Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Two weeks ago I went to an ENT to have my ears checked. My left ear has had noticeable high-frequency hearing loss for about 20 years. It was caused by a nasty cold I had. The ENT doctor started out by cleaning my ears with something that was very loud. Since that moment my left ear has noticeably more high-frequency loss and a new frequency that rings when being around a sound that is like white noise. For instance, if I am next to a river the new tone (around 1K) starts ringing. All the ENT can offer is for me to do a course of prednisone which I finally started today. Please tell me how best to deal with this situation. And what about the ENT doctor? If I now have further problems because of how he cleaned my ears is not he responsible? Kindly suggest.
Hello,
Welcome to icliniq.com.
I went through your audiogram report (attachment removed to protect the patient's identity). I gather the problem you are facing now started after the cleaning of the left ear. Now, did the ENT (ear nose throat) clean the right as well? Why did he have to clean? Was there any build-up of wax? He must have used a suction apparatus to clean and I agree, it does give a loud noise inside the ear, so close to the eardrum. Did you get a repeat audiogram done after the cleaning? You had a cold 20 years back followed by hearing loss in your left ear at high frequencies. So that should explain the dip in 1500 Hz seen in the audiogram although 1500 Hz is medium frequency. 4000 Hz and above are regarded as high frequency. Answer these questions for further suggestions:
1. Do you have any other symptoms like dizziness or fullness of the ear?
2. Can your ENT or audiology center do an electrocochleography or SISI (short increment sensitivity index) test? It can give us a lot more details regarding sudden noise-induced hearing loss or acoustic trauma.
3. When you worked as a sound engineer did you always use some protection for the ears?
4. Did you start Prednisolone (Lactose and Magnesium stearate)? Is there any improvement?
5. Do you suffer from diabetes or any other medical condition?
I hope you find this helpful. Thank you.
Patient's Query
Hello doctor,
Yes, the current problem started immediately after the loud cleaning of my left ear. I had both ears cleaned right before having the audiogram that I sent you. I had this done to see if hearing aids would help. There are no symptoms other than dullness and the 1Khz ringing that happens when I am around white noise like a river or an electric fan. I will contact the audiologist regarding an electrocochleography. No, I do not wear hearing protection when engineering. I just started to prednisone an hour ago. I will ask about direct ear injections. I do not have diabetes. I do have a GERD.
Hello,
Welcome back to icliniq.com.
GERD (gastroesophageal reflux disease) will not affect the ear. Prednisolone can worsen the acidity though. Hope you have been given Prilosec (Hypromellose and Cellulose) or something like that to reduce the acid production. Ask the ENT about direct intratympanic injections of Dexamethasone (Propylene glycol and Lactose) or Methylprednisolone. Till then keep continuing Prednisolone. We also give Piracetam (2-oxo-1-pyrrolidine acetamide), Vinpocetine, and Ginkgo Biloba in cases of sudden loss. There is a dip at 1500 Hz in the left ear in the audiogram shared. That can cause the sort of ringing you have. However, is there any audiogram done before the cleaning of the ears? Any audiograms from previous years? If so, kindly share the details.
Thank you.
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Otolaryngology (E.N.T)
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