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2026年01月03日
Hello Doctor,
I have been experiencing persistent nasal congestion and swelling inside my nose, which creates pressure around my ears. I feel a constant fullness in my ears, reduced hearing, and difficulty hearing normal conversations clearly.
My ear symptoms and hearing become significantly worse during air travel, especially during takeoff and landing, with increased pressure and discomfort. The condition has been ongoing and does not fully resolve on its own.
为保护用户隐私不显示图片
2026年01月04日
您好！首先谢谢您的信任！迟复为歉！我给您一个中英文双语版，内容以中文为准
为了更好的诊断请您再和我说一下，您的鼻塞鼻内肿胀感目前持续多久了，越来越重还是越来越轻？您有鼻痒打喷嚏流鼻涕吗？如有流鼻涕，目前持续多久了？一直不缓解吗？一直流黄脓鼻涕吗？
双耳闷胀感目前持续多久了？越来越重还是越来越轻？您做过听力检测吗（包括声导抗和纯音测听）？如有，请将听力检测结果图发给我看一下
您平时咽喉有什么不舒服症状吗？您有头痛咽痛和发烧吗？您能张大嘴照一个咽部里面扁桃体的照片我看一下吗？平时有咽炎吗？
您平时有恶心嗳气打嗝反酸水吗？您有胃炎病史吗？您吸烟喝酒吗？胸闷吗？您有紧张焦虑等心理方面的问题吗？
请您根据我说的问题再和我说一下详细情况，我接着给您进一步解释，祝您早日康复！
⸻
Hello,
Thank you very much for your trust, and I apologize for the delayed response.
To ensure accuracy, I am providing a bilingual version; please note that the Chinese version shall prevail.
To help me make a more accurate diagnosis, please provide further details regarding the following questions:
• How long have you been experiencing nasal congestion and swelling inside the nose? Are these symptoms getting progressively worse or gradually improving?
• Do you have nasal itching, sneezing, or nasal discharge? If so, how long has the nasal discharge been present? Has it been persistent without improvement? Is the discharge consistently yellow or purulent?
• How long have you been experiencing the sensation of fullness or pressure in both ears? Are these symptoms worsening or improving over time?
• Have you undergone any hearing tests, including tympanometry and pure-tone audiometry? If yes, please upload or send me the audiogram results for review.
• Do you have any throat-related symptoms such as discomfort, soreness, or irritation?
• Have you experienced headaches, sore throat, or fever?
• If possible, please open your mouth widely and take a clear photograph of the throat and tonsils and send it to me.
• Do you have a history of chronic pharyngitis?
• Do you experience nausea, belching, hiccups, or acid reflux?
• Do you have a history of gastritis?
• Do you smoke or consume alcohol?
• Do you experience chest tightness?
• Do you have symptoms of anxiety, stress, or other psychological concerns?
Please respond in detail to the above questions. I will then provide you with a further explanation and guidance accordingly.
Wishing you a speedy recovery.
为了更好的诊断请您再和我说一下，您的鼻塞鼻内肿胀感目前持续多久了，越来越重还是越来越轻？您有鼻痒打喷嚏流鼻涕吗？如有流鼻涕，目前持续多久了？一直不缓解吗？一直流黄脓鼻涕吗？
双耳闷胀感目前持续多久了？越来越重还是越来越轻？您做过听力检测吗（包括声导抗和纯音测听）？如有，请将听力检测结果图发给我看一下
您平时咽喉有什么不舒服症状吗？您有头痛咽痛和发烧吗？您能张大嘴照一个咽部里面扁桃体的照片我看一下吗？平时有咽炎吗？
您平时有恶心嗳气打嗝反酸水吗？您有胃炎病史吗？您吸烟喝酒吗？胸闷吗？您有紧张焦虑等心理方面的问题吗？
请您根据我说的问题再和我说一下详细情况，我接着给您进一步解释，祝您早日康复！
⸻
Hello,
Thank you very much for your trust, and I apologize for the delayed response.
To ensure accuracy, I am providing a bilingual version; please note that the Chinese version shall prevail.
To help me make a more accurate diagnosis, please provide further details regarding the following questions:
• How long have you been experiencing nasal congestion and swelling inside the nose? Are these symptoms getting progressively worse or gradually improving?
• Do you have nasal itching, sneezing, or nasal discharge? If so, how long has the nasal discharge been present? Has it been persistent without improvement? Is the discharge consistently yellow or purulent?
• How long have you been experiencing the sensation of fullness or pressure in both ears? Are these symptoms worsening or improving over time?
• Have you undergone any hearing tests, including tympanometry and pure-tone audiometry? If yes, please upload or send me the audiogram results for review.
• Do you have any throat-related symptoms such as discomfort, soreness, or irritation?
• Have you experienced headaches, sore throat, or fever?
• If possible, please open your mouth widely and take a clear photograph of the throat and tonsils and send it to me.
• Do you have a history of chronic pharyngitis?
• Do you experience nausea, belching, hiccups, or acid reflux?
• Do you have a history of gastritis?
• Do you smoke or consume alcohol?
• Do you experience chest tightness?
• Do you have symptoms of anxiety, stress, or other psychological concerns?
Please respond in detail to the above questions. I will then provide you with a further explanation and guidance accordingly.
Wishing you a speedy recovery.
2026年01月04日
I have had persistent nasal blockage since Feb 2025, with a constant feeling that the nasal passages are closed. I experience ear fullness and pressure in both ears, without ringing or dizziness. No hearing tests done. No sneezing or nasal discharge. Throat is normal. I have headaches but no fever. No reflux or gastritis. Chest tightness occurs only when nasal blockage is severe. Symptoms worsen during air travel. Due to limited consultation, kindly advise suitable medicines and precautions.
您好！您的咨询我已收到，我正分析病情组织答案详细回复您，请您稍等一会儿，大约50分钟。抱歉！这条您先别回复，以免浪费您的提问次数。
2026年01月04日
您好！谢谢您的回复！非常抱歉，让您久等了！
根据您说的情况，您目前的双耳耳闷主要考虑和咽鼓管功能障碍（也就是有点中耳炎的表现，咽鼓管也属于中耳的一部分）有关系，咽鼓管是连接中耳腔和鼻咽部的管道，如果其闭塞或者不能够顺利开放的时候，就会导致有耳闷塞感。咽鼓管功能障碍原因可能和您有鼻炎（鼻塞就是典型表现）有关系，鼻炎导致鼻腔鼻咽部黏膜肿胀，而鼻咽部黏膜本身和咽鼓管粘膜就是相延续的，所以也可导致咽鼓管粘膜肿胀，从而导致咽鼓管功能障碍。
目前治疗可以用糠酸莫米松喷鼻（每天1次，每次每个鼻孔喷2下），治疗2周，同时用盐酸羟甲唑啉鼻喷剂喷鼻，每鼻孔喷2下，每天2次，连续治疗1周，一般会有明显效果。
另外您这个情况建议您做一个纤维鼻咽喉镜检查，确定一下目前的鼻咽喉具体状况，您这个耳闷咽鼓管功能障碍以及鼻塞还要考虑可能和消化不良嗳气反酸导致的反流性食管炎和反流性咽喉炎有关。胃酸反流还可以反流到鼻腔刺激鼻黏膜导致鼻塞；胃酸反流可以反流到鼻腔鼻咽部刺激咽鼓管在鼻咽部的开口，所以会导致咽鼓管功能障碍及耳闷。反流性咽喉炎很多时候可以完全没有胃液返流的自觉症状，所以即使您没有反酸症状也不能完全排除反流性咽喉炎。实际上胃酸胃液反流刺激鼻咽喉是您这种耳鼻不适的常见因素，只是因为很多人不注意（甚至不相信）这个因素，甚至很多医生都不注意这个因素，所以没有得到及时有效的有针对性的治疗，所以导致了您的症状持续不好，这也是很多慢性咽喉炎持续不好的主要原因。治疗建议您首先注意三餐不要过饱，避免酸的（包括酸奶，醋，各种酸的水果柑橘柠檬等）太辣的、太热的刺激性饮食；避免太甜腻的不易消化的饮食，比如巧克力等；饭后2小时避免剧烈活动；睡前3小时不要吃任何东西不要喝水，因为夜间卧位睡眠时更容易胃酸反流。睡觉时可以将床头适当抬高20cm左右。避免碳酸饮料。不要喝茶，咖啡，奶茶。避免烟酒刺激。持续不好的话，建议您口服抑制胃酸的药艾司奥美拉唑，每天早饭前半小时口服40mg，连续治疗至少4周，慢慢耳闷鼻塞不适就能改善。必要时可以去做个24小时的食管酸碱度监测（这个是诊断返流性食管炎的金标准），以及胃镜和幽门螺杆菌检查，根据情况再做进一步处理。
祝您早日康复！如果您还有问题，请继续提问。如果方便请给予五星好评（送优惠券）谢谢您！
Hello! Thank you very much for your reply, and I sincerely apologize for the long wait. I am providing you with a bilingual version, and please note that the Chinese version shall prevail.
Based on your description, your current bilateral ear fullness is most likely related to Eustachian tube dysfunction (which can be considered a mild manifestation of otitis media, as the Eustachian tube is part of the middle ear). The Eustachian tube connects the middle ear cavity with the nasopharynx. When it becomes obstructed or cannot open properly, it can lead to a sensation of ear blockage or fullness.
The Eustachian tube dysfunction may be associated with rhinitis, as nasal congestion is a typical symptom of rhinitis. Rhinitis can cause swelling of the nasal and nasopharyngeal mucosa. Since the mucosa of the nasopharynx is continuous with the mucosa of the Eustachian tube, swelling of the nasopharyngeal mucosa can also result in swelling of the Eustachian tube mucosa, thereby leading to Eustachian tube dysfunction.
For treatment, it is recommended to use Nasonex (mometasone furoate) nasal spray, once daily, with two sprays in each nostril, for 2 weeks. In addition, use oxymetazoline nasal spray, two sprays in each nostril, twice daily, for 1 week. This regimen usually produces significant improvement.
Furthermore, I recommend that you undergo a fiberoptic nasopharyngolaryngoscopy to evaluate the current condition of your nasal cavity, nasopharynx, and throat. Your ear fullness, Eustachian tube dysfunction, and nasal congestion may also be related to gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) caused by indigestion, belching, and acid reflux.
Gastric acid can reflux into the nasal cavity and irritate the nasal mucosa, leading to nasal congestion. It can also reflux into the nasopharynx and irritate the opening of the Eustachian tube, thereby causing Eustachian tube dysfunction and ear fullness. In many cases, laryngopharyngeal reflux may occur without obvious symptoms of acid reflux, so the absence of typical reflux symptoms does not completely rule it out.
In fact, reflux of gastric acid and gastric contents irritating the nasopharynx and throat is a common cause of ear and nasal discomfort such as yours. However, many patients (and even some physicians) may overlook or underestimate this factor, resulting in a lack of timely and targeted treatment, which can lead to persistent symptoms. This is also one of the main reasons why many cases of chronic pharyngitis do not improve.
For management, I recommend the following:
• Avoid overeating at meals.
• Avoid acidic foods (including yogurt, vinegar, and acidic fruits such as citrus and lemons).
• Avoid overly spicy, very hot, or irritating foods.
• Avoid overly sweet, greasy, and difficult-to-digest foods such as chocolate.
• Avoid strenuous activity within 2 hours after meals.
• Do not eat or drink anything within 3 hours before bedtime, as gastric reflux is more likely to occur when lying down at night.
• Elevate the head of the bed by approximately 20 cm.
• Avoid carbonated beverages.
• Avoid tea, coffee, and milk tea.
• Avoid smoking and alcohol.
If symptoms do not improve, you are advised to take Nexium (esomeprazole, the original imported formulation), 40 mg orally once daily, 30 minutes before breakfast, for at least 4 weeks. Gradual improvement of ear fullness and nasal congestion can usually be expected.
If necessary, you may also undergo 24-hour esophageal pH monitoring (the gold standard for diagnosing gastroesophageal reflux disease), as well as gastroscopy and Helicobacter pylori testing, followed by further management based on the results.
I wish you a speedy recovery. If you have any further questions, please feel free to continue the consultation. If convenient, I would greatly appreciate a five-star rating (a coupon will be provided). Thank you very much!
根据您说的情况，您目前的双耳耳闷主要考虑和咽鼓管功能障碍（也就是有点中耳炎的表现，咽鼓管也属于中耳的一部分）有关系，咽鼓管是连接中耳腔和鼻咽部的管道，如果其闭塞或者不能够顺利开放的时候，就会导致有耳闷塞感。咽鼓管功能障碍原因可能和您有鼻炎（鼻塞就是典型表现）有关系，鼻炎导致鼻腔鼻咽部黏膜肿胀，而鼻咽部黏膜本身和咽鼓管粘膜就是相延续的，所以也可导致咽鼓管粘膜肿胀，从而导致咽鼓管功能障碍。
目前治疗可以用糠酸莫米松喷鼻（每天1次，每次每个鼻孔喷2下），治疗2周，同时用盐酸羟甲唑啉鼻喷剂喷鼻，每鼻孔喷2下，每天2次，连续治疗1周，一般会有明显效果。
另外您这个情况建议您做一个纤维鼻咽喉镜检查，确定一下目前的鼻咽喉具体状况，您这个耳闷咽鼓管功能障碍以及鼻塞还要考虑可能和消化不良嗳气反酸导致的反流性食管炎和反流性咽喉炎有关。胃酸反流还可以反流到鼻腔刺激鼻黏膜导致鼻塞；胃酸反流可以反流到鼻腔鼻咽部刺激咽鼓管在鼻咽部的开口，所以会导致咽鼓管功能障碍及耳闷。反流性咽喉炎很多时候可以完全没有胃液返流的自觉症状，所以即使您没有反酸症状也不能完全排除反流性咽喉炎。实际上胃酸胃液反流刺激鼻咽喉是您这种耳鼻不适的常见因素，只是因为很多人不注意（甚至不相信）这个因素，甚至很多医生都不注意这个因素，所以没有得到及时有效的有针对性的治疗，所以导致了您的症状持续不好，这也是很多慢性咽喉炎持续不好的主要原因。治疗建议您首先注意三餐不要过饱，避免酸的（包括酸奶，醋，各种酸的水果柑橘柠檬等）太辣的、太热的刺激性饮食；避免太甜腻的不易消化的饮食，比如巧克力等；饭后2小时避免剧烈活动；睡前3小时不要吃任何东西不要喝水，因为夜间卧位睡眠时更容易胃酸反流。睡觉时可以将床头适当抬高20cm左右。避免碳酸饮料。不要喝茶，咖啡，奶茶。避免烟酒刺激。持续不好的话，建议您口服抑制胃酸的药艾司奥美拉唑，每天早饭前半小时口服40mg，连续治疗至少4周，慢慢耳闷鼻塞不适就能改善。必要时可以去做个24小时的食管酸碱度监测（这个是诊断返流性食管炎的金标准），以及胃镜和幽门螺杆菌检查，根据情况再做进一步处理。
祝您早日康复！如果您还有问题，请继续提问。如果方便请给予五星好评（送优惠券）谢谢您！
Hello! Thank you very much for your reply, and I sincerely apologize for the long wait. I am providing you with a bilingual version, and please note that the Chinese version shall prevail.
Based on your description, your current bilateral ear fullness is most likely related to Eustachian tube dysfunction (which can be considered a mild manifestation of otitis media, as the Eustachian tube is part of the middle ear). The Eustachian tube connects the middle ear cavity with the nasopharynx. When it becomes obstructed or cannot open properly, it can lead to a sensation of ear blockage or fullness.
The Eustachian tube dysfunction may be associated with rhinitis, as nasal congestion is a typical symptom of rhinitis. Rhinitis can cause swelling of the nasal and nasopharyngeal mucosa. Since the mucosa of the nasopharynx is continuous with the mucosa of the Eustachian tube, swelling of the nasopharyngeal mucosa can also result in swelling of the Eustachian tube mucosa, thereby leading to Eustachian tube dysfunction.
For treatment, it is recommended to use Nasonex (mometasone furoate) nasal spray, once daily, with two sprays in each nostril, for 2 weeks. In addition, use oxymetazoline nasal spray, two sprays in each nostril, twice daily, for 1 week. This regimen usually produces significant improvement.
Furthermore, I recommend that you undergo a fiberoptic nasopharyngolaryngoscopy to evaluate the current condition of your nasal cavity, nasopharynx, and throat. Your ear fullness, Eustachian tube dysfunction, and nasal congestion may also be related to gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) caused by indigestion, belching, and acid reflux.
Gastric acid can reflux into the nasal cavity and irritate the nasal mucosa, leading to nasal congestion. It can also reflux into the nasopharynx and irritate the opening of the Eustachian tube, thereby causing Eustachian tube dysfunction and ear fullness. In many cases, laryngopharyngeal reflux may occur without obvious symptoms of acid reflux, so the absence of typical reflux symptoms does not completely rule it out.
In fact, reflux of gastric acid and gastric contents irritating the nasopharynx and throat is a common cause of ear and nasal discomfort such as yours. However, many patients (and even some physicians) may overlook or underestimate this factor, resulting in a lack of timely and targeted treatment, which can lead to persistent symptoms. This is also one of the main reasons why many cases of chronic pharyngitis do not improve.
For management, I recommend the following:
• Avoid overeating at meals.
• Avoid acidic foods (including yogurt, vinegar, and acidic fruits such as citrus and lemons).
• Avoid overly spicy, very hot, or irritating foods.
• Avoid overly sweet, greasy, and difficult-to-digest foods such as chocolate.
• Avoid strenuous activity within 2 hours after meals.
• Do not eat or drink anything within 3 hours before bedtime, as gastric reflux is more likely to occur when lying down at night.
• Elevate the head of the bed by approximately 20 cm.
• Avoid carbonated beverages.
• Avoid tea, coffee, and milk tea.
• Avoid smoking and alcohol.
If symptoms do not improve, you are advised to take Nexium (esomeprazole, the original imported formulation), 40 mg orally once daily, 30 minutes before breakfast, for at least 4 weeks. Gradual improvement of ear fullness and nasal congestion can usually be expected.
If necessary, you may also undergo 24-hour esophageal pH monitoring (the gold standard for diagnosing gastroesophageal reflux disease), as well as gastroscopy and Helicobacter pylori testing, followed by further management based on the results.
I wish you a speedy recovery. If you have any further questions, please feel free to continue the consultation. If convenient, I would greatly appreciate a five-star rating (a coupon will be provided). Thank you very much!
2026年01月04日
Please provide prescription medicines and brief points needed for future consultation and purchase.
您好！您的咨询我已收到，我正分析病情组织答案详细回复您，请您稍等一会儿，大约50分钟。抱歉！这条您先别回复，以免浪费您的提问次数。
Hello! I have received your inquiry. I am currently analyzing your condition and organizing a detailed response. Please allow me about 50 minutes. My apologies for the wait.
Please do not reply to this message for now, so as not to use up your remaining question opportunities.
Hello! I have received your inquiry. I am currently analyzing your condition and organizing a detailed response. Please allow me about 50 minutes. My apologies for the wait.
Please do not reply to this message for now, so as not to use up your remaining question opportunities.
2026年01月04日
您好！谢谢您的回复！我还是给您中英文双语版，以中文版内容为准。
我说的药我给您开上处方，您可以直接从平台购买试试（我不确定能够邮寄到中国以外，您可以问一下平台的客服）。目前您的情况就是严格按照以上我说的治疗就可以，一般来说会逐渐慢慢恢复的。如果用药（包括内舒拿和耐信）治疗4周后持续不好，建议做个听力检测及纤维鼻咽喉镜检查并将检查结果发给我看一下，我再给您进一步建议。
祝您早日康复！
⸻
Hello! Thank you very much for your reply. I will continue to provide a bilingual version for your reference, with the Chinese version serving as the primary reference.
I will issue prescriptions for the medications I mentioned, and you may try purchasing them directly through the platform. I am not sure whether these medications can be shipped outside China; you may check with the platform’s customer service.
Based on your current condition, you should strictly follow the treatment plan outlined above. In general, gradual improvement can be expected over time. If your symptoms persist after 4 weeks of medication treatment (including Nasonex and Nexium), it is recommended that you undergo hearing tests and a fiberoptic nasopharyngolaryngoscopy, and then send me the test results for further evaluation and recommendations.
Wishing you a speedy recovery!
我说的药我给您开上处方，您可以直接从平台购买试试（我不确定能够邮寄到中国以外，您可以问一下平台的客服）。目前您的情况就是严格按照以上我说的治疗就可以，一般来说会逐渐慢慢恢复的。如果用药（包括内舒拿和耐信）治疗4周后持续不好，建议做个听力检测及纤维鼻咽喉镜检查并将检查结果发给我看一下，我再给您进一步建议。
祝您早日康复！
⸻
Hello! Thank you very much for your reply. I will continue to provide a bilingual version for your reference, with the Chinese version serving as the primary reference.
I will issue prescriptions for the medications I mentioned, and you may try purchasing them directly through the platform. I am not sure whether these medications can be shipped outside China; you may check with the platform’s customer service.
Based on your current condition, you should strictly follow the treatment plan outlined above. In general, gradual improvement can be expected over time. If your symptoms persist after 4 weeks of medication treatment (including Nasonex and Nexium), it is recommended that you undergo hearing tests and a fiberoptic nasopharyngolaryngoscopy, and then send me the test results for further evaluation and recommendations.
Wishing you a speedy recovery!
为保护用户隐私不显示图片
申请处方需要核实身份证号信息，请补充身份证号，免费获得处方建议。处方开出后，你可以通过处方自主选择是否购买药品
To issue a prescription, verification of your identification number is required. Please provide your ID number to receive prescription recommendations free of charge. After the prescription is issued, you may choose whether or not to purchase the medications through the prescription.
If you do not have a Chinese national ID, I will not be able to issue a prescription.
TA的问答
1.4日拍的片子，现在还是肿的状态，这个情况是否需要复位手术
症状及患病时长：十年
就医及用药情况：无
需要解答的问题：我父亲耳聋十年，2014年开始俩个耳朵一起开始聋，2022年开始最严重，今年在鄂尔多斯中心医院做了一次检查麻烦您看下这种怎么治疗症状及患病时长：感染合胞病毒和人鼻病毒一周，一直剧烈咳嗽，加上中途坐了一次飞机，小朋友说耳朵有些疼，但没有异响。
去医院做了耳镜检查如下图，有少许积水，医生说可以用内舒拿喷鼻，和口服切诺。想问问这种情况怎么治疗比较好？
另外，病毒感冒已经恢复差不多了，现在血象正常，病毒检查也都是阴性，但还是偶有咳嗽。
症状及患病时长：儿童，女，9岁，26kg。12月9日开始甲流，甲流发烧前2天开始头晕头疼，约1周后甲流康复，然后断续头疼，太阳穴的位置疼，尤其在下午和睡前严重。12月27日去医院神经内科做了磁共振检查，脑部无问题，结论是双侧副鼻窦炎（影像无法上传，上传了结果的图片）。医生开了鼻窦炎口服液，至今已服用10天，头还是很疼，而且有痰约1周。
就医及用药情况：鼻窦炎口服液。
需要解答的问题：鼻窦炎口服液是否没有起到作用？需要改药吗？是否还需要增加其他药物？或者还需要进行什么检查吗？
谢谢医生！症状及患病时长：
鼻炎多年，两周前就医看了一下，检查报告见图1
就医及用药情况：
用药如图2
需要解答的问题：
本次就诊医生建议手术，请您帮忙看下
