(Sudden) Hearing Loss?

[Insina]

Dear Doctor!

I am a 25 year old male, smoker, extremely busy in my job, living and working in China.

Three weeks ago I had a stiff neck that lasted for almost 14 days. last week as this problem was finally gone and I felt completely normal again, I suffered a hearing loss in my left ear. No pain, no dizziness, just this feeling of pressure like you are in an airplane shortly before landing.

On the following day I also had this ringing, probably a tinnitus.

So I went to the doctor who first of all diagnosed a cerumen impaction. The ear got cleaned, but the problem didn't go away.

I was always thinking that it's just a pressure on my left ear, so I tried to pop (like you do in the airplane) which didn't really work either. Interestingly I had to fly during the last week and it seemed to me that while going up after the start my ear got better, whereas shortly before landing it got worse again.

Today - still feel this pressure and ringing - I saw the doctor again and we did two tests. First of all a tympanogram which showed the following results:

Volume 3.04 mL
Compliance 0.92 mL
Pressure 36 daPa
Gradient 0.59 mL

Furthermore we did a threshold audiometry. The only (slight) abnormality was shown by my left ear in the high frequencies between 4000 and 6000 Hz. According to the sheet the hearing impairment is considered as "mild" (27-40dB).

My problem is that I am in China and it seems to me that neither the doctors take my concern serious nor that they have a real clue about what to do. The only international expert here in town is not available due to some personal matters for the next two weeks...

I know it's impossible to diagnose through the internet. But do these test results give you any clue what it might be or not be?

Thanks a lot for your help!!

[Eric P Wilkinson, MD]

Things you can try now (while waiting to get a full ENT evaluation and MRI scan) are to follow a low salt diet (<1500 mg NaCl/day) and decrease your caffeine intake.  Also note any food triggers that cause your ear symptoms to worsen and avoid those foods.  

Good luck.

This answer is not intended as and does not substitute for medical
advice - the information presented is for patients education only.
Please see your personal physician for further evaluation of your
individual case.

[Insina]

Thanks a lot, Dr. Wilkinson. It helps.

Now it seems that the hearing loss is fluctuating. Last night it got much better so that this morning I thought it's finally gone. But now, a few hours later, it's back again, although not as strong as before.

[Eric P Wilkinson, MD]

Many of your symptoms sound like they could be caused by cochlear hydrops, a treatable inner ear pressure disorder.  However, you need a contrasted MRI scan of the brain, brainstem and inner ear to rule out a small tumor on the balance nerves.

Hope this helps.  Good luck!

This answer is not intended as and does not substitute for medical
advice - the information presented is for patients education only.
Please see your personal physician for further evaluation of your
individual case.