Atrial fullness

Specialty: Otolaryngology.

• Sensation of ear plugging
• atrial pressure
• subjective barotrauma
• clogged ear
• sense of otic occupation

Why it occurs

• Eustachian tube dysfunction secondary to edema of the nasopharyngeal mucosa due to inflammatory or allergic processes
• Impact of earwax or keratin accumulated in the external third of the external auditory canal
• Serous otitis media or middle ear effusion due to transudate of clear or mucinous fluid
• Endolymphatic hydrops or Ménière's disease due to increased pressure in the membranous labyrinth
• Dehiscence syndrome of the superior semicircular canal that generates an acoustic energy shunt
• Acute otic barotrauma after sudden changes in atmospheric pressure during flights or dives

Initial workup

Dynamic pneumatic otoscopy or detailed otomicroscopic examination, tympanometry with stapedial reflex to evaluate the compliance of the tympanoosicular system, liminal tonal audiometry through air and complete bone conduction, speech audiometry and nasofibrolaryngoscopy aimed at ruling out obstructive pathology in the cavum.

Standard management

• Nasal corticosteroids such as fluticasone — 120 mcg per nostril every 24 hours, applied with a contralateral technique aimed at the Eustachian tube for at least 4 weeks
• Systemic decongestants such as pseudoephedrine — 60 mg orally every 8 hours, limiting use to a maximum of 5 days and closely monitoring blood pressure
• Nasal hypertonic saline solutions — copious washings 3 times a day to reduce peritubal edema
• Mucolytics such as ambroxol or acetylcysteine ​​(600 mg orally every 24 hours to thin the mucus retained in the middle ear).