Ear pressure can cause dizziness
DEARDOCTOR » I have recently experienced severe vertigo due to fluid pressing against my eardrum, which happened after a sinus infection. What was going on? How can I avoid a repeat? DEARREADER » What you’re describing falls into a collection of conditions known as otitis media, a somewhat general term that refers to inflammation of themiddle ear. This is the small, airfilled chamber behind the ear drum where the tiny vibrating bones that are a crucial part of our hearing apparatus are located. Otitis media can develop any time something prevents fluid in the area from draining. Congestion arising from a cold, the flu, allergies or a respiratory infection can all lead to inflammation of themiddle ear.
There are several types of otitismedia. When an infection develops, this is known as acute otitis media, or AOM. The cause ismost often viral or bacterial. Symptoms include pain in one or both ears, a feeling of fullness in the affected ear, muffled hearing, a sore throat or drainage fromthe ear. In some cases, AOMcan progress into a condition known as chronic suppurative otitis media. Characterized by the persistent discharge of fluid from the middle ear through a rupture in the ear drum, this is a serious condition that can lead to hearing loss.
When fluid collects in the middle ear but is not infected, this is known as otitis mediawith effusion, whichmeans fluid. As with acute otitismedia, there is often a feeling of fullness in the ear, and a loss of hearing acuity. In some cases, the condition can cause the dizziness and vertigo that you described. Unlike AOM, however, symptoms typically don’t include pain or fever. Acute otitismedia with effusion can last anywhere from a fewweeks to severalmonths. If the condition persists beyond three months, or if it recurs, the diagnosis becomes chronic otitis media with effusion.
The culprit here is the Eustachian tube, a narrow passage between the middle ear and the rear of the nose, near the soft palate. Its functions are to equalize air pressure between themiddle ear and pressure outside of the body, and to drain fluids fromwithin the ear. But upper respiratory tract infections can cause the Eustachian tubes to become congested, which means fluids will remain trapped in themiddle ear. Children’s Eustachian tubes are narrower than those in adults, which is why they account for the lion’s share — at least 80 percent — of otitis media diagnoses.
When it comes to prevention, the options are somewhat limited. It’s a good idea to take a decongestant before you fly, so your ears have a better shot at equalizing pressure. When you have a cold, be sure to blow your nose gently so as not to inadvertently overcome the pressure differential of the Eustachian tubes and thus forcemucus in the wrong direction. In that same vein, never hold or close off your nose when you sneeze.
Finally, other conditions can have symptoms that are very similar to otitis media. With your complaint of extreme vertigo, we think it’s important to see your family doctor for a definitive diagnosis.
Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician atUCLAHealth. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/oMedia Relations, UCLA Health, 924Westwood Blvd., Suite 350, Los Angeles, CA, 90095.