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Q. Are my MRI and tympanogram results showing any hearing loss?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 06, 2018

Hello doctor,

I have a normal MRI and a normal tympanogram. Am I losing hearing based on both the test results?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hello,

Welcome to icliniq.com.

No, you are not (attachment removed to protect patient identity). But I would like to see the graph of pure tone audiogram to pick out if there is any early hearing loss. Kindly upload the graph of your hearing test.


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Thank you doctor,

Please note as you can notice I have noise-induced hearing loss in my left ear, which I have managed to maintain at the same level for the past four years with the use of protective ear-plugs. This is after years of loud music exposure without being careful or using any protection. This year test result is because after four years I accidentally (and stupidly) went to an event without my earplugs that also, unfortunately, was very loud. I noticed immediately that my left ear has got worse and it was confirmed via the hearing test. I will make sure I never forget my protective earplugs again. My right ear does all the work anyway and I see this slight dip in the right ear in this test even though the ranges are in the normal hearing range. It has made me slightly fearful, is this a cause of concern? Or just make sure to never forget my earplugs again. Should I keep it at the same level as it is now?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hello,

Welcome back to icliniq.com.

I went through both the audiometry reports. The one five years back seems worse than this year when you compare for the left ear. I say because the nerve conduction seems better in that ear currently than during the last one. But this variation can be due to the doctor variation or audiometer calibration difference. But on top of the nerve related loss (which most probably is noise-induced), there is a good conductive component. Have you been having any other symptoms with the left ear? Like block, muffling sound, fullness, wax, ear discharge, pain, giddiness, nose block, throat pain, etc.? These symptoms can point to a conductive problem which will have to be ascertained by visiting an ENT. The ENT will check the inside of ear using endoscope or otoscope and make sure everything is fine. I am saying this because a conductive component of hearing loss can be treated. So if you have felt any such symptoms do let us know.

When we talk of the right ear, which is hearing within normal limits and is your only performing ear, there seems to be a slight dip in 4000 Hz which indicates noise induced hearing loss. Such a dip is not present in the previous report. While you have had only a single extreme exposure, I would say it is more of a acoustic trauma than noise induced hearing loss. Acoustic trauma is more of an acute episode and with rest and the precautions, the nerve fibres should get back in shape. While this is not always true, we can expect some improvement with regards to that dip. When you repeat the audiogram after two months we can ascertain whether there has been any improvement.

Precautions, you seem to know. Ear plugs. Some even use active noise isolators which remove sounds higher than certain intensities while increase sounds of lower intensities. It is prudent to install a decibel meter in your laptop (device) and keep looking into it once a while during your performances. If dB increases beyond certain intensities you can reduce the volume or increase your level in the plug. Have a healthy diet. Smoking can accentuate hearing loss. Alcohol can subdue your responses to loud sounds and you may not feel like reducing the volume. Marijuana and acid can be equally dangerous while thinking in noise point of view. I suggest you start in good neurotropic Vitamins taken twice daily for two weeks and thereafter once daily for a couple of months. I just want to rule out any drum or middle ear related problem that can cause a conductive component of your hearing loss. Always get your hearing tests done from the best place as results vary between place to place. Do revert back to me with details. Ultimately the hearing sensitivity in your right ear is within normal limits. So not to worry about it much. Till 25 dB it is normal. It is unlikely that in noise induced hearing loss, one ear gets more affected than the other. Unless you do something that can cause a differential output of sound to each ear.


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