Sinus draining into ears

Can neti pots be dangerous?

Share on PinterestNeti pots are safe when used correctly.

The neti pot is a home remedy for congested noses and sinuses that is available as an over-the-counter (OTC) treatment at most drugstores. It is a type of saline nasal irrigation (SNI) treatment.

The user fills a neti pot with a saltwater solution, tilts their head back, and pours the solution into one nostril. The liquid goes into one nostril and out of the other one.

With its roots in Indian Ayurvedic medicine, nasal irrigation and possible devices for administering the treatment were first introduced to Western medicine by The Lancet journal in 1902. In a survey of 330 primary care physicians, 87 percent advised that they recommend SNI to people that visit for one or more conditions.

The FDA, however, warns that the incorrect use of neti pots and other devices for rinsing out the sinuses, including squeeze bottles, battery-operated pulsed water devices, and bulb syringes, have been linked to a higher risk of infection.

The FDA says it is informing doctors, other healthcare professionals, device makers, and users about safe practices when using these devices.

Users must ensure that the liquid is a dedicated saline nasal rinse. Do not use tap water or any form of unsterilized liquid.

Tap water generally has small amounts of bacteria, protozoa, and other microorganisms, including amebae. These are fine to swallow because stomach acid kills them, but they should not go into the nasal passages. If they do, they can remain alive and eventually cause serious infections.

In 2011, two neti pot users in Louisiana lost their lives after using water tainted with Naegleria fowleri (N. fowleri), a type of ameba. This happened to another individual in 2013.

N. fowleri is naturally found in warm, freshwater lakes and rivers. If the bacteria enter the nose, which most often happens while swimming, they can migrate to the brain through the olfactory nerve. This can cause primary amebic meningoencephalitis (PAM), which is fatal for almost every person with the condition.

Commenting on the tragic deaths, Louisiana State Epidemiologist, Dr. Raoult Ratard, advised:

“If you are irrigating, flushing, or rinsing your sinuses, for example, by using a neti pot, use distilled, sterile, or previously boiled water to make up the irrigation solution. Tap water is safe for drinking, but not for irrigating your nose.”

Click here to choose from a range of neti pots. Following the link will open an external page.

These mycobacteria tend to be a problem for people with medical conditions like HIV that lower their immune function. Surprisingly, only about a third of those patients identified in the new study had an immunity problem that might have put them at greater risk for infection.

Nearly all (91%) had sinus problems severe enough that they’d had surgery to relieve their symptoms, which included headaches, congestion, runny nose, and loss of smell or taste.

But the biggest common link between the patients with mycobacteria was nasal washing — 31 out of the 33 said they were using some kind of device to rinse their nasal passages, and 26 of those patients said they used tap water to do it.

That made the researchers curious about whether their home taps might be tainted with the same germs found in their sinuses.

Researchers got permission to take samples from eight of the patients’ homes. They took hot and cold water samples and swabbed the insides of taps and showerheads.

Five out of the eight tested positive for at least one strain of non-TB mycobacteria. DNA fingerprinting revealed that half of the homes tested had exactly the same strain that was found in the resident’s sinuses.

“There was one patient who was irrigating with filtered water from a Brita filter. It was actually growing in a Brita filter,” says researcher Wellington S. Tichenor, MD, the New York City allergist who treated the patients and investigated their infections.

To be fair, Tichenor says, Brita filters are great for reducing chemicals like chlorine and some metals but they don’t claim to keep bacteria out of drinking water.

Workings of the Inner Ear: What Makes It Hurt?

Eustachian tubes help maintain normal air pressure in the middle ear, in response to changes in pressure in the external environment. But when sinus congestion from a cold or allergies blocks these tubes, you could develop a variety of problems, including ear infections.

What exactly is a eustachian tube? It’s a small canal, about one and one-half inches long and only a few millimeters in diameter, that serves as a passageway connecting the back of your throat and nose to your middle ear, where your eardrum is located. Eustachian tubes are lined with the same kind of moist membrane that lines the nose and throat. They are typically closed, but they open with movements of the back of the nose and throat, such as those that occur when you swallow, yawn, or talk. Adult eustachian tubes are angled downward from the ear into the back of the throat, allowing for gravity drainage of middle ear fluids and mucus.

Your middle ear translates sounds that enter your outer ear into vibrations that can be understood by your inner ear and brain. To work properly, your middle ear should maintain the same air pressure as the air pressure around you. So your eustachian tubes open up periodically to circulate air throughout your middle ear, equalizing its air pressure to the pressure in the back of your throat.

Another function of your eustachian tubes is to allow any mucus buildup in your middle ear to drain out into your throat.

When Your Eustachian Tubes Malfunction

A number of things can go wrong with your eustachian tubes and middle ear, including:

  • Blockage due to swelling. It is not uncommon for people with sinus pressure to experience middle ear blockage due to congestion of the eustachian tubes. This swelling is most commonly caused by a sinus infection, a cold, or allergies. These conditions can cause the inner ear membranes to swell and block the tubes. A blocked eustachian tube cannot circulate air or drain mucus as it should.
  • Mechanical blockage. Sometimes overgrowth of tissues in the back of the nose (such as nasal polyps or the adenoids) can cause ear blockage by obstructing the eustachian tube opening. On rare occasions, a tumor can cause a blockage.
  • Otitis media (middle ear inflammation or infection). When sinus congestion leads to a blocked eustachian tube, fluid can accumulate in the middle ear and cause it to become inflamed. Similarly, if you have a bacterial sinus infection that spreads into your eustachian tubes, it can cause a middle ear infection, which leads to swelling and more fluid buildup. Otitis media is associated with ear pain and pressure.
  • Ruptured eardrum. If too much fluid builds up in your inner ear, it could tear your eardrum.

Speech, Language, and Hearing Problems

Particularly in children, eustachian tube blockages can result in:

  • Hearing problems. Excess fluid in the middle ear can result from a blocked eustachian tube, which can interfere with normal hearing, since fluid makes it difficult for the eardrum and bones in the inner ear to vibrate properly in response to sound. This type of hearing loss is usually temporary, but if left untreated, it can become permanent.
  • Speech and language problems. In young children, the hearing impairment caused by frequent middle ear infections can lead to disabilities with speaking and understanding language.

Eustachian tube-related problems are more common in children than adults, partly because eustachian tubes are not fully developed in children, and tend to be shorter and straighter than those in adults. Chronic or recurrent eustachian tube blockages are sometimes referred to as eustachian tube dysfunction.

When Outside Forces Harm the Eustachian Tubes

It’s not just allergies and infections that can cause eustachian tube issues. Other causes include:

  • Discomfort during air travel. Most people who have traveled by air are familiar with the sensation of increased pressure and popping in the ears, especially when the airplane is landing. This happens because your middle ear cannot keep up with rapid air pressure changes, and the pressure within your ears is lower than the air pressure around you, which increases as a plane descends. You can help keep your ears clear during air travel by doing things to open the eustachian tube, such as swallowing often, chewing gum, and yawning frequently.
  • Barotrauma. When the pressure in your middle ear is different than the pressure outside of your body for an extended period of time (for example during flight, scuba diving, or driving in very high altitudes), it can lead to severe discomfort, and even eardrum damage. This type of damage is called barotrauma (baro is from the word barometric, which relates to atmospheric pressure). Barotrauma can cause you to feel dizzy, have ear pain, and experience pressure in your ears. Symptoms of severe barotraumas include ear drum rupture, hearing loss, and nosebleeds.

Treatment Options for Eustachian Tube Problems

If you have persistent pain or pressure in your ears, or suspect you or your child has a eustachian tube-related problem, see your doctor. The following may help manage fluid buildup and even infection in your middle ear:

  • Eustachian-tube opening strategies such as swallowing and chewing are useful, and your doctor can teach you a breathing technique called a valsalva maneuver, which if done gently, may open a clogged eustachian tube.
  • Intranasal steroid sprays may help, especially if allergies are causing the problem.
  • Some doctors recommend use of an oral decongestant if the eustachian tube blockage accompanies a cold or sinus infection.
  • Antibiotics may be prescribed if there is a suspected bacterial ear infection.
  • Surgical insertion of tubes in the eardrums helps ventilate the middle ear outwardly, via the external ear canal, and to drain fluids that way as well.

If left untreated, eustachian tube problems can lead to permanent hearing loss, serious infection, or other long-term complications. So if you or your child is experiencing problems, be sure to let a doctor know.

Find more information in the Everyday Health Ear, Nose, and Throat Center.

Eustachian Tube Dysfunction

Symptoms of Eustachian tube dysfunction usually go away without treatment. You can do exercises to open up the tubes. This includes swallowing, yawning, or chewing gum. You can help relieve the “full ear” feeling by taking a deep breath, pinching your nostrils closed, and “blowing” with your mouth shut.

If you think your baby may have Eustachian tube dysfunction, feed him or her. You can also give them a pacifier. These encourage the swallow reflex.

If these strategies don’t help, your doctor may suggest other options. These can include:

  • Using a decongestant to reduce the swelling of the lining of the tubes.
  • Taking an antihistamine or using a steroid nasal spray to reduce any allergic response.
  • Making a tiny incision in the eardrum and suctioning out the fluid in the middle ear. This gives the Eustachian tube lining time to shrink while the eardrum is healing (usually 1 to 3 days).
  • Implanting small tubes in the eardrums. These let built-up fluid drain out of the middle ear. Children who get a lot of ear infections sometimes get tubes in their ears. They stay in up to 18 months and fall out on their own.
  • Using a balloon dilation system. A doctor will use a catheter (long, flexible tube) to insert a small balloon through your nose and into the Eustachian tube. When it is inflated, the balloon opens a pathway for mucus and air to flow through the tube. This can help it function properly.

FDA warning

The U.S. Food and Drug Administration (FDA) advises against the use of ear candles. Ear candling involves inserting a special candle in the ear. It is supposed to pull wax and debris out of your ear as it burns. Ear candles can cause serious injuries and there is no evidence to support their effectiveness.

Causes of Postnasal Drip and How to Treat It

Excess mucus in your nose can clog your sinus passages, which may lead to a sinus infection. Postnasal drip can also cause ear or throat discomfort. Your nose is connected to your ears and throat via an open structure called the pharynx, a cone-shaped passageway in the back of the head. Therefore, excess mucus that exits from the back of your nose can flow into your ears and throat from the pharynx. Excess fluid in your ear can cause an ear infection by clogging up the Eustachian tube. An unusual influx of mucus can also irritate your throat, causing soreness or coughing.

What causes excess mucus and postnasal drip?

Postnasal drip may be temporary or chronic, depending on its cause. Potential causes of temporary postnasal drip include the following:

  • Viral upper respiratory infections, such as cold or flu
  • Dry air or cold temperatures, often experienced during changes of seasons
  • Irritating fumes from smoke, chemicals, cleaning products, perfumes or colognes
  • Spicy food
  • Pregnancy

In these cases, postnasal drip typically subsides after the condition runs its course or the irritating stimulant is removed.

Chronic postnasal drip is excess mucus production that persists for a long period of time and may be caused by the following:

  • Side effects of certain medications
  • Allergies
  • Deviated septum, a congenital malformation of the nose

Treatments for postnasal drip

You can take steps to relieve the symptoms of postnasal drip. Exposure to steam, by taking a shower or drinking hot soup, for example, can help to thin the mucus and open the nasal passages. You can also prevent mucus from collecting in your throat while you sleep by lying on propped-up pillows. If your postnasal drip is caused by allergens or other irritants, nasal irrigation (e.g., using a neti pot) can help clear these foreign bodies away.

Postnasal drip can also be treated with medication, but the specific drug you should use depends on what is causing your symptoms. Steroid sprays or certain antihistamines, for example, are common treatments for postnasal drip caused by allergies. If your postnasal drip is caused by a bacterial infection, your doctor will likely treat it with antibiotics. Decongestants (such as pseudoephedrine) and expectorants (a medication to thin the mucus, such as guaifenesin) may also be effective.

If you have persistent upper respiratory symptoms, schedule an appointment with your primary care provider. He or she can help determine the cause and formulate an appropriate treatment plan.

Treatment for a deviated septum may involve surgery. If your deviated septum is causing symptoms like sinus infections, pain, or nasal congestion, your doctor may recommend surgery. The most common surgery for a deviated septum is septoplasty . This surgery is done inside of your nostrils, and will not cause any bruising or external signs. The surgery takes about 1 ½ hours.

During the surgery, your doctor:

  • May remove deviated parts of your septum. Or, they may be adjusted and put back into the nose in a position that makes it easier for you to breathe and reduces your symptoms.
  • Will use local or general anesthesia so that the surgery doesn’t hurt you.
    • Local anesthesia. This keeps you from feeling anything near your nose.
    • General anesthesia. This puts you to sleep and prevents feeling in your whole body.

Sometimes, your doctor may combine a septoplasty with a surgery of the outer nose or sinuses. Surgery of the outer nose, called rhinoplasty , changes the way the outside of your nose looks. If you have problems with your sinuses, your doctor may also recommend sinus surgery to help you with these symptoms.

After surgery, nasal packing will be put into your nose to help prevent bleeding after the operation. You might have some symptoms after the surgery, including:

  • Pain
  • Fatigue
  • Nasal stuffiness
  • Runny nose

These symptoms are usually mild and can be reduced with pain medicine. Usually, recovery from septoplasty takes about a week, and outcomes are usually successful. Your doctor might ask you to use a saline (salt) spray to keep your nose clean and healthy after the surgery.

The nose serves three primary functions: to warm, humidify and filter air as it passes into the body. Breathing problems may impact one or multiple of these functions. Breathing problems can be temporary or chronic, mild or severe, but they usually increase with age. Breathing problems are assessed through physical examination along with breathing tests, such as lung function tests for diagnosing asthma or spirometry to determine how much and how fast you can blow air out of your lungs. X-rays and CT scans may also be taken to get a visual picture of your breathing apparatus. The most common breathing problems are discussed below:

Allergies

When an allergen enters the body, the immune system kicks in to counter to the effects. In most cases, the immune systems produces histamine, which causes the symptoms typically associated with allergies and hay fever: headaches, sneezing, watery or itchy eyes, nasal congestion and scratchy throat. Allergic substances range from pollens to environmental and chemical pollutants. Smoking can also contribute to nasal congestion. To treat allergies, most people need to reduceg exposure to the allergen and take medication, often antihistamines and nasal decongestants. For more severe cases, allergy shots may be needed to build up the body’s immune response to the allergen over time.

Deviated Septum

The septum is the vertical structure that divides the two nasal passages in the nose. When the septum is crooked or bent, it is called a deviated septum, which can block the flow of air through the nose. If the constriction is serious, an outpatient surgical procedure can straighten out the septum and open the nasal airways.

Environmental Factors

Molds, dust and dry air are the most common culprits of environmentally induced allergies. These can be assessed by your doctor through physical examination and skin tests. If the allergic response is severe, your doctor may recommend allergy shots to build up an immunity to the allergens and alleviate your symptoms.

Lung Diseases

Certain lung diseases can also cause breathing problems, including asthma and Chronic Obstructive Pulmonary Disease (such as emphysema or chronic bronchitis).

Sinusitis

Sinusitis is an inflammation of the sinus tissue behind the upper cheeks on both sides of the nose, between the eyes and above the eyes. It is characterized by congestion and a feeling of pressure, sometimes in response to moving up and down. Sinus pressure can also cause watery eyes. Many over-the-counter medications suffice in treating mild sinusitis. For more serious cases, prescription medications may be required to alleviate the pain and pressure and open up the nasal passages. Occasionally, surgery is required to remove chronically inflamed sinus tissue.

If you’re experiencing persistent breathing problems, please contact our office and schedule an appointment with one of our otolaryngologists.

Ear Infection or Sinus Infection? Treating Your Symptoms Quickly

Sometimes it’s hard to know whether you are experiencing an ear infection or a sinus infection because of the similarities in symptoms. Both diagnoses involve significant pressure or pain in the head/neck area and both infections may trigger a fever response in your body.

So, why is it important to know whether you’re suffering from a sinus infection or an ear infection? Because the treatment option selected will only be effective if you have the right diagnosis.

Here’s how to decide whether you’re experiencing a sinus infection or an ear infection and how your ear, nose, and throat doctor can help along the way.

Symptoms of an Ear Infection

The primary symptoms of an ear infection include acute ear pain and hearing loss. You will have the sensation that your hearing is muffled and you may experience referred pain to your throat or fluid in the middle ear.

When you’re experiencing an ear infection, you may not necessarily see a change in color in or outside your ears.

Symptoms of a Sinus Infection

Meanwhile, the primary symptoms of a sinus infection include a feeling of fullness in the ear because of the obstruction in your sinus area, but not hearing loss.

You also may experience nasal congestion, facial pain, and an overall sense of pressure in your face and forehead. In some cases, you may even experience pain in your upper teeth.

How to Treat an Ear Infection

For mild to moderate ear infection pain, your doctor may decide to prescribe pain medication, ear drops and/or antibiotics to clear out the infection. For serious pain, your doctor may decide to lance your eardrum to let the infection drain out before the healing process begins.

How to Treat a Sinus Infection

In the case of sinus infections, pain medication is rarely prescribed. Patients will be encouraged to try a sinus rinse using a Neti Pot before moving on to more serious interventions.

In cases of acute sinusitis, patients may also experience cold-like symptoms. If these symptoms don’t get better or appear to get worse after 5-7 days, your doctor may decide to treat the sinus infection with antibiotics along with nasal decongestant, nasal sprays, and saline solution.

In severe cases of sinus infections, your doctor may decide to prescribe steroids.

There’s only one thing worse than suffering from a sinus infection or an ear infection: suffering from both at the same time. Unfortunately, anything that causes nasal swelling can cause swelling of the middle ear space because the nose is congested. So cases in which you have a sinus infection and ear infection at the same time can be especially painful.

When it comes to different infections in the ear, nose, and throat, it’s easy to get your wires crossed and find that you aren’t quite sure what’s going on in your body.

Complications


Non-allergic rhinitis

Sinusitis is a common complication of rhinitis. It’s where sinuses become inflamed or infected.

The sinuses naturally produce mucus, which usually drains into your nose through small channels. However, if these drainage channels are inflamed or blocked (for example, because of rhinitis or nasal polyps), the mucus cannot drain away and it may become infected.

Common symptoms of sinusitis include:

  • severe facial pain around your cheeks, eyes or forehead
  • toothache
  • a blocked nose
  • a runny nose – your nose may produce a green or yellow mucus either through the nostrils or down the back of the nose (catarrh)
  • a high temperature

Symptoms of sinusitis can be relieved using painkillers, such as paracetamol, ibuprofen or aspirin.

However, these painkillers are not suitable for everyone, so make sure you check the leaflet before you take them. For example:

  • children under 16 years of age should not take aspirin unless it’s recommended by a doctor
  • ibuprofen is not recommended for people with asthma or a history of certain stomach conditions, such as stomach ulcers

Speak to your GP or pharmacist if you’re unsure.

Antibiotics may also be recommended if your sinuses become infected. In cases of long-term sinusitis, surgery may be needed to improve the drainage of your sinuses.

Read more about treating sinusitis.

Fluid in the ear Discussion

Fluid in the ears commonly affects children from infancy until about ten years of age. The medical term for this problem is Otitis Media with effusion, also known as Serous Otitis Media. Many schools screen children for this problem. It is not uncommon for the school nurse to see the need to send a note home indicating that a child has failed a hearing test. Most often the note will include a suggestion that the child be checked by an ear doctor. Children with Down ’s syndrome and cleft palate very often have problems with fluid in the ears.

The ear has a space behind the ear drum called the middle ear. The lining of this space makes a fluid to keep the tissues moist. This fluid drains through a little tube (eustachian tube) that runs to the back of the nose. Colds, allergies, infected adenoids, or sinusitis, can cause congestion of the nose and eustachian tube. This congestion causes the tube to be blocked. With the tube blocked the fluid in the middle ear cannot drain.

The fluid causes two problems. First, the sound waves are not transmitted through the ear and this causes a hearing loss. This can be a very serious problem with children trying to hear a teacher in a noisy classroom. Most children will become bored very quickly if they can’t hear what’s going on and an educational delay can occur. Although this is serious, it is not quite as dangerous to the health of the child as the second problem.

The second problem is that the bacteria and viruses just “love” that fluid and will grow very rapidly if the child gets an infected throat or nose. Once started, an ear infection can become severe in a matter of hours.

Fluid in the ear is treated in two ways. The first treatment involves trying to decrease the congestion in the back of the nose. Usually a decongestant/antihistamine combination is given. An antibiotic is also frequently given with the decongestant. The fluid will go away with these medications in a period of six to twelve weeks.

If the fluid doesn’t clear, the second treatment is then used. A small Teflon tube is surgically placed through a hole made in the ear drum. In children this means having a general anesthesia. The tubes (middle ear ventilation tube) work very well, allowing the fluid to drain out and the air to flow in. However, there is one problem that can arise with ear tubes. That problem occurs if water is allowed to get into the ear. If water gets into the ear, it may flow through the tube and start an infection in the middle ear. Children with tubes should not go swimming and must be very careful when they bathe.

Tube placement in the ears is one of the most common operations done in the United States, today. Through the use of tubes, ear doctors have almost eliminated the serious ear disease that develops with long standing Serous Otitis Media.

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