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Intermittent hearing loss and hyperacusis....Cochlear Hydrops?
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Intermittent hearing loss and hyperacusis....Cochlear Hydrops?

     Hello,  I am a 36 year old musician (drummer in a local colorado metal band).  I have been playing drums in metal bands for over 20 years and never had a problem or experienced premanent hearing loss.  At least nothing more than the common Temporary Threshold Shift.  Just over a year ago, my band played a show at a local venue that was over the top volume wise. I had never worn earplugs up till this time.   From that point on, my ears have been "raging" as I describe it.  From the morning after that show I knew something was seriously wrong.  I was left with severe hyperacusus, hearing loss in the 4k-6k range, and a feeling of fullness in my right ear and severe hearing loss and tinnitus in my left.  These symptoms seem to fluctuate and every now and then I can pop my ears and restore a lot of the hearing but the hyperacusis seems worse.  I have had 2 ENT's tell me that I had Cochlear hydrops but I believe my symptoms don't quite match that diagnosis.  Here is a brief medical history:

As a child I had bad ear infections and tubes several times.  At 13, I had a mastoidectomy and tympanoplasi in my left ear and was also found to have benign tumors in that ear as well.  This surgery left me with the typical hearing loss in that ear which never bothered me untill now. In the last year, I have had several hearing tests which revealed a major hearing loss in my left ear and a mild loss in my right within the 4k-6k range.  I have also had a sinus CT scan that was normal and an MRI (for tumors and MS) - normal also.  The 1st ENT did an ECOG on my right ear and diagnosed Cochlear Hydrops, but my hearing loss is not low frequencies.  He said an ECOG wasn't possible in my left because of the mastoid surgery.  For a 2nd diagnosis, my current ENT did another ECOG (this time on both ears) and the result was only a 4.7 - left ear and 4.9 right ear.  I was told that 5.0 is the threshold cutoff for hydrops and if I had it, it was very mild. I have been on Diazide and Diamox with no improvement. My symptoms fluctuate very eratically.  Most times I can do the Valvasa Meneuver and get my ears to "open up".....it sounds as if I'm pulling my head out of water.
Could my problems be solely relaten to Eustation tubes?  Every now and then get a patulous eustation tubes in both ears, but it quickly goes away.  Is there something I'm overlooking?

    
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Cochlear Hydrops as opposed to Meneire's Disease is rather rare. Affecting only the cochlear portion of your inner ear and not your vesibular portion. This condition mimics Meneires but without any of the vertigo. The diagnosis is one of exclusion. There is no single diagnostic test for it, although the ECG and ENG are close. If you have had a tympanogram and it is a type A, then most likely your eustachian tubes are OK. In my case I have massive ear fullness in one ear with slight fullness in the ear, low pitched tinnitus in one along with a feeling of numbness and a loss of low frequency response. It's easy for lazy ENT docs to pin the meneire's disease
diagnosis on you because it is idiopathic and there are few, if any effective treatments.

In order to get relief you must first get an absolutely positive diagnosis. There are probably 100 different diseases out there that will mimic meneire's disease. You need to find a neurotologists that is experienced with Meneire's Disease and skull based tumors. You will need to undergo a series of medical tests desgined to 'differentiate' these possible medical conditions and narrow them down so they can be ruled out. Some of the these tests are;
MRI of the inner ear with contrast; CT scan of temporal bone. CT scan of neck, complete blood panel including ANA, SED rate, etc.You should have an ECOG and ENG performed, along with Tympanogram and audiogram. You should also be tested for syphillis (syphilis) and lyme disease. You should be evaluated for metabolic diseases such as diabetes and thyroid diseases. Once these tests have been done you can assume you have menieres disease.

If you have meneires or cochlear hypdrops you will likely be put on a 90 days trial of oral steroids along with a mild diuretic to keep your hydration and salt level down.

I wish you luck in discovering what precisely is wrong.
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