There was associated tinnitus but no otalgia, no ear discharge and no sensation of disequilibrium or vertiginous spells. She erstwhile had experienced repeated episodes of this symptom, which occurred each time she flew, but there was always complete resolution after a few days following treatment from an outside health facility. Hence, we report an unexpected presentation of nasopharyngeal cancer, with isolated otologic symptoms, which was initially managed as otitic barotrauma.Ī 29-year-old Nigerian woman, who frequently travels by air, presented with a six-month history of persistent bilateral hearing impairment following a flight. A high index of suspicion is required to evaluate the patient for nasopharyngeal cancer as a differential diagnosis. When they do occur, other more common benign ear diseases that present with similar symptoms are usually considered. It is quite uncommon for nasopharyngeal cancer patients to present with only isolated otologic symptoms, especially in regions where the incidence of this disease is low. However, these presentations are not pathognomonic of nasopharyngeal cancer. The otological manifestations of this disease entity are commonly unilateral Eustachian tube dysfunction, fluid accumulation within the middle ear, conductive hearing loss, otalgia and tinnitus. The clinical morphology of the lesion may be infiltrative, ulcerative or exophytic. They may include cervical lymphadenopathy, nasal blockage, epistaxis, hyponasal speech and otologic and neuro-ophthalmic manifestations. They are usually related to the local, regional and distant spread or metastasis of the lesion. Or, they may need to release the pressure or fluid with a small incision in your ear drum.The clinical presentations of nasopharyngeal cancer may sometimes be insidious and nonspecific. They may recommend inserting small pressure equalization tubes or a balloon to help dilate your eustachian tubes. If your ears fail to open, or if you are experiencing persistent pain in your ears, seek the help of an ENT (ear, nose, and throat) specialist, or otolaryngologist. Extended use of decongestant nasal sprays can also cause more congestion than relief, and even result in a type of addiction. However, if you are pregnant, or have heart disease, high blood pressure, irregular heart rhythms, thyroid disease, or excessive nervousness, consult your physician before using these medications. Over-the-counter nasal sprays or decongestants can also help air travelers to shrink the membranes and help the ears pop more easily. If you have allergies, take your medications at the beginning of your flight. You and your children should avoid sleeping during descent because swallowing may not occur often enough to keep up with changes in air pressure. Plus, babies cannot intentionally pop their ears, but sucking on a bottle or pacifier can help. You’ll know if it worked when you hear a pop, and your ears feel less plugged.īabies and children are especially vulnerable to ear blockage because their eustachian tubes are narrower than in adults. You can also try pinching your nose, taking a mouthful of air, blowing gently (not forcefully) against your pinched nose, then swallowing. Yawning, chewing gum, or sucking on hard candy can help, especially just before take-off and during descent. The simplest way to help clear your ears-particularly when flying-is to swallow.
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