Expert: Harriet B Jacobster, Au.D. - 5/6/2009

Question
I am 44 yrs old. I recently was treated with 2 rounds of antibiotics and 1 round of prednisone for sinusitis/bronchitis and fluid in my ears. I had to fly with the fluid in my ears. After the flight, my ears go much worse as far as feeling full,hearing loss ,ringing in my ears etc. I saw the ENT again today who said there was a lot of fluid in both ears. A tympanogram was flat and the hearing test showed my hearing was down to 35%. He elected to do bilateral myringotomies but no tubes at this time. My hearing dramatically improved afterwards.The fluid suctioned out was clear. But tonight, my ears are starting to feel full again esp. the left one (it was the worst) and the ringing is starting to come back.I also am having some pain in both ears. Is it normal for this to happen? I am scheduled to go back in a week and he said if the fluid recurs then,tubes will have to inserted.
I am really hoping I don't have to have the tubes. Thanks for your help.

Answer
Hi Linda,
Although Myringotomies are more common in children, many adults have to get them as well.  The major reason for tubes in adults is Eustachian Tube Dysfunction (ETD).  The ET is a tube that extends from the middle ear cavity to the nasal cavity.  The role of this tube is to maintain pressure equalization in the middle ear.  If this tube does not function properly, usually due to swelling from an upper respiratory infection or even allergies, then negative pressure begins to build up in the middle ear.  This creates a vacuum and eventually fluid build-up.  Draining the fluid is a temporary condition, but if the underlying condition, ie, the ETD, is not cured, you will have recurring fluid in the middle ear as well as the other symptoms you described.  Pressure Equalization Tubes (PETs) simply take the place of the dysfunctional ET.  Without these tubes, you will keep having the fluid buildup, keep experiencing hearing loss, and may over time develop an growth in the middle ear known as a cholesteatoma.  

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