Hearing loss following ear infection and persistent clog

[bonnie202]

So perplexed and so are doctors. After an ear  infection I developed a clog in the ear that won't go away; for 6 weeks now.  Test show 30% hearing loss. Additionally, I get severe pain from loud voices and music. Its really interrupting my life. They tried tubes and I am waiting for the hole from the tube to close as well as a spontaneous perforation. Seeing another specialist in NY feb 8 hoping for answers.

Why the pain from the loud noises? No expert I've seen can answer this.

I'm also very nervous, the only thing thats changed in my life is getting a dog; so called "hypoallergenic" wondering if that could be causing clog. Saw an allergist and did test pos for alergy to dogs. Taking all precautions and getting allergy shots; think they're helping. Family would be devastated if I had to give the puppy way.
I also make sure not to get any water in the ear.
thanks!
Any suggestions/thoughts?

[Sumit Bhatti, MD]

Dear bonnie202,

Thank you for writing back.

The cement like wax plug that was removed was most probably keratosis obturans. As your right ear feels clogged in spite of two perforations, you need to get a PTA (Pure Tone Audiogram) and an Impedance Audiogram (I/A or Tympanogram) done to help us understand this. As I believe that more information can help a physician help a patient better, I would like to ask you whether you have any history of ear discharge.

A plain computerised tomography of the paranasal sinuses (CT PNS) can confirm or rule out a sinus clog / congestion.

An allergy may or may not be the cause for your symptoms. As such , there is no cure for allergy. Avoidance is the best measure. You may take a trial of anti-allergy drugs (like oral anti-histaminics) by requesting someone else to take care of your puppy for a few days.

Scar tissue or specifically adhesions in the middle ear may lead to hyperacusis and the clogged feeling.

Since you are hearing echoes in your head (a symptom known as autophony), certain fistulas, superior semicircular canal dehiscence and a patulous eustachian tube, need to be ruled out. For this you may require further audiological tests like a High Resolution computerised tomography scan (HRCT) and contrast enhanced magnetic resonance imaging (MRI) Temporal bone Scans.

I hope I have answered your query.

Best Regards
Dr. Sumit Bhatti

[bonnie202]

This is amazing to get a reply from an MD thank you so much for your time.
Yes a tube was removed from my right ear leaving a perforation which has not closed yet; plus I have another perforation which the Dr.said was spontaneous. I first presented with what the Dr.  said was an upper respiratory infection resulting in an ear infection (plus a wax plug they said was  like removing cement). Once they removed the wax they saw scar tissue which they said must have built up over years without me knowing I had ear infections or whatever issues but they did check their archives and found that back in 2004 and again later on I did complain of "ear pressure".
So now i feel "ear pressure again". With this episode it began with with terrible pain, then the pain subsided however I still felt TERRIBLE  PAIN AFTER LOUD NOISE such as music or voices in a restaurant. The pain is not terrible after the noise now but uncomfortable and I have to avoid loud
places. It seems like the clog is worse the next day if I have eaten in a loud restaurant.

These issues have always been in the right ear plus sinus clog as well.
At the present time I still have a clog in the right ear, my voice echo's in my head. But I am now feeling it in my left ear too; slight pressure/clog and feeling echo in my head, under water.

I am very anxious that this may allergy? We recently got a dog and I am allergic to dogs, I get allergy injections (although he is low dander only hair, non shed dog).

I have had no loud noise or other damage that I can recall to precipitate this problem.

Can it be an allergy? I am really upset and anxious that I would have to give it away my family would be crushed.

To summarize:
I do not get dizzyness
The sensitivity to noise is in the right ear with a bad "clog" feeling
the left ear is clogged but not sensitive to noise.

I do not recall anything that could have damaged the ear, no accident, no loud noise etc.

Is it possible the scar tissue plays a role?
Thank you sooo much. I am so anxious over this I hope you will reply at your earliest convenience.

[Sumit Bhatti, MD]

Dear bonnie202,

Thanks for posting your query.

You most probably have developed hyperacusis.  One of the most common causes of hyperacusis is Recruitment. In people with hearing loss, there is some damage to the hair cells in the cochlea. This causes neighbouring hair cells to get ‘recruited’ into neighbouring frequencies leading to an abnormal increase in the loudness of certain sounds. Other causes of hyperacusis include exposure to loud sounds (may be accidental or occupational), ear surgery, injury to the delicate nerves and muscles of the middle ear, etc.

If a grommet is removed (instead of extruding on its own), it usually results in a small perforation which may not heal. Such a perforation will have an effect on hearing, however small, depending on its position on the eardrum.

As I believe that more information can help a physician help a patient better, I would request you to answer the following questions:
a. Do you have hyperacusis in one or both ears?
b. Do you also get dizziness when the sound is loud?

The appropriate treatment can be started once the cause of hyperacusis has been determined.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Sumit Bhatti