Right ear clogged, popping and tinnitus

[caue Feres]

Hi @Duke Dive Medicine @doctormike

Firstly, I would like to thank you for the dedication in the responses, not just to my questions, but in other experiences that I was able to read in the Q&A. It was certainly the place where I learned the most about barotrauma.
Regarding my case, I am still unsure if it was a deep ear injury (possibly caused by forced equalization) or a middle ear injury (since I had a bit of secretion on the day of snorkeling and perhaps I surfaced too quickly), since at no point did I feel pain, nausea, dizziness, or lost balance
My only symptoms, which started right after snorkeling, were: ear clogged, can hear some popping sometimes and tinnitus (apparently wax and waine).
I continue to hear tinnitus one month and four days after the incident, apart of that, I am feeling normal, doing exercises, running, cycling, swimming, working, everything looks normal.
Next week I will have a CT scan and a new audiometry. According to my last consultation, the doctor informed me that there was still fluid in the middle ear.
would you recommend any other exam that could help the analysis?
Could be a SHL even with no symptoms like: pain, lost balance, vertigo? If so, in thus circumstances, would it be possible to make a surgery to improve?
thank you again for all the efforts you guys are putting in the case. Best Regards,

 

[doctormike]

Hi,

Sorry, I really can't give specific management recommnedations over the Internet, but happy to review the results of your scan and new audiogram and help explain them.

 

[Duke Dive Medicine]

Hi @Duke Dive Medicine @doctormike

Firstly, I would like to thank you for the dedication in the responses, not just to my questions, but in other experiences that I was able to read in the Q&A. It was certainly the place where I learned the most about barotrauma.
Regarding my case, I am still unsure if it was a deep ear injury (possibly caused by forced equalization) or a middle ear injury (since I had a bit of secretion on the day of snorkeling and perhaps I surfaced too quickly), since at no point did I feel pain, nausea, dizziness, or lost balance
My only symptoms, which started right after snorkeling, were: ear clogged, can hear some popping sometimes and tinnitus (apparently wax and waine).
I continue to hear tinnitus one month and four days after the incident, apart of that, I am feeling normal, doing exercises, running, cycling, swimming, working, everything looks normal.
Next week I will have a CT scan and a new audiometry. According to my last consultation, the doctor informed me that there was still fluid in the middle ear.
would you recommend any other exam that could help the analysis?
Could be a SHL even with no symptoms like: pain, lost balance, vertigo? If so, in thus circumstances, would it be possible to make a surgery to improve?
thank you again for all the efforts you guys are putting in the case. Best Regards,

Like @doctormike , I can only offer general thoughts based on the information you've provided. Another audiogram could tell you whether your hearing is improving but of course it won't treat the tinnitus or determine exactly what caused it.

SHL (sensorineural hearing loss) is a general term that means hearing loss related to either the vestibular apparatus or the nerves associated with hearing. I think what you're asking is whether you could have experienced inner ear barotrauma given that you don't have pain or vertigo, which is definitely possible. The only scenario I can imagine where surgery might be beneficial is if your ENT physician thinks you have a fistula (tear) in your vestibular apparatus, but I would defer to him/her for that decision and for specific information.

Best regards,
DDM

 

[doctormike]

Right, and it's not uncommon for patients with IE barotrauma to have hearing loss without balance issues. PLF surgery is sometimes an option, but usually soon after injury. Not sure of any benefit a month out.

 

[caue Feres]

Right, thank you! Is it possible to check for a perilymph fistula with a CT scan? And is it also possible to evaluate if there is fluid in the middle ear? I understand that the audiogram will only tell if the hearing loss has improved. Thanks

 

[doctormike]

The CT scan may show a bony abnormality of the ear, which could be associated with a PLF. But many patients with PLFs do not have a large enough bony defect to be visible on a scan, or the leak is through the membranous borders of the inner ear and the bone is normal.

The CT scan will definitely show if there is fluid in the middle ear, as would the tympanometry (part of the audiogram).

 

[caue Feres]

Ok, thank you @doctormike. I'll share with you when I receive the results.