Some brutal ear ringing

[francousteau]

I was doing a dive a couple of weeks ago (cold water) and the dive seemed to have been fine with no problems on the descent or on the bottom. On the ascent, somewhere around 45ffw, I noticed some bad ringing in my left ear. I developed a cold the next week and waited for it (the cold) to subside before making an appt. with the ENT (reasoning that the ringing might have been part of the cold issue).

I get to the ENT and he takes a look into the ear, using the normal handheld whatever it's called. He then looked into it with the microscope and did something using a handheld machine that graphed the ears response to some pressure (I think). Anyway, both ears showed the same high point on the graph and he said this indicated that there wasn't any fluid behind the drum. Next, to the audiologist for a hearing test (same day, same office). The test showed some slight loss in the left ear. I asked the audiologist what she thought of the loss based on a 1 - 10 scale, being that the right ear was a 10. She said she'd give it a 9.

Back to the ENT (same day) and he prescribes a steroid (prednisone) and valtrex (although I have no herpes in my ear or any other place). I'm taking 40mg of the prednisone and 2 caps 2x per/day of Valtrex (I forget the dossage right now) for 7 days. Next Tuesday I go back and if it's still bad, the ENT says that he'll inject a steroid, through the ear drum (after taking another hearing test).

In the meantime, this thing keeps ringing and even wakes me up at night.

Any thoughts on my situation??

 

[DocVikingo]

Hi francousteau,

No fun.

"The normal handheld whatever it's called" is an otoscope. It allows the physician to visualize the auditory canal and ear drum.

When "He then looked into it with the microscope and did something using a handheld machine that graphed the ears response to some pressure," this likely was a form of tympanometry, which charts ear drum response to pressure.

Interpretation of audiometry that if the unaffected right ear was a 10, then the left ear was a 9, is consistent with the clinical picture but suggests no significant diminution of hearing.

As regards the Valtrex (valacyclovir), skin manifestations of a herpes virus, such as cold sores or genital herpetic lesions, are not required for its use. It sometimes is prescribed when a viral infection of the inner ear is suspected, and then not infrequently in combination with an oral steroid.

Your description does suggest involvement of the inner ear. Although the problem may be dive-related, the basis is unclear at the moment. It appears that your ENT is being thorough and aggressive in his treatment of you.

In the meantime, there seems little you can do other than wait and monitor the response to the medication regimen.

Please do keep us posted.

Helpful?

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[DandyDon]

Good luck on your problem. Sounds like you sought the right help, and you already have a response from DocV - none better.

You might find this video helpful? Most do: The Diver's Ear: Under Pressure here

 

[francousteau]

Doc,

Thanks much for your response!

Nice to know that your "educational" thoughts are in line with that of the ENT and that he seems to be heading me in the right direction.

Next appointment is Tuesday and I'm hoping it's better and I don't have to get the shot. I'm not looking forward to getting jabbed in the ear drum.

Thanks again for your "education".

 

[Hemlon]

Good luck on your problem. Sounds like you sought the right help, and you already have a response from DocV - none better.

You might find this video helpful? Most do: The Diver's Ear: Under Pressure here

Who is the doctor in the film, Dan?

 

[Hemlon]

Nevermind, Dan. I just saw it in the video.

 

[tedwhiteva]

Good luck on your problem. Sounds like you sought the right help, and you already have a response from DocV - none better.

You might find this video helpful? Most do: The Diver's Ear: Under Pressure here

A bit long and too many "huhs", but some great information and techniques

 

[francousteau]

Doc,
Went back to the ENT today and the hearing has improved, based on the audio test, in almost all areas. The ringing, although settled down somewhat, is still present. The ENT had a fishker test or something like that done on me to see if any signs of baratrauma were present. None there . . . whew! He then put some numbing stuff into my ear and then shot a steroid into it. Even with the numbing stuff, it wasn't a pleasant experience. Ringing is still there and it feels like I have a low grade ear ache. Back on Thursday for another shot. Any idea on how long it takes for that needle hole to heal?

 

[shakeybrainsurgeon]

One question: did the ENT tell you to steer clear of NSAIDS like aspirin, Advil, Aleve, Motrin, Lodine, Mobic, etc? Non-steroidals, particularly in high doses, can cause tinnitus or make it worse. You had a cold and many cold remedies (like alka selzer) have aspirin in them. Did the ringing worsen during the cold? Were you taking NSAIDS while diving?

Ringing is a sign of inner ear (cochlea or auditory nerve) injury, although often reversible. NSAIDS (and now Viagra!) are among the medications which can worsen such injuries. Other meds that can do it are lasix (a diuretic) if given intravenously and certain antibiotics.

 

[Scubakevdm]

... I have no herpes in my ear ...

Could it be possible that they were concerned with some other auditory STD? I read recently that the United States currently is reporting record numbers of hearing AIDS.