From: anonymous@epix.net
Subject: Mastoid Bone Loss
Posted-By: xx108 (ENT Clinic Moderator)
Organization: Organization For Community Networks
Date: Wed, 4 Sep 96 09:33:07 PDT
Newsgroups: ofcn.clinic.ent


Eleven months ago while sleeping under a new bedspread/comforter made in China which had a faint chemical smell, I awoke at 4AM with pain in the left ear. The pain subsided within a few hours and I was left with a fullness in the ear. The sensation was the same as the typical pressure change in the ear while landing in an aircraft. After 2 weeks of steady blockage and clicking sounds when swallowing, I was examined, the results were indications of a high frequency loss with the remaining tests unremarkable. The placement of a T Tube was of no help as were Amoxicillan, Flonase, Humibid/Guiaifed. Concerns of damage from a previous mild stroke leaving partial numbness of the left cheek and upper lip led to a CT Scan and MRI. These exams did not reveal any abnormalities. Two other clinical exams by Otolaryngolists concluded " I would have to learn to live with it" Another opinion was expressed as a lack of bone or very thin bone structure between the mastoid area and the brain was the culprit and led to the occassional heart beat thumping in the ear. This theory was dismissed by Walter Reed ENT doctors and a "see you in 6 months" conclusion.

From this history is there a possibility that you have seen this problem before and could provide some advise for this senoir citizen. Thank you in advance

Reply: -----------------

It is somewhat difficult to discern the exact nature of your problem based on what you have posted. As best as I can tell, you must have had an otitis media (an infection of the middle ear) which failed to clear promptly with antibiotic therapy thereby necessitating placement of a tympanostomy tube designed to drain fluid trapped in the middle ear space. I assume that the high frequency hearing loss described affects both ears and was most likely pre-existent and unrelated to the infection. The "blockage" and "clicking" suggests obstruction of the eustachian tube which connects the middle ear space with the throat and whose purpose is to ventilate or equalize air pressure as well as drain the middle ear. Infections of the middle ear may result in protracted eustachian tube dysfunction which persists long after the actual infection has resolved leaving typical symptoms of plugging, crackling, or clicking in the ears. Often a test known as a tympanogram will reveal eustachian tube problems. Such eustachian tube problems are occasionally very difficult to eradicate in timely fashion despite medications such as antibiotics and decongestants. In my experience, topical nasal steroids such as Flonase, Rhinocort, Nasacort, etc if used on a regular daily basis over a period of one month often improves eustachian tube related symptoms.

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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis

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