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Ear pressure for 8+ weeks
An_248534 posted:
I have been experiencing pressure in both ears for over 8 weeks now and I'm trying to figure out where to go from here. I'm a 27yo female, no history of ear infections or allergies. Timeline of symptoms and events below:

day 0 - Ear pressure (both ears) started ~24 hrs after a flight. Over next week pressure becomes increasingly uncomfortable. Often (but not always) a wooshing (not ringing) in both ears, occasional pain and infrequent spells of dizziness (length ~ 1-10 min).
day 8 - See PCP, no inflammation, infection or build-up, she recommends taking pseudofed throughout the day to relieve pressure and return in several weeks if it doesn't go away. Start taking 30 mg pseudofed every 3 hours while awake, which generally keeps pressure at bay though it was very bad first thing in the morning or if I missed a dose.
day 10 - coughing begins, deep and very phlemy
day 11 - Fell ill with a 102 degree fever and coughing significantly worsens. Fever breaks within 48 hours, ear pressure is very bad, Urgent Care prescribes Z-pack and cough meds.
day 24 - cough subsides, pressure remains
day 26 - "new" cough begins, more a reactionary cough to a feeling of something stuck under my tongue
day 30 - see ENT, still no inflammation, infection or buildup visible. Endoscopy reveals swollen lymph nodes on back of tongue, prescribes anti-inflammatory nasal spray for pressure and 10 days of avelox for lymph nodes.
day 45 - By end of abx, cough is gone. Pressure remains significant. Flew twice in 3 days, pressure was slightly worse while flying though I used 'Earplanes.' Briefly experienced diminished hearing after flight.
day 51 - Hearing test showed hearing is "excellent." Pressure is less than when I had the fever and cough but still generally constant. Occasional sinus pain in face. No dizzy spells. Follow-up with partner of original ENT results in new prescription of a muscle relaxer to rule out issues from TMJ (have some jaw popping).
day 60 - No improvement since starting muscle relaxer

Any thoughts as to what this may be? I'm trying to be prepared and ask the right questions of my ENT. What tests should I ask about so I can get past this? A friend who is an RN of 30 years was thinking maybe fungal sinusitis and suggesting an MRI?
Rod Moser, PA, PhD responded:
That is a difficult question since your ENTs have tried many things to clear this pressure-sensation you are feeling. Sometimes, the pressure is not in the middle ear, but rather the INNER EAR, but you are not having dizzy spells. Whether you have sinusitis or not, would need to be determined. A CT scan is the Gold Standard for looking at the sinuses, not an MRI. Fungal sinusitis??? That would be very unlikely.

Without the ability to delve into your case, I am not sure what to advise you at this point. It would be important to remain under ENT care. I know it has been two months, so other than getting a second opinion from a different ENT, this would really be your best chance of finally...finally...finding some relief from yous symptoms.

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