September 20th, 2010
11:56 AM ET
Every weekday, a CNNHealth expert doctor answers a viewer question. On Monday, it's Dr. Jennifer Shu, a pediatrician.
Question asked by Becky M. of Oklahoma City, Oklahoma: After taking antibiotics for a sinus infection or ear infection, what is the best way to help encourage drainage of the middle ear or eustachian tube?
I have seen many remedies online, some of which recommend using a neti pot, but I feared making the situation worse. Is it normal to still feel some congestion in the ear area even after finishing the antibiotics?
Expert answer: Thanks for your question. Sinus infections are very common, affecting more than 30 million adults in the United States each year.
In these infections, the sinuses (such as those found in the forehead, under the eyes and along the sides of the nasal bridge) become inflamed and may feel full or painful.
The eustachian tube is the channel that connects the middle ear with the back of the nose and throat. During colds, allergies, ear infections or sinusitis, the eustachian tube can become blocked by mucus and cause a person's ears to feel clogged, with a temporary loss of hearing. These symptoms may continue for a few weeks after a cold or other upper respiratory problem has resolved.
In many instances, the sinuses and eustachian tubes will clear on their own after a few days. Treating the underlying cause of the problem (sinusitis, allergies, etc.) is the first step. Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help with the discomfort in the meantime. Some people require antibiotics to treat a bacterial infection of the ears or sinuses. In addition, it can be helpful to try other remedies to clear the head of mucus.
I consulted with Dr. Aaron Rogers, an otolaryngologist in Atlanta, Georgia, who shared the following information about some common remedies:
• Nasal washes: Saline rinses, sprays and neti pots don't directly treat the eustachian tube but can be a huge help for sinusitis and runny or stuffy noses. Be sure to clean neti pots with soap and water, and use commercial saline products or make the saline solution yourself with sterile or distilled rather than tap water.
• Nasal steroid sprays: These are available by prescription and can help open up the eustachian tube.
• Physical maneuvers: Chewing gum is a common way to try to keep the eustachian tubes open. You can also pinch your nose and swallow or close your mouth, pinch your nose and blow.
• Nasal decongestant sprays: These medications are available over the counter (such as Afrin) or by prescription and are especially helpful when flying (use 30 minutes before takeoff and landing). They are recommended to be used for no more than about three days at a time, since longer use can cause "rebound" swelling of the nasal passages. Of note, nasal sprays containing zinc should be avoided, as they have been reported to cause the permanent loss of the sense of smell in some cases.
• Oral decongestant medicines: Examples of ingredients include pseudoephedrine and phenylephrine. While the problem of rebound is less common with oral decongestants, some people experience palpitations or a rise in blood pressure.
• Oral steroids and antihistamines are sometimes used, particularly in longer-lasting sinus infections; however, they may have side effects such as drying up the mucous membranes of the nasal tissue and thickening the secretions. These are not routinely recommended for the treatment of uncomplicated sinusitis or ear infections.
Since every person's situation may be a little different, it's always best to talk to your own physician for the most appropriate treatment for your case. Good luck!
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