Understanding Refractory Chronic Cough: What You Need to Know Have you ever faced a cough that simply refuses to subside? While most coughs resolve independently, some persist for an unacceptable length of time—weeks, months, or even years. This condition is known as refractory chronic cough (RCC), and it is a significant issue that demands attention in the medical community, especially among specialists in ear, nose, and throat (ENT) care. In this blog post, we will clearly outline what RCC is, why it occurs, and the most promising treatments available to those suffering from relentless coughing. What is Refractory Chronic Cough? A chronic cough is defined as one that lasts longer than eight weeks in adults. For many individuals, it is associated with conditions such as asthma, allergies, acid reflux, or certain medications. However, there are instances where the cough continues even after these underlying causes have been effectively ad...
Are you unable to pop your ears or feeling pressure in your ears?
Eustachian tube dysfunction is a very common problem after flu or cold or even after long haul flight when you feel hearing is muffled, feel pressure around the ears and sometimes you feel as if you are underwater. Good news is most of the time it is temporary. If you try decongestants, antihistamine ( hay fever tablets ) and Valsalva (ie try and pop your ears) things should improve after a few days to a week.
Why do we have symptoms of Eustachian tube dysfunction?
The eustachian tube is present at the back of our nose and connects the nose to the middle ear. It is there to maintain equal pressure on both sides of the eardrum. The eustachian tube also helps in clearing normal mucus from the middle ear. Hence opening and closing of this ventilation tube are very important for hearing. Normally every time we yawn and chew this tube opens and closes without us noticing it. So, if this opening of ventilation tube gets affected we get eustachian tube dysfunction and some times glue ear.
How do I know I have Eustachian Tube Dysfunction?
If you have symptoms of muffled hearing and intermittent ear pain with or without tinnitus and mild dizziness do not resolve after a few weeks you see your doctor or ENT surgeon. If you have persistent earache with or without throat pain for more than three weeks you need to see your doctor or ENT to examine you. Common causes of persistent eustachian tube dysfunction are the common cold, allergic rhinitis, sinusitis, smoking and reflux. Rarely adenoids or tumour at the back the nose can give you this symptom.
What happens when I see an Ear Nose Throat Surgeon?
During the consultation with ENT surgeon for eustachian tube dysfunction, he or she will take a detailed history, past medical history and will examine back of the nose with a soft flexible endoscope. You may need a hearing test, ear pressure test and a scan of your ear depending on your symptoms. 20%of eustachian tube dysfunction patients will have no cause for it.
How is Eustachian Tube Dysfunction Treated?
If you have not yet tried medical treatment the doctor may advise you to use a nasal decongestant, steroid nasal spray and do Valsalva manoeuvre ( ie to try and pop your ear). If on examination with endoscopy there is a lump at the back of your nose that will need a biopsy.
What is Eustachian Tube Dilation?
Failing medical treatment and symptoms of recurrent eustachian tube dysfunction, patients are offered eustachian tube dilation. Eustachian tube dilation is a minimally invasive endoscopic day case procedure. It is usually done under general anaesthetic. A balloon catheter is passed in the eustachian tube and filled with saline at the pressure of 10bars for 2 minutes. The balloon is emptied and removed and dilated open eustachian tube is checked with an endoscope at the end of the procedure.
Are there any complications of Eustachian Tube Dilation?
Eustachian tube dilation is a very safe procedure. Complications after eustachian tube dilation for eustachian tube dysfunction are very rare. Rare complications are bleeding, infection, pressure pain and failure of the procedure. Most patients start to see improvement in the symptoms after two to three weeks.
Video link
https://www.youtube.com/watch?v=ooqJJt-LLaY&t=10s
Mr Gaurav Kumar Ear Nose Throat Specialist
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Disclaimer: For general information only, always seek medical advice from your treating consultant. https://www.entsurgeon-london.co.uk/