Expert: Harriet B Jacobster, Au.D. - 9/20/2008

Question
Doctor,

I have a very bothersome condition that developed a couple of months ago.

I am experiencing chronic sensation of fullness, stuffiness in both ears.

At no time are my ears fully clear and free.

If I shake my head violently from side to side, whilst doing so my ears clear up and feel clear BUT as soon as I stop the stuffy fullness resumes.

Ocassionally  when breathing through my nose I can hear my breathing being magnified VERY loudly  inside my head and inside my ear drums. This occurs time to time and intermittently. It can last awhile and then leaves me and may not recurr for a while; minutes, hours or even days. It is a horrible annoying sensation.

When I voluntarily contract my ear muscles when my mouth is closed, I feel it at both eardrums (fullness) and sometimes get an internal 'crackling' sound.

If I squeeze my nostrils and try to 'clear my ears' (equalize)...most often I cannot do so and feel like I am blowing inwardly against a wall...my ears won't "pop" clear and in fact get stuffier. There is also a fluid like feeling in my ear drums when I do this and a bit of a crackling sound.

Sometimes there is a sensation of mild pain or dull earache right at the area of my ear drums. There can be a fluid-like internal sensation as well. particularly when lying down or when I awake from a sleep; and when I awake my head feels very heavy internally and find it hard to get out of bed. The condition is worse at the start of the day BUT it does not ever entirely go away..

If I tilt my head over to either side all the way and hold it there, the lower ear clears alot but the upper ear feels fuller and vice versa.

The condition is rather debilitating physically as I feel quite rotten....and it saps out my energy because I simply don't feel right. My head feels like it weighs a ton , my ears are full.

My hearing seems to be reasonably clear and good but sounds may be a tadd muffled at times.

The symptoms are WORST felt when I awake and for the first couple hours of the day.

I would appreciate any help. guidance, opinion/feedback as I am in a bad way as result.

It is annoying and hurtful and is really screwing up how I feel.

.I had an abssessed tooth, upper central canine with localized infection in gum in area of root of tooth and the ear problem may have started around the same time.

2 1/2 weeks ago I had a root canal done on the tooth with no post-op antibiotic therapy.
COULD the gum infection have transferred itself into the eustation tubes or inner ear canals, etc.?

Since the root canal I think it may be getting a bit better but am not fully sure.

ps: am 55 yr. old male...take atenolol for high BP....otherwise  healthy. I have been a night grinder for years;bruxism and wear a tooth guard.

I have tried to explain my symptoms as well as possible.

Do you have any ideas as to what may be happening with me and what the problem(s) may be? and how to fix?

Could this be a result of chewing heavy on my night guard whilst I sleep?

Could the dental infection have affected my ears?

OR??????

Thanks so much...Ian

Answer
Hi Ian,
Since I am not a dentist, I am not sure of the treatment of an abscess.  I do know that root canal is one and sometimes they are treated with antibiotics, sometimes not.  However, it is always possible that an infection in one area of the head can spread to another, especially to the sinuses, especially with an upper tooth, since there is a very thin separation from the maxilla to the sinuses while some upper teeth are even rooted in the maxillary sinus.  From there, it is not a far trip to the middle ear and the Eustachian tube.  Bruxism is also a cause of TMJ which can also cause Eustachian tube dysfunction.  The biggest concern now, if your Eustachian tube has been dysfunctional for a couple of months, there is the possibility that you have fluid in the middle ear.  Therefore, it is my advice that you consult an ENT as soon as possible.  You may also want to return to your dentist and have him make sure that the abscess has been removed.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology