From the Guidelines
Ear fullness can be treated by addressing its underlying cause, which often includes allergies, sinus infections, or Eustachian tube dysfunction, and managing the condition with a combination of lifestyle modifications, medical therapies, and surgical interventions, as recommended in the clinical practice guideline for Ménière's disease 1. For immediate relief, try yawning, chewing gum, or performing the Valsalva maneuver (pinching your nose closed while gently blowing out with your mouth closed) to help equalize pressure. Over-the-counter options include antihistamines like cetirizine (10mg daily) or loratadine (10mg daily) for allergy-related fullness, or nasal decongestant sprays like oxymetazoline for short-term use (no more than 3 days to avoid rebound congestion) 1. Nasal saline sprays can safely be used multiple times daily to moisturize nasal passages and reduce congestion. If ear fullness persists beyond 1-2 weeks, is accompanied by severe pain, hearing loss, or dizziness, or occurs after head trauma, seek medical attention promptly. Ear fullness happens because fluid or negative pressure builds up in the middle ear when the Eustachian tube, which connects your middle ear to your throat, becomes blocked or doesn't function properly, preventing normal air pressure equalization. Some key points to consider in managing ear fullness include:
- Identifying and addressing the underlying cause of ear fullness, such as allergies, sinus infections, or Eustachian tube dysfunction
- Using lifestyle modifications, such as diet restrictions, to help manage symptoms
- Considering medical therapies, such as diuretics or antivertigo medications, to help reduce symptoms
- Evaluating the need for surgical interventions, such as endolymphatic sac decompression or vestibular nerve section, in severe cases
- Providing ongoing management and support to patients with persistent or recurrent ear fullness, including vestibular rehabilitation and hearing aids.
From the Research
Ear Fullness Symptoms and Causes
- Ear fullness is a common symptom that can be caused by various factors, including Eustachian tube dysfunction, temporomandibular joint (TMJ) dysfunction, migraine disorder, and anxiety 2.
- A study found that 94.7% of patients presenting with unexplained ear fullness were diagnosed as having a possible contribution of TMJ dysfunction, intermittent Eustachian tube dysfunction (iETD), migraine disorder, anxiety, or a combination of these conditions to their symptomatology 2.
Eustachian Tube Dysfunction
- The Eustachian tube plays a crucial role in protecting against secretion, germs, and sound pressure from the nasopharynx, and serves pressure equalization in both directions so that the ear drum and sound-conducting apparatus can vibrate optimally 3.
- Eustachian tube dysfunction can be caused by obstructive or patulous conditions, and treatment options include steroid nasal sprays, regular performance of the Valsalva maneuver, and tube dilation with the Bielefelder balloon catheter 3.
- Allergy has been linked to Eustachian tube dysfunction, with studies suggesting that nasal allergens, such as allergic rhinitis, can contribute to chronic ETD 4.
Diagnosis and Treatment
- The Eustachian tube score (ETS-5) can be used to diagnose Eustachian tube dysfunction in patients with a perforated ear drum, and the ETS-7 score in patients with intact ear drum 3.
- Treatment of Eustachian tube dysfunction depends on the underlying cause, and may include medications to decrease intranasal inflammation, such as intranasal corticosteroids or oral antihistamines 4.
- Directing treatments toward underlying diagnoses, such as TMJ dysfunction, iETD, migraine disorder, anxiety, or a combination of these conditions, may alleviate symptoms of ear fullness 2.