Hearing management

Question
Posted by: | 2018/05/28

Q.

Hearing loss after head trauma and prolonged symptoms

September 2016 Fell off of a wall around 3 am. Remember the fall and severe pain in chest and the need to fall asleep. Approximately 15 minutes later a friend carried me to the car, I was able to speak normally, although slightly confused. About 5 minutes later I started feeling a severe pain in my clavicle, the pain worsened and a few minutes later the hearing in my right ear cut off completely. I was taken to the emergency room, it was concluded that I had broken my right clavicle. Paralysed and confused from the pain, I can’t recall if I mentioned the hearing problem. Whilst lying in the bed in the hospital, my right ear started bleeding. I had ruptured my ear drum. I also had a concussion and took me a while to recall what had happened. X-rays were taken of my shoulder and skull; the only evident broken bones were my right clavicle. I was released from the hospital, as I do not have a medical aid. I spent the rest of the day sleeping and vomiting in the backseat of the car. I had been drinking the night before and was given morphine. At about 17h00 that day, I attempted to move from the car to the bed. I couldn’t balance on my own, and became severely nauseous when upright or moving. My ear and back of my right shoulder were bruised, thus can be assumed that I fell directly on them. After 2 days the vertigo lessened significantly. I was able to walk slowly and by myself. I experienced and overwhelming sensation of tinnitus. To the extent that I struggled to hear in normal conditions, as it was so over powering. Hearing didn’t return after a few weeks, went for an auditory test. The first ENT concluded that I had damaged the internal nerves. The second ENT had a different reason (I can’t recall). The same auditory test was done a few weeks later, but less of a distortion was heard. The audiologists didn’t think anything of this, and offered a cochlear implant. Weeks after the incident, and after being cleaned by more than one specialist, an audiologist noted blood on my eardrum. About 4 weeks after, for a few days, clear liquid uncontrollably expelled from my nose. I thought it to be sinuses, although I’d never experienced such problems. It was small amounts, but enough to need wiping away. It was completely clear and thin. Within 6 weeks of the incident, I would hear loud noises in the right ear, but they would feel far away from the ear, as if the ear is hearing them, but not processing them as closely as it should. Sounds like drums, ie rathe

Expert's Reply

A.

Hearing Expert
- 2018/05/28

Hi there

It sounds like you could have had some sort of base of skull fracture, or even a leak of fluid from your inner ear from the head injury, which generally causes the severe hearing loss, tinnitus and imbalance that you are describing.

The bleeding from the ear could mean one of 2 things: base of skull fracture OR a perforation of your eardrum.

I would strongly recommend a repeat audiology assessment, including VNG (balance assessment), as well as scans to see where the lesion is so that it can be treated appropriately.  You need to see a really good ENT with previous experience in balance disturbance and head injuries - he / she will know what to look for.

Good luck and hope you feel better soon.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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user comments

C.

Posted by: Anonymous | 2018/06/02

Thank you!! You're response makes so much more sense than what I've been told by ENTs so far. It seemed that the post didn't work at first, but also cut off some more symptoms: (Sorry for the exceptionally long read) Within 6 weeks of the incident, I would hear loud noises in the right ear, but they would feel far away from the ear, as if the ear is hearing them, but not processing them as closely as it should. Sounds like drums, ie rather very loud. I was cleared to fly in that time. While the aeroplane was descending, I was asleep and woken up to an extremely loud pop/bang in the broken ear. About a week later, after taking a shower, I felt something discharging from my ear. An ear bud revealed a watery, bloody substance. I could hear very loud sounds, but they felt very far away and were not clear of perfect. Random clicking/tapping noise would be heard in broken ear, over the sound of tinnitus, and not as constant. Especially when getting up. Strange tinnitus sounds were heard every now & again, a sound that sounded like something trying to connect. When I stood upright and held my head at a certain angle, the pressure in my broken ear would make me feel as if my head was going to explode, until I angled my head normally again. November 2016 When touching my outer ear, the touch would trigger a shock to my tongue. At first it was subtle, but the feeling became more prominent and consistent. December 2016 I blew my nose normally (and quite hard) for the first time since the incident and heard my ear ‘pop’ for the first time. Before this, there was no sound at all, nor do I recall a feeling of eardrum movement. In a clavicle related check-up in September, a GP claimed that my eardrum was moving normally, but looking back, I don’t think he made the correct diagnosis. Was driving long distances and ear felt like it wanted to equalise, sensation was slow, and didn’t feel relief. Felt like it went up to about 55%. January 2017 The shocking tongue sensation lessened, but transformed into moving my tongue from side to side causes a feeling of movement inside of my broken ear. I have this sensation to this day. February onwards Feeling the need to equalise often, but to no avail. Pressure in head feels irritated, equalising eventually started working, but wasn’t always an optimal feeling. Mostly the pressure just felt better temporarily. After equalising, I am able to hear loud sounds as a distortion. The sound is similar to that of bicycle training wheels, I hear this distortion until I swallow, and then everything cuts off again. I started feeling a sharp pain in my ear and pain behind the bone of my ear. Ear often felt wet inside and itchy. When pushing down on my tragus, sounds like it’s blocked and makes a wobbly echo at the end. Very loud and perfect sound, definitely not transferable over the skull to working ear. Chewing sounds became very prominent, even in the broken ear. Could hear the water crashing to the floor in the shower, only certain sounds of, and sound felf far away, but still in the right ear. Moving my head from side to side quickly, it sounds as if there is water inside the broken ear. I started feeling like there is liquid running out of my ear, but it is completely dry. July 2017 As time progressed, my tinnitus lessened immeasurably. Today, at times, I can barely hear it and is not affected by fatigue or external noise, as it was fir the first few months. An accidental loud shout in the broken ear, and accidental slap, on several occasions, both caused the overwhelming tinnitus that I had first experienced and lasted a few days. Found myself instinctively massaging the upper neck muscles on the right side. Physical exercise made my ear feel like it needs to equalise. September 2017 I went to a loud music concert, the next day there was blood in right ear’s canal. I was working in a bar at the time, so loud music wasn’t something that I was completely estranged to, although this was louder than usual. December 2017 Woke up to an extremely loud sound in ear. Like a bang or tear, its difficult to describe, but it was so loud that I lay still for a few minutes, scared to move as I thought I would break something. January 2018 Can now hear my finger scratching in my ear canal. Isolated and clear, no distortion. Can hear loud sounds like a blender, still not clear, but doesn’t feel as far away in skull as used to. Such loud sounds make my broken ear feel extremely uncomfortable afterwards. I start feeling sickly, as if I’m getting flu. The gland in my neck on the right side swells up and I feel like I’m getting a throat infection. This clears up after a few hours. Feels as if there is a baby hair in my ear. Was given a neck massage and heard movement in ear – as if there was waves/ water in ear and moving. February 2018 Equalised and for less than a second I could hear a “whole” sound – wasn’t distorted, and a lot closer than usual. Hasn’t happened again. When I get out of bed very quickly, my tinnitus disappears for a few seconds. As if trying to find balance. Only happens sometimes. Attended a ballet class and the jumps made my ear feel very uneasy. 1/20 times will actually feel relief when equalising. May 2018 Hearing bones creek in broken ear, eg neck. Was listening to music, softly, could converse normally, picked up certain sounds as whistle sensations in broken ear. Ear doesn’t produce any wax at all when compared to working ear. To this day I have done numerous auditory tests and seen 3 ENTs. None of them come to the same conclusion, nor have any interest in these strange symptoms. I don’t have a medical aid, so finding the right direction to go in has proved very challenging. After each hearing test, my tinnitus was excruciating.

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