Differential Diagnosis for Bilateral Ear Fullness
- Single most likely diagnosis
- Cerumen impaction: The patient's attempt to use peroxide and an ear bulb syringe without improvement suggests a possible blockage, and cerumen impaction is a common cause of ear fullness, especially in older adults.
- Other Likely diagnoses
- Eustachian tube dysfunction: This condition can cause ear fullness and is often associated with allergies, colds, or sinus infections, which are common in the general population.
- Middle ear effusion: The patient's symptoms of gradual worsening of ear fullness could be indicative of a middle ear effusion, which can be caused by various factors, including infection or Eustachian tube dysfunction.
- Hypertension: The patient's elevated blood pressure reading (188/90) could be contributing to his symptoms, as hypertension can cause ear fullness due to increased blood volume and pressure in the ears.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acoustic neuroma: Although rare, an acoustic neuroma (a type of tumor) can cause ear fullness and should be considered, especially in older adults, as it can have serious consequences if left untreated.
- Temporal bone fracture or infection: Trauma or infection in the temporal bone can cause ear fullness and is a potentially life-threatening condition that requires prompt attention.
- Malignant otitis externa: This is a rare but serious infection of the outer ear and skull base, often seen in diabetic or immunocompromised patients, which can cause ear fullness and other symptoms.
- Rare diagnoses
- Meniere's disease: A disorder of the inner ear that can cause ear fullness, vertigo, and hearing loss, but is less common than other causes of ear fullness.
- Otosclerosis: A condition that affects the middle ear and can cause ear fullness, hearing loss, and other symptoms, but is relatively rare.