I really need your professional help with two scenarios. After 10 years of allergy shots every two weeks and 20 years of taking various medications such as: numerous steroid nasal sprays (as much as three times a day), Guaifenesin (twice every day), Cetirizine or Loratadine (once every day) and five nasal polyp surgeries. Now, imagine me without all these medications and shots 30 years ago what my life was like with uncontrollable sinus drainage. In 1975 I was given service- connected disabilities for triad asthma (allergic asthma, nasal polyps, allergic to aspirin), chronic sinusitis, and allergic rhinitis plus dysgeusia and anosmia associated to allergic rhinitis. Last year I was seen for sinus drainage on my vocal chords. Here is briefly what some medical records state that I can provide for you if you would prefer to see in lieu of this; 1978 paranasal sinuses are well pneumotized. There is complete opacification of right maxillary sinus. There is almost complete opacification of the left maxillary sinus. The frontal sinuses are somewhat hypoplastic. The ethmoid air cells and sphenoid sinuses are clouded, 1979 chronic nasal airway obstruction and nasal polyps, 1980 the grossly polypoid and infected mucous in the sinus… and it was found grossly thickened mucosa, 1981 sinusitis severe will need repeat surgery… sinus pain, 1982 mucosal thickening noted in the left maxillary sinus. Frontal sinus is opacified bilaterally as in the sphenoid sinus and ethmoid sinus. Imp: pansinusitis with more opacification in both the left and right maxillary sinus than on 4/8/82 however again sinusitis is still present, 1983 rhinitis/sinusitis is severe…unchanged over previous visits, 1984 triad asthma with nasal stuffiness…nasal redness… post nasal drip…sinusitis severe today…severe and persistent rhinitis/sinusitis…chronic sinusitis secondary to his intranasal polyp disease. He presents now with recurrent intranasal polyps, bilateral nasal obstruction…a CT scan was performed which confirmed this density, 1985 lateral wall of the sinus appeared to be somewhat eroded and roughened as evidence of expanding mucole…The area of the old nasoantral window was identified and appear to be fibrosed and did not allow adequate drainage…drainage constantly down NP and out both nostrils…no improvement since surgery…persistent drainage, congestion 1986 continues to have sinusitis…severe vasomotor rhinitis…Has taken a number of antihistamines. Having difficulty breathing through nose…Nasal mucosa swollen. Then the incident happened where I lost my hearing in the right ear with tinnitus. There are two scenarios why I lost my hearing and if you would offer your professional advice to which one most likely happened, I would absolutely appreciate it. Scenario 1: Knowing all the facts above, the incident was as follows (1986); I was sitting at home on the PC with severe nasal drainage, presumably from polyps, rhinitis and/or sinusitis blowing my nose hundreds of times per day into bath towels all day. The mucus was thick and sticky resisting coming out, much like what you called mine, like dental cement. Next thing I know, my children and wife are picking me up off the floor carrying me to the LRVA emergency room and stayed for three days. The physician in the ER told my wife that I had blown so hard that it ruptured my ear membrane. I did have my eyes darting back and forth very quickly causing me to vomit if I opened my eyes. When I left the VA, I immediately went back to work without ever having any complications other total hearing loss in the right ear with tinnitus. A VA hearing test several months later confirmed total hearing loss. Was hearing loss from blowing my nose too hard the result and was sinus drainage the reason? Scenario 2: Knowing the facts above, a neurology physician the third day in the VA saw me and said it was probably vertigo with Labyrinthitis. This was 1986 so he is no longer available to question to see if he had any idea of my decades of sinus problems and the VA hospital charts those days showed normal temperature. The eyes stopped darting and no vomiting after the first day, nor any prior viruses or colds. How likely did this scenario cause the hearing loss, knowing I was blowing my nose severely before the incident? Is Labyrinthitis the cause or the result of the cause (trauma from blowing the nose and rupturing the ear membrane) causing the hearing loss? (1) Which scenario would you in your professional opinion believe is most likely to have happened, knowing all the facts preceding the incident and with the facts you know presently? (2) Reviewing the medical records summarized (1975-1986), the service-connected disabilities, and the observations you have made present day, how likely did the severe sinus drainage with thickened, sticky mucus cause the blowing of the nose that caused the ear membrane to rupture causing hearing loss? Larry Beshears