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Ear, Nose, and Throat Disorders

Negative Ear Pressure

12/17/2001

Question:

I am a 33 year old female who has noticed an "ocean wave" sound in my left ear when I get up quickly from a horizontal position. I can only hear this in complete silence. It does it about 3 times and then stops. I went to an ENT today because of this problem, a little hearing loss, and a fullness feeling. He said I had negative pressure when he tried to blow air in that ear. He says if it doesn`t go away in 2 weeks come back and he will do more testing. What could this be and what is the treatment? I have experienced this for 6 months now and I don`t suspect it will go away in the next 2 weeks.

Answer:

From the information that you have provided, it certainly sounds reasonable that you may indeed have some negative pressure in your middle ear causing the sensation of fullness and sounds in your left ear. The root cause of such a problem is most commonly related to the eustachian tube - which normally equalizes pressure in your middle ear space (the space deep to the eardrum). With fairly common problems such as head colds, allergies, etc., the eustachian tube does not work properly and people can develop a negative pressure behind their eardrum. This can cause symptoms such as pressure, fullness, and echoing quality to sounds, as well as tinnitus (noises in the ear or head). Many times, this is just a temporary situation and does indeed resolve itself in a few weeks and does not require medical treatment. Routine evaluation and care for this should include a thorough history and physical examination as well as an audiologic assessment (hearing tests). Based upon this initial screening and evaluation, your physician may observe the ear for a period of time if things look very benign. If there are identiable pathologies (as an example, allergy features), then your physician might recommend appropriate allergy medications or testing/treatments. Additional workup for patients with unilateral ear fullness and tinnitus can include an imaging study (CT and/or MRI scan) or a nasopharyngoscopy (looking into the back of the nose at the area where the eustachian tube opens).

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Response by:

Daniel   Choo, MD Daniel Choo, MD
Associate Professor and Director, Division of Otology/Neurotology
College of Medicine
University of Cincinnati