeing a new doctor tomorrow. i think my original doctor should have put a tube in for drainage. i have been on flonase for 15 days now. the steam seemed to make it worse. i am miserable. how do i find out what is causing the fluid? so then i know for sure what the best course is?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (2 hours later)

Brief Answer:
Oral steroids and Xylometazoline/oxymetazoline...

Detailed Answer:
Hi

Thanks for writing back

I do understand your concern. The Eustachian tube seems to be still blocked.

The best treatment for relieving the ear symptoms is a short course of oral steroids. Oral steroids are powerful anti-inflammatory substance, which helps in quick decongestion of the nose and Eustachian tube.

Please continue with Flonase and along with it you can try using OTC intra-nasal decongestant such as Xylometazoline or Oxymetazoline for not more than 1 week.

Do not worry! You will definitely get better soon. 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. Shanthi.E