Differential Diagnosis
- Single most likely diagnosis
- Eustachian tube dysfunction: This condition is characterized by the inability of the Eustachian tube to properly regulate air pressure in the ear, leading to symptoms such as ear fullness, hearing one's heartbeat (pulsatile tinnitus), and ear pain. The exacerbation of symptoms with coughing and the temporary relief with eardrops suggest a functional issue with the Eustachian tube.
- Other Likely diagnoses
- Middle ear effusion: The patient's symptoms of ear fullness, hearing her heartbeat, and intermittent pressure could be indicative of fluid accumulation in the middle ear, which may not have been fully addressed by the previous treatment with eardrops.
- Patulous Eustachian tube: This condition involves the abnormal patency of the Eustachian tube, leading to autophony (hearing internal sounds) and a sensation of fullness, which aligns with the patient's symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Nasopharyngeal carcinoma: Although rare, nasopharyngeal carcinoma can cause Eustachian tube dysfunction by obstructing the tube, leading to the patient's symptoms. It is crucial to consider this diagnosis due to its potential severity and the need for early intervention.
- Temporal bone tumors or cysts: Similar to nasopharyngeal carcinoma, tumors or cysts in the temporal bone can cause Eustachian tube dysfunction and must be ruled out due to their potential impact on the patient's health.
- Rare diagnoses
- Superior canal dehiscence syndrome: This rare condition involves an abnormal opening in the bone overlying the superior canal, leading to symptoms such as hearing internal sounds and experiencing ear fullness, which could explain the patient's symptoms.
- Otosclerosis: A condition characterized by abnormal bone growth in the middle ear, which can cause hearing loss, ear fullness, and tinnitus, although it is less likely given the patient's specific symptoms and the lack of mention of hearing loss.