Expert: Harriet B Jacobster, Au.D. - 10/4/2009

Question

Greetings!

After a pretty rough cold, I was left with fluid in my middle ear.  Outer ear looks good, but there's moderate feeling of pressure inside and I have a bit of autophony.  This has gone on for roughly a month now.  Couldn't get an appointment with a DR., but the PA I saw told me to take decongestants/antihistamines.  I don't have a history of allergies.  Someone else told me that this doesn't work.  My questions are:

1. Who's right?  do antihistamines and decongestants for middle ear fluid in patients work?  Even without a history of allergies, where the fluid was probably due to a previous cold?
2. If so, how long is it okay to take these types of medications on a daily basis?  Is there anything that I should be concerned with doing so?  The PA I saw told me that I might have to do this for a month or longer.

Thanks for listening and any advice you can provide--

Answer
Hi Jeff,
Sometimes antihistamines/decongestants work by shrinking the membranes in the Eustachian tube and the middle ear.  This aids is allowing the fluid to be reabsorbed.  However, a lot depends on the cause of the swelling and how long the fluid has been there.  The longer the fluid is allowed to remain in the ear, the more likely it can become infected and turn into something we call "glue ear" which can permanently damage the middle ear bones.  Untreated fluid can also build up and rupture your eardrum.

You should not take these for a long time if you have certain conditions, for example, glaucoma(narrow angle), stomach ulcers, difficulty urinating (e.g., enlarged prostate), heart disease, high blood pressure, seizures, lung problems, overactive thyroid. Also, since these medications can cause dizziness and drowsiness, you should be careful if driving or handling machinery.

I would advise you to consult an ear specialist if the fluid does not subside within a couple of weeks; if you get a fever or ear pain, you would need to go to the ER.

Hope this helps.
Dr. Harriet B. Jacobster, AuD
Board Certified in Audiology