Ear, Nose, and Throat Disorders

Chronic earache

04/24/2008 08:32AM

Question:

I have had pain in my right ear on and off for several years, along with loss of hearing, vertigo, and pressure. I have been to five ENT doctors, and they try to say I have Meniere`s disease because when they look inside my ears, there usually is no fluid. However, I believe I have chronic otitis media and ETD since if I can get my ears to "pop", my hearing is improved until I swallow. The last doctor I saw wanted me to take diuretics, but I refused, so he basically didn`t reschedule me to return. I am tired of the ear pain, tired of physicians not wanting to help me, and very frustrated as to what to do. Can you advise?

Answer:

First, it is hopefully very logical and evident to you that finding the appropriate doctor to help you in your condition/problem is going to be necessary. So even though you have seen 5 different doctors, seeing a 6th, 7th or 8th is important. However many it takes. Looking for information on the web is perfectly fine, but it does not substitute for establishing a care plan with your physician.
While its impossible to provide you with specific information regarding your condition, one point to explore with your next doctor is the complaint of ear pain. Your email beings with a complaint of ear pain and the ends with the same complaint. In the middle, you changed topics to ear popping, eustachian tube dysfunction and hearing. Notably, Meniere's is not typically characterized by ear pain. Hearing loss, ear fullness, vertigo, tinnitus - all part of Meniere's disease. But not typically ear pain. So further investigation is probably warranted. Everyone tends to seek one neat solution to all symptoms. However, multiple problems might be occurring simultaneously.
Greater than 90% of the diagnosis in something like Meniere's disease is made from the patient's history. Other information is gathered by exam, testing, imaging, etc. Those ancillary items tend to be corroborative or supportive of a diagnosis. However, what the patient tells the physician is often the most valuable. So if you are committed to seeking proper help and treatment, assume part of the responsibility and methodically list and analyze your symptoms. Some patients keep a diary or log to help document patterns of dizziness, possible triggers, coincidental symptoms, etc. Its often difficult for physicians to decipher which symptoms are most bothersome to the patient, which problems need to be addressed first, and which issues are most critical to the patient when they present with a scattered array of complaints.

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Response by:

Daniel Choo, MD
Associate Professor and Director, Division of Otology/Neurotology
Department of Otolaryngology
College of Medicine
University of Cincinnati