"Doctor, doctor, I caught a cold and got angry a few days ago. My nose is stuffy and my throat hurts. But now I have recovered from my cold. Why do my ears always feel stuffy? Is it water in my ears? Could you please help me get it out? I can’t get it out myself … …”
The above situation is often encountered by otolaryngologists in outpatient clinics. In fact, most of this situation is secretory otitis media, which is very common in our otolaryngology department. The most common causes are poor drainage of eustachian tube and upper respiratory tract infection.
So, what is the eustachian tube? Eustachian tube is a channel connecting our ears and nasopharynx. It is normally closed, and it only opens when we open our mouths, swallow, yawn and sing, so as to keep the pressure balance inside and outside the middle ear and tympanic membrane.
However, when we catch a cold and catch fire and get an upper respiratory infection, bacteria and viruses can also infect the middle ear from the nasopharynx and oropharynx through the eustachian tube, leading to our middle ear infection, commonly known as "otitis media". Patients with otitis media caused by upper respiratory tract infection generally have no ear pus, and most of them show a feeling of stuffy ears, accompanied by a slight decline in hearing. But it generally does not cause severe hearing loss.
Patients sometimes feel that their hearing loss is not obvious, and they may only find it when they answer the phone with their left and right ears and feel that the sound is different. When you go to the hospital, the doctor will ask you about his medical history. Some patients may be complicated with allergic rhinitis, and they have been used to allergic rhinitis for many years, so they don’t think there is something wrong with their noses.
In fact, only when patients control nasal diseases such as allergic rhinitis well, nasal ventilation will be better, and the effusion in the middle ear will slowly improve. Like a kitchen sewer, only when the sewer is open can the water on it flow down. The inflammation of our nose and throat is controlled, and the eustachian tube is unobstructed, so that the effusion in the middle ear can be slowly absorbed or drained through the eustachian tube and discharged through the pharynx.
By giving the above patient an otoscope examination, it was found that his eardrum was intact, his external auditory canal was clean and there was no bath water. On the contrary, you can see that there is water in the eardrum through the eardrum. After more than a week of conservative treatment with nasal spray and oral mucus-promoting agent, the hearing of the patient has improved obviously and basically returned to normal level.
Therefore, if we have sudden hearing loss after catching a cold, we should seek medical advice as soon as possible. Because the earlier the diagnosis and treatment, the easier it is to cure, and generally oral nasal spray hormone combined with mucus excretion promoter can be used. If it is delayed for a long time, the effusion will become thicker and thicker like egg white, which will easily form "glue ears", and the treatment effect will be poor, which may also affect hearing in the future.
Text/Guo Bingyan (Beijing Geriatric Hospital)
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