Your persistent year-round breathing issues, hearing blockages, and noisy nighttime breathing suggest chronic nasal allergy or sinus inflammation that is affecting your Eustachian tubes (which connect your nose to your ears). Since Montemac-LC has not provided relief, oral tablets alone may not be sufficient. You may benefit from a prescription corticosteroid nasal spray (such as Fluticasone) to directly reduce swelling in your nasal passages and ears. However, it is highly recommended that you consult an ENT (Ear, Nose, Throat) specialist. They must evaluate you for nasal polyps, a deviated septum, or fluid behind the eardrums before starting new medications.