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Ask The Expert Archive

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Hearing and Balance Archive Questions

Below are Dr. Eisenman’s answers to Hearing and Balance questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 15 of 91.

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Q : 1

I've been diagnosed with Vestibular Neuritis. My MRI and hearing tested normal. I did all sorts of balance and dizziness testing. It's Week 4 of onset and dizziness/nausea are improving but my left arm/leg are numb/tingling. Is this a typical symptom of VN?

Tingling in the arms and legs (or one arm and one leg) is not a symptom of vestibular neuritis. If you are holding your neck stiffly, or not moving freely, because of the dizziness, it is possible that you could develop tingling from a "pinched nerve" or the like. Nevertheless, if those are symptoms associated with your problem, you should be evaluated to ensure that there nothing else other than vestibular neuritis going on.

Q : 2

About 2 years ago people began pointing out that I was having hearing problems. I went to an ENT and was told that the hearing loss I have is due to inner ear nerve damage. An MRI was done to rule out a tumor. Less than 6 months later, I had facial palsy and returned to the same ENT and was given steroids and famvir. This past Thursday night during my ritual of tossing from right side to back to left side at bed time (I most always have trouble falling asleep)when I turned to my left side I became immediately nauseated, flushed with uncomfortable warmth and when I looked at the window it appeared to be shifting from side to side. After lying on my back with a wet cloth my husband got for me and letting the nausea settle,I turned back on my left side and the same thing happened. The next morning my stomach was tight and somewhat nauseated but I showered and then tipped my head over while drying my hair and the same thing as happened. I've read that this is vertigo. My concern is that either there is a tumor that somehow got overlooked or something is continuing to deteriorate my nerve(s) or something else is going on. Please advise.

The vertigo you had is suggestive of a problem called BPPV. This is a very common problem, and can be associated with numerous other ear problems, including certain causes of hearing loss. It might be appropriate to repeat the MRI, if a sufficient interval has elapsed since the first exam. I would recommend reconsulting with the ENT to see if that is indicated.

Q : 3

What is the cause of skin flaking and getting a build-up of it in my ears? I don't seem to have a normal production of earwax. When I remove the build-up, the earwax is a yellowish color, and dry and hard. It seems to be mostly dry skin build up.

There are a variety of skin conditions that can lead to that problem, and it can also sometimes occur in isolation, with no associated skin disorders. One such disorder is something called keratosis obturans, but it doesn't sound like your problem is as severe as that commonly is. You may wish to see an ENT or a dermatologist in consultation.

Q : 4

I have Meniere's disease. I have not have a vertigo attack for about a year and a half. But the ringing ear is continuous and now I have fullness and loss of hearing. Other than low sodioum intake, do you have other treatment for the three symptoms?

A low-sodium diet, drinking enough water, and sometimes taking a diuretic are the main treatments we use for the non-vertigo symptoms of Meniere's disease. There are times when steroids by mouth or injected into the ear can be appropriate too.

Q : 5

For the past year, I've been having some ear issues where I hear a humming noise (sort of like morse code mechanical drone) in my right ear only. Sometimes it goes away, sometimes it stays for a while. I am not handling this well. I went to two general ENTs who didn't know. Both said I had great hearing. Then I went to a neurotologist in Philadelphia who said I had Menieres disease, but I do not have vertigo or ear fullness. Just the strange noises. I had a MRI - all clear. He also said I had mild hearing loss in the bad ear (which led to the MD diagnosis), but I had previously had two hearing tests and they said I had good hearing. Have you ever heard of anyone having this humming noise in their ear? It's preceeded by a beeping noise and sometimes feels like a spasm or something. For the past week or so, it's developed a pattern of coming about in the wee hours of the morning and then going away the rest of the day. Then repeat! Any information would be great.

It is possible that your symptoms are due to cochlear hydrops, which is thought to be related to Meniere's disease though without the vertigo. If your hearing test demonstrated fluctuations (i.e. no hearing loss on one test followed by loss on another, then improving again), that would be suggested. Another possibility is that you are hearing a spasm of one of the middle ear muscles. This is usually perceived as a fluttering or clicking sensation ("morse code"). This is a common problem that usually resolves on its own, though it can sometimes persists for months. Dehydration can be a cause. Rarely it persists for very long times, and in those cases it can be treated by severing the affected muscle in the middle ear.

Q : 6

Two years ago, I got a Baha implant. Since then, I have had nothing but problems: chronic ear infections, pain and dizziness. Can this be removed?

Baha implants can be removed, but I would not expect that to help with chronic ear infections or dizziness. I would need to examine you to see how the sites look, and try to figure out what may be causing some of the symptoms you are having.

Q : 7

I have pulsatile tinnitus. I've had an MRI and MRA, which revealed normal artery and vein functions. There were some "small abnormalities due to aging". After the results of the MRI and MRA were given to me, my primary care said the condition is just due to aging and I need to learn to live with it. Can aging alone be the cause of pulsatile tinnitus? Everything I've read says no.

Aging alone does not explain pulsatile tinnitus. The next study we would recommend to try to identify a cause would be a non-contrast CT scan of the temporal bones. This can identify a treatable cause in many people, though some causes are frequently overlooked by less experienced clinicians.

Q : 8

I have had tinnitus since 1992. In 2008, I had three stents put in and ever since then, it is getting louder. Are there any other options?

If your tinnitus has intensified after previous TRT treatment, you are still a candidate for tinnitus habituation therapy again.

Q : 9

I have hearing loss due to middle ear perforation in both ears. Is it curable or do I need hearing aids?

A hole in the eardrum can often be repaired surgically. Any hearing loss that is due to the presence of the hole would have a high likelihood of improving after successful surgery.

Q : 10

I've had pulsatile tinnitus in one ear for a year, but no hearing loss. Should I get an MRI and CT scan?

Our initial evaluation for pulsatile tinnitus is usually with a non-contrast CT scan of the temporal bones, and an MR angiogram/venogram or CT angiogram/venogram. A regular MRI is usually not helpful. Many of the identifiable causes are treatable, and can provide relief from the tinnitus.

Q : 11

I have branchial cleft cysts behind my left ear. I visited an ENT and he recommended that I have surgery. However, he stated that there is some risk of facial paralysis. What is the recommended treatment? And if surgery is necessary, what are the major risks?

Branchial cleft cysts can occur around the ear, but those are typically in the outer ear canal, rather than behind the ear. You could have a cyst that extends through the parotid gland, which is more below and in front of the ear. These can intertwine around branches of the facial nerve, and that nerve needs to be identified and preserved to safely remove the cyst.

Q : 12

How helpful is the bilateral BAHA implant? What is the difference between the BAHA and cochlear implants?

Bialteral BAHA implants are reserved for those who had either bilateral conductive hearing loss (both inner ears work well, but the sound doesn't get through), or conductive hearing loss in one ear and sensorineural hearing loss (the inner ear itself does not work) in the other. Cochlear implants are currently reserved for people with severe sensorineural hearing loss in both ears. At some point in the future a cochlear implant in one ear might be indicated for somebody with unilateral sensorineural hearing loss--a situation where currently a Baha is the only surgical option--but cochlear implants are not yet approved for that use.

Q : 13

Is there a program at UMMC for someone who has constant ringing in the ears?

We have a very well-established and large tinnitus program that has been around for more than 20 years. You can find information about it on our website, or you could call the office and we would be happy to send you a brochure and some other information.

Q : 14

How successful is the cochlear implant in cases of dysynchrony?

There is some controversy about that. It is likely not as successful as in situations not associated with auditory neuropathy or dysynchrony, but it is nonetheless still the best option for somebody in that situation who cannot use conventional hearing aids.

Q : 15

I have had nerve deafness in one ear since I was 7 years old. It was caused by mumps and very high fever. How can I find out if I would be a candidate for Baha?

If you have hearing loss in one ear that is too severe to be helped with a regular hearing aid, and if the other ear has good hearing, you're likely a candidate for a Baha. You might also be a candidate for a CROS hearing aid system, which is a non-surgical alternative. Some studies have suggested that the Baha is superior to the CROS. The first step in the evaluation would be a visit with an ENT physician and a complete audiogram.

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