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Ear, Nose, and Throat Disorders

Sinus blockage

06/03/2002

Question:

Yes, this info was very, very informative to me. I am currently suffering from chronic otitis media with sinus blockage. Anitbiotics do not help since the tubes cannot drain. I will be seeing an ENT in two weeks. A CT scan showed an area of fluid or blockage, possibly a mass in my sinus cavity area which is blocking the drainage of my eustachian tubes. I am 42. I am also frightened of the procedure. If there is a mass of some sort, how do they go about removing it? Do they go through the nose, the ears??? If it is fluid, how do they eliminate that problem??? If they end up putting in ear tubes, is that a painful procedure? I am hard of hearing...probably due to the fluid, I do not know, but will the fluid reduction help in my hearing ability? Please respond to my questions. Anything you have to say to help ease my fears will greatly be appreciated. Thank you,

Answer:

In most cases, a sinus problem that adversely affects eustachian tube function is due to chronic sinus drainage that causes secondary swelling around the openings of the eustachian tubes in the back of the nose. As a result, the eustachian tubes don`t open properly, and fluid may build up in the middle ear space (behind the ear drum).

This problem is best addressed by first clearing up the sinus problem, whether it be infection, allergy, or whatever is causing the persistent drainage. This can often be done with appropriate medications, but if not then sometimes surgery is helpful to improve proper sinus drainage. Such surgery is usually done through the nose using telescopes, and therefore there are no external incisions, and very little discomfort (or packing) afterwards.

If there is persistent fluid in the ears, behind the ear drums, it will certainly cause some hearing loss. It can be drained with a simple office procedure. The ear drum is made numb with a TOPICAL medication, and a small incision is made to remove the fluid. Usually a small tube is placed to prevent further build up, and this will simply fall out on its own.

If there is truly a mass in the sinus cavity or by the eustachian tube, then the treatment would be determined by the nature of that mass. However, this would be very unusual.

I hope this puts your mind at ease. Chances are very good that the problem can be addressed without causing significant discomfort.

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Response by:

Allen M Seiden, MD Allen M Seiden, MD
Professor of Otolaryngology, Director of Division of Rhinology and Sinus Disorders, Director of University Taste and Smell Center, Director of University Sinus and Allergy
College of Medicine
University of Cincinnati