Unsolvable ear problem.

Hello,
So I've been to two ENT specialists who couldn't help so before I gave up I thought I would ask here.
I have a feeling of fullness in my right ear with tinnitus and mild hearing loss (things sound a bit muffled).
I had an audiogram and across all frequencies my hearing was a little bit less in my right ear, with one specific frequency being significantly lower. I don't remember exaclty which frequency but it was towards the higher end.
The problem seems to get worse/better. Some nights the feeling is very annoying, with the feeling that my ear is completley blocked and very noticeable tinnitus. Some times, especially in the morning after just waking up, It's not very noticeable.
I have had this problem for a long time, probably a year, although i don't remember exactly. It may have begun with an ear infection I had around then which I was prescribed antibiotics for.

Around 4 or 5 years ago I had an accident with a bunger (small firework) going off next to the same ear. I had a swollen ear drum and tinnitus for a couple of weeks but this healed up completely and my hearing was fine up until this. The specialists can only attribute this problem to that, although I had forgotten to tell them about the ear infection.
The first specialist said it was probably permanent inner ear (cochlear) damage.
The second specialist put a small camera tube through my head and said things looked fine.
He also advised me to do this saline water irrigation process, which involves basically snorting salt water and have it come to the back of my mouth, which i have been doing for the last couple of days.

Does this sound like permanent cochlear damage? Can this cause a feeling of unequal pressure in the head?
Any thoughts would be much appreciated.

Thank you,
Adam.

[adammd]

-- I should have mentioned that I am a 20 year old male

[tomsant]

20 M with hearing loss, fullness and tinnitus in the right ear for about a year; may have begun with an ear infection. Had hearing problem etc for two weeks in the same ear due to probably a blast injury, about 5 yr back, and was asymptomatic until one year back. (I got it right?)

Hope you are otherwise healthy.

The middle ear is a an 'air-bubble' cavity deep to the ear drum. It has a ventilation tube (eustachian tube) opening into the backyard  of the nose (nasopharynx), through which the middle ear pressure is maintained equal to the atmospheric pressure.

There are some situations in which this tube may get blocked or swollen and thus affect the middle ear pressure etc, and reduce the hearing.

Cochlea is part of the inner ear (the other part being 'vestibular organ'  dealing with 'balance'), and sits in the skull bone deep to the middle ear, connected with the latter through two 'windows'. A loud blast can shake up the drum and middle ear so much that the whole shock is carried to the inner ear, rattling and maybe permanently damaging the fragile micro structures within it. Depending on the intensity of the 'blast' the magnitude of injury can vary. Some get full recovery, others partial.

You would have recovered to a good extent, and hence were not aware of any hearing impairment. (An audiogram done then would have thrown light into this) An infection in the same ear a year back, either put in some more damage or drew your attention to it.

Nasal endoscopy would have been done to ***** the dynamics of Eustachian tube. Since the ear may 'look' normal otherwise, tests are done to evaluate the hearing loss. A pure tone audiogram (you say that there was a dip in some high tone) will show if there is an inner ear problem or a middle ear problem or both. Sometimes an 'impedance audiometry' also is done.

It is difficult to say if it is a permanent cochlear damage without seeing the results ot the various tests. A feeling of unequal pressure in the head? You mean the right and left ears? If one middle ear is not aerated properly, this can happen.

You have to be under care of an ENT specialist to diagnose what is wrong, and to manage the problem, if any.

Hope this helps.

Rgds,
Thomas Antony