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876588 tn?1267813519

This danged Tinnitus... Otosclerosis or SCSD?

I'm 34, and this came on after a cold.  Tinnitus may have been mildly present, but really popped up after a cold eight months ago.  

My report from the hearing and balance center (Dr. of Audiology):

...patient 34 y.o. male reports constant tinnitus in left ear and intermittent tinnitus in the right ear… present for at least several months, may have been present longer and worsened more recently.  Currently denies the presence of otalgia, otorrhea and vertigo.

TEST RESULTS: Otoscopy revealed minimal cerumen and a normal appearing tympanic membrane in the right ear.  Otosopic exam. Of the left ear revealed normal Type A tympanograms, bilaterally.  Eustachian tube dysfunction testing revealed no clinically significant shift in peak pressure in either ear.  Pure tone air and bone conduction audiometry completed in the right ear revealed normal peripheral auditory sensitivity across all test frequencies, with a conductive component at 500 Hz.  Pure tone air and bone conduction audiometry completed in the left ear revealed mid conductive hearing loss form 250- 2000 Hz and normal peripheral auditory sensitivity at 4000 and 8000 Hz.  Word discrimination scores of 100% were obtained, bilaterally, when stimuli were presented at 60 db HL to each ear.  Word discrimination testing completed at 90 dB HL in the left ear was negative for rollover.

IMPRESSION: the audiometric test results obtained at this appointment indicate normal peripheral auditory sensitivity across all test frequencies with a conductive component at 500 Hz in the right ear and mild conductive hearing loss from 250 through 2000 Hz with normal peripheral auditory sensitivity at 4000 and 8000 Hz in the left ear.  Word discrimination scores were deemed excellent, bilaterally.  Work discrimination testing completed at 90 dB HL in the left ear contraindicates the presence of retrocochlear pathology in that ear.  Tympanometric test results indicate normal middle ear function, bilaterally.  The absence of ipsiliateral acoustic reflexes correlates with the conducive components noted in ear during audiometric testing.  Eustachian tube dysfunction testing was positive for Eustachian tube dysfunction, bilaterally.  

After the test my ENT said: "Otosclerosis; or maybe Superior Canal Semicurcular Dehiscence."  He said that surgery isn't too successful, but if I wanted he could refer me to a specialist.

Any thoughts?  Should I start researching surgery options?
4 Responses
876588 tn?1267813519
Conductive hearing loss and absence of the acoustic reflex do seem to fit what the Audiologist and ENT described.  It seemed like my ENT was trying to talk me out of surgery options, but I'm tired of not hearing people, and it's probably going to get worse.
876588 tn?1267813519
Any help on what surgical procedures might be helpful?
Avatar universal
Hi,, it sounds like you have Otosclerosis,, normal tympanogram with absent acoustic reflex is indicative of otosclerosis.  With SCSD u would have a rupture in one of the semi circular canal,, and you would experience vertigo in the presence of louds sounds,, but u complain of no vertigo.  Now being that you have a conductive hearing loss hearing aid will do the trick,, your auditory nerve is normal and your problem is in the middle ear,.. one of the bones is fixated and wont move so the sound has to be made louder just to get it thru to the inner ear,,,,and getting a hearing aid will also help with the tinnitus... Some of my older patients have been coming in who have had surgery for otosclerosis are getting hearing aids (but this is 30 years after surgery),, being that you have a mild hearing loss i dont think surgery is worth it at this time. having surgery does not gurantee that your hearing will go back up to normal.... hope this helps.. btw im an audiologist
876588 tn?1267813519

Thank you.  I am enjoying learning more about this stuff, tho it is a little frustrating at times.  I appreciate any and all input.

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