The headers indicate that you are in Australia.

Have you had a CT scan and if so, what is the state of your nose and sinuses
according to the CT scan?

If you are talking about the Eustachian tube (ET) portion of the ear, there
are several things you can try.

1) If you use nasal steroid spray you could try to tilt your head so the
steriod liquid goes toward the ear. If the steriod goes by the ET it will
reduce inflammation and make it so it opens and drains to the throat.

2) You could also use decongestants or natural decongestants products like
Dr. Grossan's Clear-Ease or Guifensian (Humabid or Mucinex) to thin the
mucus. Drink plenty of fluids especially hot teas and liquids avoiding
cold ones.

3) If you are irrigating your sinuses be careful not to get any water in
there. How to do this will depend if you are using a water pik / grossan
irrigator or neti pot to do irrigations. Make sure you follow instructions
so you do not flood the ear.

You could ask your ENT if ear tubes would help you. They should measure
the pressure in your ear to see if you have developed a thickening of the
fluid in the ear called 'glue ear'. They put tubes in adults if the ears
are constantly blocked. I would avoid antihistimines unless you are
severly allergic as the drying affect will make the mucus thicker.

Have you been checked for allergies?

Good luck hopefully you can resolve your problem.

Ive had this problem for 3 months non stop now.. I cant imagine 4 years!! I
feel for you.
My doc says its due to allergies for me - in his examination he says I have
TONS of pressure behind my ear drum.. I iassume this means fluid. . I have
no other allergy symptoms.. just clogged ears.
I have been trying to clear my ears so often that my jaw is incredibly sore,
and i have to consciously hang my mouth open because the tension is too much
.. I clench like crazy due to the jaw irritation. I hate the feeling in my
ears!

Anyways,  I went through all of the antihisthamine/allergy meds out there,
prescription and non... NOTHING for this entire 3 months worked..  I thought
zyrtech would.. but it was short lived.. about 2 days really.
Anyways, my doc just gave me rhinocord steroid nasal spray.. Ive only used
it 2 days, but I feel a HUGE difference, I  can actually feel my ears
draining.. I sure hope it lasts. It tastes like junk and is about 100 us
dollars.. but the doc says it WILL work. Also-- it gives me a really dry
throat.

Hope it gets better for you! (And for me too!)