Why does air come out of my ear when I blow my nose? DR MARTIN SCURR answers your health questions

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Air escapes from my ear when I blow my nose. I can even blow bubbles out when I’m underwater. It’s not painful, but it can’t be right, can it? I am 67.

Carol Lawrence, Morecambe, Lancashire.

Air coming out of the ear is a classic sign of a perforated eardrum. The eardrum (or eardrum) is a wafer-thin structure that separates the outer ear from the middle ear.

The external auditory canal, where wax accumulates, is only 2.5 cm long and the eardrum – which is only 8 mm in diameter – can be easily perforated or cracked.

Possible causes include untreated middle ear infections and physical injuries, including injuries from cotton swabs (one reason why you shouldn’t use these to clean your ears).

You say in your longer letter that many years ago you burst your eardrum in the same ear in a swimming accident; Being able to blow air out of your ear as you described indicates that the healed perforation has broken off.

Air coming out of the ear is a classic sign of a perforated eardrum.  The eardrum (or eardrum) is a wafer-thin structure that separates the outer ear from the middle ear

Air coming out of the ear is a classic sign of a perforated eardrum. The eardrum (or eardrum) is a wafer-thin structure that separates the outer ear from the middle ear

This has disrupted the normal process of air pressure in the head being ‘regulated’ by the Eustachian tube.

Normally, the Eustachian tube – which connects the middle ear to the area behind the nose – brings the air pressure in the head equal to that on the outside. So, for example, if you blow your nose or descend on an airplane, the internal pressure rises, so the

Eustachian tube ‘opens’ to regulate air pressure. It also opens naturally when we chew, yawn or swallow (you can hear a ‘click’, this is the sound of the valve closing again).

In your case, however, the eardrum has ruptured. The scar on it meant it would never have been as strong as the original structure and at some point you must have sneezed or put pressure on the eardrum, which ruptured it again.

As a result, when you blow your nose, air is pushed up by the pressure in the Eustachian tube, into the cavity of the middle ear and out through the perforation (normally, blowing your nose would push the pressure in the cavity of the middle ear and stretch the eardrum).

The concern is that while swimming or showering, water can enter the middle ear cavity and you develop an infection that can cause complications.

For this reason, you should consult your doctor and be referred to an ear, nose and throat specialist (ENT) for surgical repair of the eardrum (usually under general anesthesia, but as an outpatient treatment).

I have a fairly large lump which causes problems with throat clearing and acid reflux, which makes me cough especially at night. I’ve been taking omeprazole but it doesn’t seem to help. What else would you recommend?

Michael Symons, Penzance.

The term goiter means abnormal growth of the thyroid gland, a butterfly-shaped gland in the front of the neck that extends over the trachea, with a lobe on either side. An enlarged thyroid gland can affect the esophagus (gullet), which is behind the trachea, or move or even compress blood vessels in the neck.

In the UK, goiter is most commonly associated with autoimmune diseases – most commonly Graves’ disease, where the thyroid gland becomes overactive.

This affects hormone levels and I am sure your doctor has checked it, suggesting you have what is called a multinodular goiter.

This is where the thyroid gland slowly enlarges over many years without causing symptoms, although eventually the trachea can be compressed, causing breathlessness with exercise (this occurs in more than 30 percent of cases).

Some patients notice that the shortness of breath occurs in certain positions, such as when bending over. About 10 percent of patients experience a cough and a feeling of choking, and this too may be related to their position.

Difficulty swallowing are less commonly reported – acid reflux is not a recognized symptom, but it can simply coincide with the goiter.

So is your cough due to acid reflux, or compression of your trachea by your enlarged thyroid?

Omeprazole suppresses acid production and therefore relieves coughing due to reflux. But you have found it ineffective, suggesting the thyroid gland is the problem.

Options include surgically removing or “shrinking” the gland with a single oral dose of radioiodine – this reduces the gland by 30 to 60 percent over a few weeks.

I would recommend getting an ultrasound to check the degree of compression of the trachea. A specialized thyroid surgeon can then advise you.

The acid reflux may persist, but there are more medical options that can suppress it.

Write to Dr. Scurr

Write to Dr Scurr from Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co.uk – include your contact details. Dr. Scurr cannot enter into personal correspondence.

Answers should be taken in a general context and always consult your own GP if you have any health concerns.

IN MY OPINION: Don’t worry about waiting for your second Covid shot

Are you one of those still waiting to hear about your second shot as the clock ticks towards the promised 12 week timeframe?

After nearly 11 weeks, I just had mine, but I know some readers have waited longer and are concerned about the delay.

I personally don’t think waiting longer between the two doses is a cause for concern. But I’m afraid the government has been bad at explaining why (and not for the first time).

When it announced that the second injection (a booster for better immune protection) would be given after 12 weeks rather than four weeks, this seemed arbitrary rather than evidence-based – further adding to the confidence of those unsure about the vaccine. harmed.

Are you one of those still waiting to hear about your second shot as the clock ticks towards the promised 12 week timeframe?

Are you one of those still waiting to hear about your second shot as the clock ticks towards the promised 12 week timeframe?

The fact is that the immune system is not watching. In the past, we gave injections to infants at three, six and nine months. Then it was changed to two months, with boosters at three and four months.

The evidence showed that compressing the vaccine timings did not make them any less effective or less safe. The same is true of extending the Covid-19 immunization schedule. The first shot provides excellent protection; the booster amplifies that regardless of the timing.

Indeed, research shows that with the AstraZeneca shot, immunity is much higher when given after 12 weeks or more (up to 91.7 percent effective) than when given less than six weeks apart (69.7 percent ).

We don’t know yet if this is true of the Pfizer jab, but in my opinion it’s a reasonable assumption. Those concerned about a slightly longer wait should be reassured.

My main concern remains about those who qualify but haven’t had their first shot, and what can be done to turn the heads of anti-vaxxers. Shouting louder statistics isn’t the answer: we need clear explanations from our unparalleled chief medical officers.

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