Making Recommendations for an Evaluation and Treatment Algorithm for Patients with Ear Fullness and No Objective...

Area of Science:

• Otolaryngology
• Neurology
• Psychiatry

Background:

• Ear fullness without objective findings is a common yet challenging clinical presentation.
• Identifying underlying causes is crucial for effective patient management and counseling.

Purpose of the Study:

• To recommend evaluation, counseling, and treatment strategies for patients with ear fullness and normal otoscopic, audiometric, and imaging results.
• To identify common diagnoses associated with unexplained ear fullness.

Main Methods:

• Retrospective chart review of 263 adult patients with ear fullness and no objective abnormalities.
• Data included demographics, symptom characteristics, comorbidities, and diagnoses such as temporomandibular joint (TMJ) dysfunction, intermittent Eustachian tube dysfunction (iETD), migraine, and anxiety.

Main Results:

• Women were more likely than men to present with ear fullness and no objective abnormalities.
• Isolated ear fullness correlated with iETD, while otalgia was more associated with TMJ dysfunction.
• Over 94% of patients were diagnosed with TMJ dysfunction, iETD, migraine, anxiety, or a combination thereof.

Conclusions:

• The majority of patients with unexplained ear fullness have contributing factors like TMJ dysfunction, iETD, migraine, or anxiety.
• Treatments targeting these conditions may resolve symptoms or inform counseling within a functional neurologic disorder framework.