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Blocked Ear After a Cold: What ENT Doctors Actually See

  • salisonsalim
  • Feb 5
  • 3 min read

Blocked ears following a cold are not just a sensation — in many cases, there is real fluid inside the middle ear. This is a common ENT condition and can be objectively diagnosed, not guessed.


What Actually Happens After a Cold


Upper respiratory infections cause inflammation of the nasopharynx and Eustachian tube, leading to:


  • Failure of middle ear ventilation

  • Negative middle ear pressure

  • Filling of fluid into the middle ear space


Fluid filled middle EAR
Fluid filled middle EAR

This results in early acute otitis media, depending on severity.



What We See on ENT Examination (Very Important)


🔍 Otoscopy / Endoscopic Examination


  • Dull tympanic membrane

  • Visible fluid level or air–fluid bubbles

  • Bulging tympanic membrane (in acute cases)

  • Tympanic membrane congestion or redness

  • Reduced or absent cone of light


👉 These findings are clearly visible on:


  • Standard otoscope

  • Rigid or flexible endoscopic ear examination


This is not a “normal ear”.



How It Is Confirmed Clinically


🎵 Tuning Fork Tests



Rinne Test on a patient
Rinne Test on a patient

  • Rinne test: Negative (conductive hearing loss)

  • Weber test: Lateralises to affected ear


These confirm conductive hearing loss due to middle ear fluid.



  • Conductive hearing loss pattern

  • Type B or Type C tympanogram


👉 Imaging is not required in routine cases.


Symptoms Patients Experience


  • Ear blockage or fullness

  • Muffled hearing

  • Ear pressure

  • Mild to moderate ear pain

  • Crackling or popping sensation

  • Tinnitus (occasionally)


⚠️ Vertigo is uncommon unless inner ear involvement exists.


What DOES NOT Help (Remove These Myths)


🚫 Warm compress

🚫 Ear candling

🚫 Oil drops

🚫 Steam directed into the ear

🚫 Cotton buds

🚫 Empirical antibiotics without examination

These have no role in treating middle ear fluid and should not be promoted.


Evidence-Based Management


Management depends on severity and duration:


✅ Nasal treatment (key step)


  • Short course topical nasal decongestants

  • Intranasal steroid sprays (especially if allergic rhinitis present)


✅ Autoinflation (selected patients) better toynbee manuveur


  • Valsalva manoeuvre (only if tympanic membrane intact)


✅ Analgesics


  • For pain relief only


❌ Antibiotics

  • Not routinely needed unless acute bacterial otitis media is present


⏳ Observation [ very important ]


  • Many cases resolve as Eustachian tube function returns


When ENT Intervention Is Required


Consult an ENT specialist urgently if:

  • Severe ear pain

  • High fever

  • Progressive hearing loss

  • Bulging tympanic membrane

  • Persistent effusion beyond 3 months

  • Recurrent episodes after every cold


Chronic cases may require myringotomy or grommet insertion, especially in children.


Why Early ENT Diagnosis Matters


Incorrect or delayed treatment can lead to:


  • Chronic otitis media with effusion

  • Recurrent ear infections

  • Speech delay (children)

  • Persistent conductive hearing loss


Early ENT evaluation prevents unnecessary medications and complications.


ENT Care at Relentcare ENT Centre, Thrissur


At Relentcare ENT Centre, ear blockage after colds is assessed using:

  • Otoscopy and endoscopic ear examination

  • Tuning fork tests

  • Targeted audiology only when required


We focus on evidence-based treatment, not home remedies or guesswork.


📍 Relentcare ENT Centre – Thrissur- Accurate diagnosis. Ethical treatment. ENT care you can trust.



Read More: Related Ear Conditions Explained by ENT Specialists


  • 🔗 Fluid Behind the Eardrum (Otitis Media with Effusion)Understand why fluid collects in the middle ear, how it’s diagnosed on otoscopy, and when treatment is required.


  • 🔗 Eustachian Tube Dysfunction After ColdLearn how nasal infections affect ear ventilation and cause blockage, pressure, and hearing changes.


  • 🔗 Toynbee vs Valsalva Manoeuvre – Which Is Safer for Blocked Ears?ENT-approved guidance on pressure equalisation techniques and when to avoid forceful ear popping.


  • 🔗 Ear Fullness with Normal Ear ExaminationWhy some patients feel blocked ears even when initial findings appear normal.


  • 🔗 Muffled Hearing After Cold – Is It Temporary?Causes of temporary hearing loss following upper respiratory infections.


  • 🔗 When Ear Blockage Needs ENT TreatmentRed-flag symptoms that should not be ignored.


  • 🔗 Blocked Ear in Children After ColdHow middle ear fluid affects children differently and when grommets are considered.

 
 
 

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