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Hit on one side of head, unable to hear, air and noises coming out of ears on closing nose. Treatment ?

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i had a bang to the side of my head and now i cant hear in one ear and when i hold my nose air and a strange noise is coming out of my ear
Posted Thu, 3 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. It is possible that you have had a traumatic rupture of your eardrum. This can be easily observed by an ENT Specialist with an otoscope or even shared with you with the help of a video-endoscope. A traumatic rupture can be easily recognized by it's posterior position on the ear drum and blood stained jagged edges. As opposed to this, a chronic long standing eardrum perforation will have smooth round edges. Sometimes such perforations may be discovered on examination where a patient with a bang to the side of the head has a pre-existing ear perforation.

2. The Eustachian tube connects the middle ear (behind the ear drum) to the nose. This tube helps equalize the air pressure on both sides of the eardrum. When a perforation is present in the eardrum, blowing the nose causes rapid airflow with air being forced out through the Eustachian Tube into the middle ear and out through the perforation into the external ear canal. One can hear the sound of airflow and sometimes air bubbles are normally seen as the middle ear is wet with normal secretions.

3. You should then have a Pure Tone Audiometry (PTA) to rule out any sensorineural hearing loss (SSNHL), which which needs to be addressed immediately. You should get your ear examined by an ENT Specialist to confirm the above. You should get your hearing examined for any hearing loss. This is because a mild conductive hearing loss is usually expected which will go away after the eardrum heals. In case there is a sensorineural hearing loss, it has to be treated as soon as possible or it may become permanent. A few patients may get vertigo (dizziness) due to concussion.

4. If you do have a traumatic perforation in your ear drum, and if you have only mild conductive hearing loss (CHL), keep a regular follow up with your ENT Specialist for four to six weeks. Traumatic perforations usually heal well within this time period and the hearing should return to normal as the ear drum heals. Long term complications are rare. Healing is usually excellent.

5. It is important to avoid water entry into the ear (keep it dry) and to prevent any infection which may delay healing. Medication may be prescribed to achieve this. Regular check-ups to monitor the progress of the healing are required. In the rare case that the perforation is confirmed and does not heal, it may require an operative procedure to close the defect.

6. You may share the test results, ear examination findings and images, if possible for further instructions and follow up.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

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