ONE WEEK AGO I DIDN'T HAVE ANY HEARING PROBLEMS IN MY LEFT EAR. ( MY RIGHT EAR ON THE OTHER HAND, HAS BEEN A TOTAL LOSS SINCE BIRTH DUE TO MENINGITIS. ) I WAS KNOCKED DOWN PLAYING BASEBALL AND HIT IN THE RIGHT SIDE OF MY HEAD WITH A BASEBALL BAT, BUT NOT HARD. I NEVER LOST CONSCIOUSNESS NOR WAS I DIZZY AT THE TIME. HOWEVER, TWO DAYS AFTER THE INCIDENT I BEGAN FEELING DIZZY AND HAD MINOR RINGING IN MY LEFT EAR. I WENT TO A PHYSICIAN THREE DAYS AFTER THE INCIDENT AND HE GAVE ME MECLIZINE AND AMOXICILLIN. SINCE THEN, THE DIZZINESS HAS GONE AWAY BUT THE RINGING AND HEAR LOSS HAS GOTTEN WORSE. I SAW AN ENT SPECIALISTS JUST TWO DAYS AGO AND HE COULDN'T SEE ANY FLUID OR WAX BUILD UP IN THE OUTER EAR. HE PRESCRIBED A STERIOD CALLED PREDNISONE B/C HE THINKS MY INNER EAR MIGHT BE INFLAMED. HE DOESN'T BELIEVE THE HEAD INCIDENT HAS ANYTHING TO DO WITH THIS. IS THERE ANY WAY THE DOCTOR CAN TELL IF THERE IS FLUID BUILDUP IN MIDDLE EAR OR WHETHER IT IS A MIDDLE EAR PROBLEM JUST BY LOOKING IN MY EAR WITH THE TYPICAL INSTRUMENT? DOES THIS SOUND LIKE AN INNER OR MIDDLE EAR PROBLEM AND IS THIS RELATED TO THE HEAD INCIDENT? THE OTHER PROBLEM I HAVE WITH MY LEFT EAR IS IT FEELS LIKE THERE IS PRESSURE OR SOME TYPE OF CONGESTION. IS THIS NORMAL FOR INNER OR MIDDLE EAR INFECTIONS? I CAN STILL HEAR NOISES BUT WHEN PEOPLE TALK IT SOUNDS MUFFLED. IF YOU COULD ANSWER THESE QUESTIONS FOR ME AND MAYBE GIVE ME SOME DO'S AND DONT'S AS FAR AS ACTIVITY IS CONCERNED I WOULD GREATLY APPRECIATE IT. I PLAN ON HAVING A SECOND OPINION BY AN EAR SPECIALISTS/SURGEONS IN ABOUT ONE WEEK SO PLEASE RESPOND ASAP, THANK YOU.
Reply: ---------------------------
First of all, physical examination of the ears combined with audiometric testing can conclusively determine whether the hearing loss is primarily due to a middle ear problem or whether it is due to an inner ear problem.
Given your history of closed head trauma (even if it were relatively minor) preceding the hearing loss and dizziness, I would be particularly concerned about the possibility of a perilymphatic fistula. You might refer to a previous discussion of this subject in the "review" section of the ENT clinic or directly at http://ofcn.org/cyber.serv/hwp/hwc/ent/news/ent201.html where I discuss the diagnosis and management of idiopathic perilymphatic fistulae. Traumatic perilymphatic fistulae are managed similarly in many cases.
I would also point out that in your specific case, where the involved ear is apparently the only hearing ear, this should be considered an urgent matter in terms of making a diagnosis and instituting treatment. I might consider seeing a type of ear, nose, and throat specialist who limits his/her practice to ear problems - ie an otologist or neurotologist.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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