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Have Blocked Eustachian Tube, Diziness, Affected Eye Focus And Hearing Loss. Have White Patches And Swollen Glands In Throat. What To Do?

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Posted on Wed, 31 Jul 2013
Question: Hi, I'm having some unusual symptoms. I have blocked eustachian tube now for a number of years - getting worse this year with dizziness, affecting eye focus and hearing. I had an allergic reaction where my tongue swelled up and had small white spots on my lips and was treated with an antihistamine shot & predisolone for three days. I still feel slightly uncomfortable in the throat with a slightly swollen tongue - have gotten sty in my eyes and feel tired, dizzy and having panic attacks. Blood tests are normal but Free T4 and TSH are on the higher side.

Recently I have developed white patches in my mouth and have swollen glands in throat and underarm.
doctor
Answered by Dr. Dr. Prasad J (1 hour later)
Hi,

Thanks for writing to us. I went through your history with diligence. Occasionally we do see patients with multiple conditions and each of those conditions needs to be treated individually for proper well being. Yours seems to be one such case. Let me explain.

1. A TSH on higher side suggests hypothyroid (underactive thyroid) state. Hypothyroidism can explain generalized weakness and occasional dizziness. You may be adding weight even with normal food/dieting. It needs to be corrected with thyroid supplements as per TSH levels.

2. Long term blocked eustachian tube with dizziness and impaired hearing indicates chronic middle ear pathology. The nerves in the middle ear also supply throat and jaw, which means the pain can be referred to the throat and jaw. Not to forget, throat/tonsil inflammation can be as chronic as middle ear condition. A detailed examination of ear and throat along with battery of test which includes tympanometry and audiogram can help us isolate the condition.
A qualified ENT surgeon will know about the tests. You might need surgical treatment following detailed evaluation.

3. Swollen tongue and lips is related to angioedema or localised inflammation. You may learn from your treating doctor about the possible allergens that induced it and avoid it. It could be associated with hypothyroid especially if you also have swollen feet and under eye swelling.

4. Sty is an incidental occurrence unrelated to the previous condition. I shall comment further about it if you are still suffering from it. You need not worry if it is resolved now.

5. White patches in the mouth have varied causes. If they are not painful, oral thrush and leukoplakia are the likely cause. It needs to be evaluated under the guidance of dental surgeon. Perhaps an ENT surgeon can also be able to name its treatment, you may discuss about it when you visit them for your ear complaints.

6. Swollen glands in the neck and underarms are most likely enlarged lymph nodes. If they have been there for long duration, I would recommend biopsy of the node to rule out chronic infections such as tuberculosis.

Let me know if you need clarifications.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (4 hours later)
Hi Dr. XXXXXXX

Thank you for your detailed answer. I was wondering if you thought the symptoms would be related at all - for example maybe the ear infection could cause my immunity to lower, leading to swollen lymph, sty's, etc.

Regarding the thyroid tests - my results were Free T4 = 23 and TSH was 3.0. I think these are within the normal ranges but seem to be on the high side of normal?!

Last thing - I had an episode of Bell's Palsy last year after a flight - could this be because of my ear issues?

On waiting list for the past 2 YEARS for an ent so finger's crossed I get an appointment soon.

Thanks
doctor
Answered by Dr. Dr. Prasad J (2 hours later)
Hi,

My comments are:

1. Thyroid values are in limits. This excludes possibility of hypothyroidism.

2. Chronic ear inflammation (middle ear pathology) to some an extent explain neck lymph node swelling. However other symptoms including sty are unrelated.

3. Bell’s Palsy if it involved the same side as the blocked ear, then they can be related.

4. I understand the waiting list, but that is going to provide us with the missing clues to treat your condition. I hope you get the appointment at the earliest.

I will be glad to provide further assistance to the best of my abilities. Do write back for further enquiries.

Best Wishes!!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3708 Questions

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Have Blocked Eustachian Tube, Diziness, Affected Eye Focus And Hearing Loss. Have White Patches And Swollen Glands In Throat. What To Do?

Hi,

Thanks for writing to us. I went through your history with diligence. Occasionally we do see patients with multiple conditions and each of those conditions needs to be treated individually for proper well being. Yours seems to be one such case. Let me explain.

1. A TSH on higher side suggests hypothyroid (underactive thyroid) state. Hypothyroidism can explain generalized weakness and occasional dizziness. You may be adding weight even with normal food/dieting. It needs to be corrected with thyroid supplements as per TSH levels.

2. Long term blocked eustachian tube with dizziness and impaired hearing indicates chronic middle ear pathology. The nerves in the middle ear also supply throat and jaw, which means the pain can be referred to the throat and jaw. Not to forget, throat/tonsil inflammation can be as chronic as middle ear condition. A detailed examination of ear and throat along with battery of test which includes tympanometry and audiogram can help us isolate the condition.
A qualified ENT surgeon will know about the tests. You might need surgical treatment following detailed evaluation.

3. Swollen tongue and lips is related to angioedema or localised inflammation. You may learn from your treating doctor about the possible allergens that induced it and avoid it. It could be associated with hypothyroid especially if you also have swollen feet and under eye swelling.

4. Sty is an incidental occurrence unrelated to the previous condition. I shall comment further about it if you are still suffering from it. You need not worry if it is resolved now.

5. White patches in the mouth have varied causes. If they are not painful, oral thrush and leukoplakia are the likely cause. It needs to be evaluated under the guidance of dental surgeon. Perhaps an ENT surgeon can also be able to name its treatment, you may discuss about it when you visit them for your ear complaints.

6. Swollen glands in the neck and underarms are most likely enlarged lymph nodes. If they have been there for long duration, I would recommend biopsy of the node to rule out chronic infections such as tuberculosis.

Let me know if you need clarifications.

Regards