Differential Diagnosis for Pressure in the Ears and Bad Hearing

Single Most Likely Diagnosis

• Middle Ear Effusion (Otitis Media with Effusion): This condition is characterized by fluid accumulation in the middle ear, which can cause a feeling of pressure and hearing loss. It's a common issue that can arise from upper respiratory infections, allergies, or Eustachian tube dysfunction.

Other Likely Diagnoses

• Eustachian Tube Dysfunction: The Eustachian tube connects the middle ear to the back of the nose and throat. Dysfunction of this tube can lead to problems with equalizing air pressure in the ears, resulting in feelings of fullness or pressure and potentially affecting hearing.
• Earwax Impaction: Excessive earwax can block the ear canal, causing hearing loss and a sensation of fullness or pressure in the ear.
• Acute Otitis Media: An infection of the middle ear that can cause pain, fever, and hearing loss, often accompanied by a feeling of pressure in the ear.

Do Not Miss Diagnoses

• Mastoiditis: An infection of the mastoid bone in the skull, located behind the ear. It's a serious condition that can arise from untreated or inadequately treated otitis media and can lead to significant complications if not promptly addressed.
• Meniere's Disease: A disorder of the inner ear that affects balance and hearing, characterized by episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear.
• Acoustic Neuroma: A non-cancerous tumor on the nerve connecting the inner ear to the brain, which can cause hearing loss, tinnitus, and balance problems.

Rare Diagnoses

• Otosclerosis: A type of bone growth in the middle ear that can cause hearing loss by interfering with the ability of sound vibrations to travel through the ear.
• Cholesteatoma: A skin cyst in the middle ear that can be destructive to the surrounding bone and tissue, leading to hearing loss, vertigo, and other complications.
• Temporal Bone Fracture: A fracture of the temporal bone, which houses critical structures of the ear and can lead to hearing loss, vertigo, and facial paralysis, among other symptoms.

Each of these diagnoses has the potential to cause the symptoms described, with varying degrees of likelihood and potential for serious outcomes if not properly diagnosed and treated.