Yonsei Med J.  2012 Sep;53(5):985-991.

Clinical Manifestations of Aural Fullness

• Park MS
• Lee HY
• Kang HM
• Ryu EW
• Lee SK
• Yeo SG

Abstract

PURPOSE
Even though aural fullness is ubiquitous among patients presenting to otolaryngology clinics, the association between aural fullness and disease development has not yet been clearly determined.
MATERIALS AND METHODS
Our study was performed on outpatients from June 2006 to February 2010 whose major complaint was "ear fullness", "aural fullness", or "ear pressure". We assessed their demographic and clinical characteristics, including sex, associated diseases, symptoms, otoscopic findings, audiology test results, and final diagnoses.
RESULTS
Among 432 patients, 165 (38.2%) were males and 267 (61.8%) were females, with mean ages of 42+/-19 years and 47+/-17 years, respectively. Tinnitus, hearing disturbance, autophony (p<0.01) as well as nasal obstruction and sore throat (p<0.05) showed a statistically significant correlation with aural fullness. Among patients who complained of hearing fullness, tests and measures such as impedance audiometry, speech reception threshold, and pure tone audiometry generated statistically significant results (p<0.05). Ear fullness was most frequently diagnosed as Eustachian tube dysfunction (28.9%), followed by otitis media with effusion (13.4%) and chronic otitis media (7.2%). However, 13.4% of patients could not be definitively diagnosed.
CONCLUSION
Among patients complaining of ear fullness, Eustachian tube dysfunction, otitis media with effusion, chronic otitis media were most commonly observed. Performance of otoscopy, nasal endoscopy, the Valsalva maneuver, and additional audiological tests is necessary to exclude other diseases.

Keyword

Aural fullness; tinnitus; hearing; audiologic test; nasopharyngeal cancer

MeSH Terms

Acoustic Impedance Tests
Audiology
Audiometry
Diagnosis
Ear
Endoscopy
Eustachian Tube
Female
Hearing
Humans
Male
Nasal Obstruction
Nasopharyngeal Neoplasms
Otitis Media
Otitis Media with Effusion
Otolaryngology
Otoscopy
Outpatients
Pharyngitis
Tinnitus
Valsalva Maneuver

Reference

1. Tokumasu K, Fujino A, Naganuma H, Hoshino I, Arai M. Initial symptoms and retrospective evaluation of prognosis in Menière's disease. Acta Otolaryngol Suppl. 1996. 524:43–49.

2. Westerlaken BO, Stokroos RJ, Dhooge IJ, Wit HP, Albers FW. Treatment of idiopathic sudden sensorineural hearing loss with antiviral therapy: a prospective, randomized, double-blind clinical trial. Ann Otol Rhinol Laryngol. 2003. 112:993–1000.

3. Nir D, Weissman A, Drugan A, Zimmer EZ, Danino J, Shenhav R, et al. Effect of estrogen on eustachian tube performance. Am J Otol. 1991. 12:119–121.

4. Kakarlapudi V, Sawyer R, Staecker H. The effect of diabetes on sensorineural hearing loss. Otol Neurotol. 2003. 24:382–386.

5. Cukierman T, Gerstein HC, Williamson JD. Cognitive decline and dementia in diabetes--systematic overview of prospective observational studies. Diabetologia. 2005. 48:2460–2469.

6. Zhang J, Zhou H, Zhang G, Xu Y. [A study on early hearing impairment with essential hypertension]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009. 23:731–733.

7. Aspris AK, Thodi CD, Balatsouras DG, Thodis ED, Vargemezis V, Danielides V. Auditory brainstem responses in patients under treatment of hemodialysis. Ren Fail. 2008. 30:383–390.

8. Baloh RW. Neurotology of migraine. Headache. 1997. 37:615–621.

9. Capella-McDonnall ME. The effects of single and dual sensory loss on symptoms of depression in the elderly. Int J Geriatr Psychiatry. 2005. 20:855–861.

10. Chia EM, Mitchell P, Rochtchina E, Foran S, Golding M, Wang JJ. Association between vision and hearing impairments and their combined effects on quality of life. Arch Ophthalmol. 2006. 124:1465–1470.

11. Seibert JW, Danner CJ. Eustachian tube function and the middle ear. Otolaryngol Clin North Am. 2006. 39:1221–1235.

12. Yeo SG, Park DC, Eun YG, Cha CI. The role of allergic rhinitis in the development of otitis media with effusion: effect on eustachian tube function. Am J Otolaryngol. 2007. 28:148–152.

13. Westerman ST. Tasting instilled otologic drops is not a reliable test of eustachian tube function. Arch Otolaryngol Head Neck Surg. 2000. 126:1042.

14. van der Avoort SJ, van Heerbeek N, Zielhuis GA, Cremers CW. Sonotubometry: eustachian tube ventilatory function test: a state-of-the-art review. Otol Neurotol. 2005. 26:538–543.

15. Shanmugaratnam K. Nasopharyngeal carcinoma: epidemiology, histopathology and aetiology. Ann Acad Med Singapore. 1980. 9:289–295.

16. Yu WM, Hussain SS. Incidence of nasopharyngeal carcinoma in Chinese immigrants, compared with Chinese in China and South East Asia: review. J Laryngol Otol. 2009. 123:1067–1074.

17. Li X, Fasano R, Wang E, Yao KT, Marincola FM. HLA associations with nasopharyngeal carcinoma. Curr Mol Med. 2009. 9:751–765.

18. Skinner DW, Van Hasselt CA, Tsao SY. Nasopharyngeal carcinoma: modes of presentation. Ann Otol Rhinol Laryngol. 1991. 100:544–551.