For the past few weeks I have been trying to get over a cold/flu. I still have sinus congestion. On a recent car trip, as we went through a change in elevation, the pressure in my right ear increased and the right side of my face started to go numb. My right eyelid wasn't blinking at the same time as my left, my tongue was tingling and I had an earache as well. This continued for about one hour. Should I see a doctor? Does this have any effect on my pregnancy? (I'm about five months along.)

Debbie

Most of your symptoms may be related to pressure in your middle ears. The middle ear is the air-filled space behind the eardrum. The eustachian tube is a muscular/cartilaginous tube that extends from the middle ear to the top of throat. The tube remains closed most of the time. When you "pop" your ears, you use throat muscles to yank on the tube, opening it enough for air to pass into the middle ear. This equalizes the air pressure between the outside world and your middle ear.

The eustachian-tube openings typically become inflamed when someone has a cold or flu. That's why these infections may involve ear symptoms. If you have difficulty "popping" your eustachian tubes, and if you travel through different elevations, a pressure difference will develop between the middle ear and the outside world. There will be a feeling of pressure in the ears. If the pressure change occurs rapidly while driving or flying, it may cause pain.

What about your other symptoms? Let's consider them in order.

The tingling tongue. One of the nerves to the tongue, a little guy called the chorda tympani, travels through the middle ear on its course from your brain to your tongue. Conceivably, pressure changes could cause a temporary impairment of blood flow to the nerve, resulting in your symptoms.

The sluggish blink. The nerve that powers ALL the muscles of facial expression, including the muscles that allow you to blink, is called the facial nerve. The facial nerve also traverses the middle ear. Once again, rapid pressure changes might alter blood flow to the nerve, causing temporary weakness.

Facial numbness. I suspect that this may be due, not to pressure changes in your middle ear, but in your sinuses. As with the middle ear, the sinuses are "air pockets" that at times may get "cut off from the outside world." The sinuses do have natural drainage channels, through which air enters and mucus exits. If you have had nasal congestion from a cold, these tiny channels may have swollen shut. A nerve that provides sensation to the middle portion of your face, the infraorbital nerve, traverses the maxillary sinus (immediately below your eye, to the side of your nose). If blood flow were altered to this nerve, you would notice numbness of the middle part of your face, including your cheek, upper lip and upper teeth.

How can you prevent this? Decongestant medications may help, but you MUST talk to your obstetrician about this because many such drugs are harmful to your baby.

Should you see a doctor? If your symptoms have fully resolved, you probably do not need to see your doctor (although your obstetrician would appreciate a phone call, I suspect). If any of your symptoms have persisted, you should see your doctor.

Does this have any effect on your pregnancy? Probably not. The only possible harm that I can think of is related to pain. If you were in severe pain, you would have experienced a number of changes (such as increased heart rate and blood pressure) that could affect your baby. I suspect that you are fine, but the only person who can really reassure you is your obstetrician.

One final comment: Your pregnancy may be part of the reason that this happened to you. Many women develop severe nasal congestion during pregnancy (so-called "rhinitis of pregnancy"), and this may lead to sinusitis and eustachian-tube dysfunction. If you had this problem to some degree and subsequently developed a cold, the cold may have "pushed you over the edge."