WEEK 1-2 AGO: Initial Problem Day 1-3: Perineal Swelling (Sitting Trauma) Sat for 7-10 hours daily for 10-12 days listening to classes with earbuds Developed perineum swelling + inflammation + pain One side affected, then switched to other side Then subsided Cause: Prolonged sitting + earbuds pressure Day 4-7: Ear Pain Develops Left ear pain started (especially during chewing/talking) Pain increased significantly Took Ibuprofen repeatedly for pain + swelling One night: severe pain, couldn't sleep, took Ibuprofen to sleep Cause: Likely secondary infection from sitting posture + earbud use FIRST DOCTOR VISIT (Visit 1) Initial Diagnosis: Pus found in left ear Confirmed bacterial infection (acute otitis media or externa) Doctor used pointed tweezers, extracted pus Ear blockage opened temporarily Symptoms at this visit: Pain, blockage, discharge with pus Treatment Given: Antibiotic ear drops (to clean pus with cotton earbuds) Antibiotics (oral) Fever/flu medication Immediate After Visit 1: Developed fever, sneezing, flu-like symptoms Took medications at night before bed Morning: Pain and fever subsided somewhat Next morning: Attempted to clean ear with drops Result: Ear got blocked again SECOND VISIT: ENT Clinic Procedure: Doctor suctioned ear (suction machine) Some pus removed Ear opened from suction Applied white ointment on cotton Cotton placed in ear to protect/treat Treatment Given: Antifungal drops (new finding - fungal infection discovered) Steroid tablets Painkillers Told to clean pus with antibiotic drops using earbuds After This Visit: Cotton left in ear overnight Experience: Severe itching (couldn't tolerate) Morning: Tried to clean with drops Result: Ear blocked again THIRD VISIT (Last Visit - The Critical One) Condition When Arriving: Left ear was OPEN and fine (no blockage) No major issues Healing was progressing Doctor's Findings: Fungal infection confirmed HOLE IN EARDRUM discovered/confirmed Hole can swell shut (from fungal inflammation) When swelling reduces, hole opens again Procedure Done: Doctor used suction machine AGAIN IMMEDIATELY AFTER SUCTION: Ear BLOCKED This is the KEY POINT: Suction closed the open ear Treatment Given: Antifungal drops Steroid tablets (Levocet - actually antihistamine) Antibiotics Painkillers Result: Prescribed these but you stopped taking them What Happened After: Ear remained BLOCKED from that point Still blocked until now CURRENT CONDITION (Since Last Suction) Symptoms NOW: Ear Blockage: Left ear completely blocked/closed feeling Sometimes opens slightly (pop sound) Pop sounds during yawning and mouth movement Feeling fluctuates (sometimes more open, sometimes more closed) Pain: Initially: Expanding pain with swallowing (rare) No pain with normal eating No pain with yawning Only rare pain during burping NOW: Pain is INCREASING (gaining started to paining) Hearing: Can still hear but BLOCKED/MUFFLED Sound transmission affected but still present Not complete deafness Drainage: Yellow fluid coming out when lying on left side Suggests pus/infected fluid draining Only happens in certain positions Tick-tock Sound: When moving head Clicking/popping sound Indicates fluid moving in middle ear Sign of trapped fluid with air bubbles UNDERLYING ISSUES (Your Medical History) 1. Previous Patulous Eustachian Tube (PET) After previous fever: developed PET More in right ear, less in left ear Had subsided by now Causes autophony (hearing own voice loudly) Makes you susceptible to infections 2. Allergies Dust allergies (significant) Morning allergy symptoms Causes sneezing vigorously in dusty conditions This is ROOT CAUSE of many ear problems Allergic inflammation → nasal congestion → Eustachian tube dysfunction → infection risk 3. Family History Father had ear hole + pus oozing from ear Possible genetic predisposition to: Eustachian tube weakness Chronic ear infections Eardrum vulnerability Susceptibility to infections 4. Flying Experience During plane takeoff/landing: ear pain + blockage Indicates Eustachian tube dysfunction Pressure change sensitivity Related to PET history 5. Hearing Test Last year: Hearing test showed NORMAL But you sometimes hear sounds unclearly Suggests conductive issue (fluid, wax, tube dysfunction) rather than hearing loss THE THREE INFECTIONS (Current) 1. BACTERIAL INFECTION Start: 2 weeks ago (from earbuds + sitting) Confirmed: Pus in ear (doctor saw it) Current: May still be partially active Status: Antibiotics were started but you stopped 2. FUNGAL INFECTION Discovery: Second visit (ENT doctor found it) Cause: Hole in eardrum allowed fungus to grow Current: Likely still present/active Status: Antifungal drops prescribed, you have clarithromycin drops only Treatment needed: Longer course (2-4 weeks) 3. SUCTION-INDUCED TRAUMA SWELLING (NEW) When: Last visit - immediately after suction Cause: Second unnecessary suction to already-open ear Effect: Added inflammation + swelling Current: This closed your previously-open ear Status: Swelling from trauma + original infection Timeline: Should resolve in 3-7 days with proper treatment THE EARDRUM HOLE What It Means: Hole in eardrum from bacterial infection pressure Small to moderate size (not massive) Can heal on its own in 2-4 weeks typically OR may need drainage tube if fluid won't drain Impact: Sound can enter directly through hole Eardrum can't stretch to release pressure Pressure builds up → pain Fluid can leak out (yellow drainage you're seeing) Higher infection risk Healing: Needs dry environment Needs pressure relief Needs inflammation reduction Usually closes naturally once infection/swelling controlled

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eardrum perforation with fungal otitis media treatment healing blocked ear after suction

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I now have enough clinical data to give you a thorough, well-organized response. Here it is:

Clinical Analysis: Your Ear Condition (July 13, 2026)

This is a complex situation with several overlapping issues. Let me break it down systematically so you understand exactly what is happening and why.

1. What You Are Dealing With - A Summary

You have three simultaneous problems in your left ear:

Problem	Status	Key Risk
Tympanic membrane (eardrum) perforation	Confirmed, present	Allows fluid + fungus into middle ear
Fungal infection (otomycosis)	Active, undertreated	Can worsen perforation, block canal
Middle ear fluid / conductive blockage	Current main symptom	Causes muffled hearing + clicks

2. Why Your Ear Is Still Blocked

The feeling of blockage after the third visit suction is explained by a chain of events, not one single cause:

A. The suction itself caused new trauma Suction on an already-inflamed ear canal with a perforated drum creates negative pressure. The Merck Manual notes that "a decrease in pressure, such as strong suction applied to the ear canal" can itself cause or worsen eardrum problems. The sudden "blocking" immediately after suction is almost certainly suction-induced mucosal swelling and inflammation, not a coincidence.

B. The eardrum perforation changes pressure dynamics Normally your eardrum stretches to equalize pressure. With a hole in it, air can pass directly - but when swollen tissue partially covers that hole, you get a one-way valve effect. This explains:

The pop sounds when yawning / moving your head
Sometimes feeling "more open" (hole is uncovered) then "more closed" (hole swells shut again)
The tick-tock/clicking sounds = fluid trapped in the middle ear with air bubbles moving through it

C. Fungal debris is physically blocking the canal From Scott-Brown's Otorhinolaryngology: otomycosis produces "a black, grey, green, yellow or white discharge with debris" that accumulates and blocks the canal. This debris needs to be cleared - but only by an ENT with suction under direct vision, not at home with cotton buds.

D. Eustachian tube dysfunction (your pre-existing issue) Your known history of patulous Eustachian tube (PET) + dust allergy means your tube does not regulate middle ear pressure well at baseline. Allergic inflammation -> nasal mucosal swelling -> Eustachian tube oedema -> fluid cannot drain from the middle ear. The "tick-tock" clicking and positional yellow drainage confirm fluid is sitting in the middle ear, unable to drain properly.

3. The Eardrum Hole - What to Expect

From Shambaugh - Surgery of the Ear:

"Either approach [observation vs early surgery] will result in perforation closure in approximately 90% of cases... expectant management cites the high likelihood of spontaneous healing."

From Goldman-Cecil Medicine:

"Acute perforation of the eardrum often results in otorrhea, relief of pain, and spontaneous healing of the perforation."

Key conditions required for the hole to heal on its own:

The infection (bacterial + fungal) must be fully controlled
The ear must be kept dry - moisture impairs fibroblast proliferation and healing (Shambaugh)
No ongoing trauma (no cotton buds in the ear)
Usually closes within 2-6 weeks once infection is controlled

If it does not heal: A paper patch procedure (myringoplasty) can be done in clinic - a patch of paper is placed over the perforation to guide healing. This is low-risk and done under local anaesthesia.

4. Why You Stopped Treatment - And Why That Matters

You stopped the prescribed medications after the third visit. This is the single most important issue right now.

Bacterial antibiotics stopped early: Incomplete antibiotic courses allow resistant bacteria to persist and can cause the infection to flare again. Your increasing pain is a warning sign.

Antifungal drops stopped: Otomycosis requires 2-4 weeks of antifungal treatment minimum. Stopping early is a well-known reason for relapse. From Scott-Brown's: treatment involves "toilet and removal of debris + topical antifungal drops (e.g. clotrimazole)" - this is not a short course.

Critical warning about antifungal drops with a perforation: Research from a Turkish otolaryngology study is clear: "Topical antifungal solutions (ear drops) will be more suitable in this group [perforated eardrum] unless the ear drop is ototoxic." Standard antifungal solutions like clotrimazole are generally acceptable, BUT ototoxic preparations (e.g. alcohol-based, acetic acid) must be avoided as they can damage the inner ear through the hole. You need to tell your ENT which drops you have and confirm they are safe for use with a perforation.

Clarithromycin drops: You mentioned you only have clarithromycin drops. Clarithromycin is an antibiotic, not an antifungal - it will not treat your fungal infection. You need a specific antifungal agent.

5. What Is Actually Happening With the Yellow Fluid

Yellow fluid draining when you lie on your left side = middle ear pus/infected fluid draining through the eardrum perforation. This is actually a sign the hole is still open (good for drainage, bad for infection control). It means:

Active infection still in the middle ear
The Eustachian tube is not draining it upward efficiently
Gravity is doing the drainage when you lie down

This is not an emergency by itself, but the increasing pain you mention is concerning - it suggests pressure is building or the infection is worsening. This warrants prompt ENT review.

6. Your Risk Factors Working Against You

Factor	Effect
Dust allergy	Ongoing nasal inflammation -> Eustachian tube oedema -> poor middle ear drainage
Previous PET	Structurally abnormal Eustachian tube - less resilient to infection
Father's history of ear hole + pus	Genetic predisposition to chronic suppurative otitis media (CSOM)
Incomplete treatment courses	Infection not fully cleared; fungal infection not adequately treated
Cotton bud use in infected canal	Packs debris deeper, traumatises inflamed skin, delays healing

7. Clear Action Plan

STOP immediately:

Do NOT insert anything into the ear (no cotton buds, no earbuds, no fingers)
Do NOT put water in the ear - keep the ear completely dry (shower with cotton ball + Vaseline blocking the canal)
Do NOT use alcohol-based or acetic acid solutions in the ear (ototoxic with perforation)
Do NOT fly until the eardrum has healed

Do TODAY or within 24-48 hours:

Resume the antibiotic course you were prescribed - incomplete treatment is driving your worsening symptoms
Return to the ENT, specifically explain: (a) the immediate post-suction blockage, (b) worsening pain, (c) yellow drainage, (d) that you stopped medications. Show them this summary if helpful
Ask the ENT specifically: "Are my antifungal drops safe for use with a perforated eardrum?" and "Do I need a paper patch procedure to help the hole heal?"

At the ENT visit:

Professional ear toilet/suction under direct vision (by the ENT, not at home) to clear fungal debris
Confirm the correct antifungal agent - clotrimazole drops are first-line if safe with perforation
Discuss allergy management: if your dust allergy is driving Eustachian tube dysfunction, antihistamines or nasal steroids (e.g. mometasone spray) can significantly help middle ear drainage

Longer term (ask your ENT):

If the hole does not close within 4-6 weeks after infection control, a paper patch myringoplasty or formal tympanoplasty may be considered
Hearing test at 6 weeks to confirm the conductive loss is resolving and no sensorineural component

8. Red Flags - Seek Emergency Care If:

Sudden severe vertigo (room spinning, inability to stand) - suggests inner ear involvement or perilymph fistula
Facial weakness or asymmetry - suggests facial nerve involvement
High fever + severe headache + stiff neck - suggests spread of infection (rare but serious)
Sudden complete hearing loss in the left ear
Rapidly worsening pain unresponsive to painkillers

Summary in Plain Terms

Your ear is blocked because: fungal debris + post-suction swelling + middle ear fluid + Eustachian tube dysfunction are all happening at once. The eardrum hole can heal on its own, but only once the infections are fully cleared - which requires completing the full antibiotic and antifungal courses. The most important things right now are to restart your medications, stop putting anything in the ear, keep it dry, and see your ENT promptly given the increasing pain. The prognosis is good - 90% of eardrum perforations heal spontaneously - but you need to give the treatment a real chance to work.

Sources: Scott-Brown's Otorhinolaryngology Head & Neck Surgery Vol. 2, p. 1000 | Shambaugh Surgery of the Ear, p. 419 | Goldman-Cecil Medicine | PMC research on otomycosis with tympanic membrane perforation (PMC10188761) | Turkish Archives of Otolaryngology (2019)

Disclaimer: This is educational information based on your reported history. It does not replace in-person clinical assessment. Given your worsening pain and confirmed eardrum perforation, please see your ENT as soon as possible.

Right now I had pain sometimes sometimes okay .and hearing this pop sound sometimes .a yellow colured fluid comes out when I lie down on left side ( left ear had issue) and had muffled sound hearing only..blocked feeling of ears

Based on everything you've described, here is a clear picture of what each symptom means right now:

What Your Symptoms Mean Right Now

🔊 Pop Sounds

The popping you hear is air moving past the partially-blocked eardrum perforation and through trapped fluid in the middle ear. It actually means the hole is still open enough to allow some pressure equalization. Popping during yawning or jaw movement is classic Eustachian tube activity - the tube briefly opens, air shifts, you hear the pop. This is not dangerous, but it confirms fluid is still present behind the drum.

💛 Yellow Fluid When Lying on Left Side

This is middle ear pus draining through the eardrum perforation by gravity. When you lie on your left side, the hole in your eardrum faces downward and fluid runs out. This is actually the body doing something useful - draining the infection - but it tells you:

The infection in the middle ear is still active
The hole is still open (which is why it can drain)
The fluid is infected (yellow = pus/bacteria/fungal debris mix)

Do not try to stop this drainage. It is better out than trapped inside under pressure.

🔇 Muffled Hearing + Blocked Feeling

There are two reasons for this happening together:

Middle ear fluid - sound vibrations have to travel through liquid instead of air, which dampens them significantly. This causes the muffled, "underwater" quality.
Swollen ear canal + debris - the fungal infection and post-suction swelling are physically narrowing the canal, adding to the blocked feeling.

This type of hearing loss is conductive (a mechanical problem), not nerve damage. It is reversible once the fluid clears and the infection resolves. Your inner ear is almost certainly fine.

Pain (Comes and Goes)

The intermittent pain pattern makes sense:

Pain present = pressure building in middle ear (fluid trapped, Eustachian tube closed, inflammation peaking)
Pain gone = tube opens briefly, pressure equalizes, or some fluid drains through the hole
The fact that it is not constant is reassuring - it means you are not in a fully sealed, high-pressure situation

The Core Problem Right Now

Infection still active in middle ear
        ↓
Fluid (pus) accumulating
        ↓
Eustachian tube swollen/dysfunctional (allergy + infection)
        ↓
Fluid can't drain upward through tube
        ↓
Only exit = the eardrum hole (downward drainage when you lie left)
        ↓
Blocked + muffled + intermittent pain + pops

What Needs to Happen

Right now, at home:

Sleep with your left side DOWN occasionally to encourage drainage through the hole - it is helping
Keep the ear dry at all other times (no water, no drops unless ENT-confirmed safe)
Take any antihistamine you have (like the Levocet prescribed) - it reduces Eustachian tube swelling from your allergy, which helps drainage
Do not put cotton buds, earbuds, or fingers in the ear

Urgently - within today or tomorrow:

You need to go back to the ENT. The yellow drainage + muffled hearing + ongoing pain means the infection is still active and you need:
- Proper ear cleaning under suction (by the ENT, not at home)
- Confirmation of which antifungal drops to use that are safe with your perforated drum
- Full antibiotic course restarted
- Possibly oral antifungal (fluconazole or itraconazole) if topical drops are not reaching the middle ear through the hole

Tell the ENT exactly:

"After the last suction my ear blocked immediately. I have yellow fluid draining when I lie on the left side, muffled hearing, intermittent pain, and popping sounds. I stopped the medications - what do I restart and is it safe with the perforation?"

Reassurance

Your symptoms - pop sounds, positional drainage, intermittent pain, muffled hearing - are all consistent with a resolving but still active middle ear infection with a perforated drum. This is a known, treatable condition. The fact that you can still hear (just muffled), that pain is not constant, and that fluid is draining are all signs your body is trying to resolve this. With proper treatment completed in full, the vast majority of these cases heal completely, including the eardrum hole closing on its own.

The danger zone would be: sudden complete hearing loss, vertigo/dizziness, facial weakness, or fever with severe headache. None of those are in your current picture, which is a good sign.

Go see the ENT today if possible. Do not delay further.

I had a appointment with ent at august 17..so how can I naturally at home hels this infection and the doctor said sometimes the hole get closed by its own

Your doctor is correct - the hole very commonly closes on its own. But August 17 is 35 days away, and you have an active infection with a perforated drum. The goal at home is to control the infection enough to let the hole heal without making things worse.

Here is a realistic, safe home management plan:

The Most Important Thing First

You have medications already prescribed to you. The single most helpful thing you can do at home is take them as directed. Stopping them is what stalled your recovery. If you still have them:

Antibiotics (oral) - restart the course, complete every dose, do not stop early even if you feel better
Antifungal drops - use as directed by your ENT (confirm with a pharmacist they are safe with perforation)
Levocet (antihistamine) - take this daily, it directly helps your Eustachian tube swelling from dust allergy
Steroids if still available - reduce inflammation that is keeping the tube blocked

If you have run out, call your ENT clinic or a general doctor and explain you need a refill before August 17. Most clinics will do a phone prescription for a continuing course.

Daily Home Routine (Safe, Evidence-Based)

Morning

Warm compress - hold a warm (not hot) cloth against your left ear for 10-15 minutes. Warmth increases blood flow, reduces swelling, and helps the Eustachian tube open slightly. Do this every morning.
Nasal rinse (saline) - use a saline nasal spray or Neti pot. Your allergy causes nasal inflammation that blocks the Eustachian tube. Clearing your nasal passages helps middle ear drainage. This is one of the most underrated things you can do.
Steam inhalation - lean over a bowl of hot (not boiling) water with a towel over your head for 5-10 minutes. Helps open swollen nasal and Eustachian tube passages. Do this once or twice daily.

Throughout the Day

Yawn deliberately and swallow - gentle Eustachian tube exercises. When you feel the ear blocked, try yawning wide + swallowing at the same time. This naturally pumps the tube open.
Valsalva maneuver - GENTLY only - pinch your nose, close your mouth, and very gently try to blow through your nose (do not force it hard). This pushes air through the Eustachian tube and can temporarily open the blockage. Only do this gently - aggressive Valsalva with a perforation can push infected air further in.
Chew gum - jaw movement activates the muscles that open the Eustachian tube. Simple but genuinely helpful.

Sleeping

Sleep with head slightly elevated - use an extra pillow. This reduces fluid pooling in the middle ear and reduces overnight Eustachian tube swelling.
Left side down occasionally - allows gravity to drain fluid through the perforation when needed. But do not sleep on left side all night as it also introduces moisture risk.

Strict Prohibitions (These Will Make It Worse)

Do NOT	Why
Put cotton buds in the ear	Pushes debris deeper, traumatises healing tissue
Use earbuds/earphones in left ear	Pressure + moisture = prevents healing
Get water in the ear	Moisture feeds fungal infection aggressively
Shower without protecting the ear	Use a cotton ball lightly coated with Vaseline to plug the canal entrance during showers
Blow your nose hard	Forces infected mucus into the Eustachian tube
Swim or submerge head	Absolutely off-limits until the hole closes
Fly in a plane	Pressure changes with a perforation can be very painful and damaging

Ear Dryness is Critical

The fungal infection thrives on moisture. Keeping the ear canal dry is as important as taking the antifungal drops. After any accidental water exposure, tilt your head left side down and let gravity drain it out. You can use a hairdryer on the lowest heat setting, held 30cm away, aimed at the ear for 30 seconds to gently dry the canal.

Diet and General Support

Increase Vitamin C - supports immune function and tissue healing (fruits, vegetables, or a supplement)
Zinc-rich foods - supports wound healing (nuts, seeds, legumes, meat)
Avoid sugar heavily - sugar feeds fungal infections
Stay well hydrated - helps thin mucus secretions and supports Eustachian tube function
Manage your dust allergy - vacuum your room, use a damp cloth to wipe surfaces, avoid dusty environments, keep windows closed on windy days. Your allergy is a root driver of the Eustachian tube problem.

Signs the Hole Is Healing

Over the coming weeks, if healing is progressing, you should notice:

Gradual reduction in yellow drainage
Pop sounds becoming less frequent as fluid clears
Muffled hearing slowly improving
Blocked feeling reducing, especially after yawning/swallowing
Pain reducing and becoming less frequent

When to NOT Wait Until August 17

Go to a doctor sooner (urgent care, general doctor, or ENT emergency line) if you develop:

Fever above 38.5°C
Severe pain that does not respond to ibuprofen/paracetamol
Dizziness or room spinning (vertigo)
Sudden significant worsening of hearing
Swelling or redness behind the ear (mastoid bone area)
Facial weakness on the left side

These are signs the infection may be spreading, which needs immediate treatment.

Realistic Timeline

If you take medications consistently and follow the above:

Week	Expected Progress
Week 1-2	Yellow drainage reduces, pain less frequent, slight improvement in muffling
Week 2-3	Blocked feeling starts to ease, pop sounds reduce
Week 3-5	Hearing improving, hole may begin closing
By August 17	ENT can assess if the hole has closed or needs a paper patch procedure

The doctor is right - these holes close on their own in the majority of cases. Your job between now and August 17 is to create the best possible conditions for that to happen: dry ear, completed medications, allergy managed, no trauma to the canal.

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