Severe Ear trauma

[Keith127]

72 hours ago my nephew placed a Lego Bionicle Sword at my right ear and shoved it all the way in.  I immediately experienced pain and ringing in the ear and lost all my hearing.  I have experienced a small amount of bloody discharge from the ear.  I have since regained some hearing, and since I am a recording engineer I can detail this.  I now hear nothing below 100Hz in my right ear.  Everything from 100Hz to 2500Hz is down 12dB with respect to my good ear.  2500Hz to 10kHz is also down 12dB, but exhibits a "ring modulated" type of interference.  Above 10kHz is severely attenuated.  My left ear remains relatively flat from 30Hz to 12.5kHz.

My doctor says that I am experiencing ruptured eardrum and it will most likely heal within 3 weeks and I should go to a specialist then if it is not significantly better.  Does this diagnosis seem correct from your experience and does my ear's frequency response corroborate this diagnosis?  Should I be doing anything else other than just waiting?  Thanks for your help.

[ENTMD]

Wow, I have never seen anyone able to report on their own hearing as detailed as you have!

An injured ear drum would certainly exhibit hearing loss along the lines you are reporting.  As long as you are not completely deaf AND dizzy (this is an important point), this will likely resolve.  I believe patients should be placed on prophylactic ear drops during the healing process.  If you are dizzy (vertigo) and/or your hearing worsens, you need to get in to see an ENT doc right away.  Either way, make sure someone qualified follows through with this and can document a well-healed drum.

[Keith127]

Thanks for the response ENTMD.  I am taking your advice and will spend the day tomorrow securing the services of an ENT.  Should I look for one that is qualified to do ear surgery, which I believe is called otologic surgery, or are all ENT's similarly qualified?

I will mention your recommendation of prophylactic ear drops during the healing process.  Thanks.

I have been studying diagrams of the ear.  If any of those 3 little bones were moved out of place or broken by the Lego Bionicle sword would I hear anything at all?  I understand that if the cochlea was pierced it would have drained and I would be completely deaf in that ear.  Is it damage to the cochlea that would cause this dizzyness you mentioned?

Lastly, you indicated that this would likely resolve.  I am a really healthy 44 year old male, I eat right and swim a mile a day.  I have perfect blood pressure and I take no medications (except for coffee :-) and have no medical conditions.  With this kind of history and the care of an ENT what percentage of my hearing should I expect to recover?  What can I do to move this number closer to 100%?  

Thank you for your time, really.  I have been doing music my whole life and to abruptly change course at this stage in the game would be quite unpleasant.

[Keith127]

I forgot to address my previous response to you.  I also have one more question.  Why does the right side of my head feel like it's full of water?  Is this because the middle ear is pressurized when the eardrum is intact?

[Keith127]

I just got back from my ENT appointment and he prescribed prophylactic ear drops, but only for 3 days.  I have an appointment for next Tuesday at their office that has the Audiology gear so they'll check my hearing then.  He seems to think that the bones are intact and that although it's a large perforation, it should heal within a month.  

He is a little bit concerned about my hearing loss above 10kHz, though.  He said something about possible nerve damage.  It was a little disconcerting when he mixed up his dB's and kHz, though.  You'd think that a hearing professional would know the language of sound.  I'll fill you all in on what happens as it happens.

Cheers!

[ENTMD]

Keith - good move on your part.  Some ENT docs rely very strongly upon their Audiologists to speak "hearing".  In fact, there has been a recent push within our academy to have ENT docs bone up a little on their hearing-ese.

Maybe your questions were already answered.  You can still hear without the hearing bones, just not very well.  Inner ear damage (cochlea included) generally causes intense vertigo.  You should expect full recovery if this is just a drum issue or even a minor hearing bone injury.

All ENTs are "ear surgeons".  Some do more than others; it's very person-dependent.