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Have Eustachian Tube Dysfunction. Using Hearing Protection. Do I Have Hearing Loss Or Cold Allergy?

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Posted on Tue, 26 Feb 2013
Question: Hello
just a question about hearing loss and protection..

I have very sensitive hearing and also long time; like when I am stressed.
My ears feel very good when I don't suffer of tube dysfunction; and am getting a bit scared of sounds and music; because everything seems hard and XXXXXXX too me; and also my ears block up if I work on music for a long period of time; even if I use earplugs; and I always use ear-protection -9,-15 and -25 db.

My ENT specialist doctor told me that it's just cold allergy and the ear block doesn't come from the music and I have nothing to be worried about; But I just feel and get scared of every time my ears get blocked up; because I got temporally hearing loss of it; and my ears make sounds.

For excample: I was working on music production in a small room; the sound pressure was about 80-90 db; and I was using -9 db hearing protection; that kind of hearing protection that out-block linear sound frequency; so I didn't felt it was to hard for me.
I was working on this in 6 hours straight; and the day after the tube became blocked and I had temporarily hearing loss.
What I am interested to know; is? do I just think in my mind that the music and sound pressure is the reason of ear block; or do I have a problem?
Because I use steam and allergy medicine; and it works really good normally; but not this time; . and I am really getting confused and desperate of this; and my doctor told me that could make it worse.

I have had this problem for 6 years, But my ears still make it 100% through the hearing test.
and my doctor told me that I have no hearing loss at all; and I hear perfectly.

Plz give me a answear;
sincerely
XXXXXXX
doctor
Answered by Dr. Sumit Bhatti (7 hours later)
Hi,

Thank you for your query.

1. Continuous exposure to more than 80-90 dB sound for more than 8 hours may be associated with noise induced hearing loss and hence it is good that you use hearing protection.

2. Get a Tympanometry / Impedance Audiometry done when you have a blocked feeling due to myringotomy and grommet insertion done.

4. If you have temporary hearing loss, get a PTA (Pure Tone Audiogram) done.

5. Since you seem to have a normal PTA at other times, there seems to be either a conductive hearing loss due to ETD or a Temporary Threshold Shift (TTS). The sounds that you hear may be due to ETD or Tinnitus.

6. ETD is treated with anti-histamines, anti-leukotrienes, nasal steroid sprays and regular steam inhalation. Chronic ETD may damage your hearing and hence must be treated.

7. Unless you test your ears at the exact moments when you have the discomfort and hearing loss, it will be difficult to evaluate the exact cause of your hearing loss.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (21 hours later)
Thanks for your answer

When I mean I have temporarily hearing loss; i mean like the sound is a little fatigue or left out; but I hear frequency and music details perfect; just feels like the ears ear closes up a little; and at the same time my nose blocks. Almost everything I have blocked ears; I have blocked nose.
Sometimes my ear can be perfect for like 1-2 weeks; and then it comes again; and it often depends on the weather.
I have done the Tympanometry / Impedance Audiometry when I had blocked ears, and also a thousands hearing tests; and I made them all 100% .. Doctor told me I heard like and eagle.
but it's like pressure in the ears sometimes; and when I use antihistamine and steam; the nose and ears clocks open after period of time. But sometimes it can takes 1 week; and sometimes just 1 day. and when I am tired or angry; it gets worse; so I was thinking of maybe it has something to do with more than just technical ears explanations.
Sometimes I have very blocked ears; and the minute after the open for real.

About the sounds and whispers in my ear like tinnitus; is only when I have blocked ears. When the ears opens again; the sound is gone.
Sometimes if I have sounds in my right ear; and I hold my nose and let some air pressure on; ; the sound goes away; feels like it's only there when there is blocked ears.

I have been to my ENT 2 times, and he told me both times I had nothing to be worried about; because it was pressure in my ears because of allergy or cold. and I had to use steam..

Chronic ETD may damage your hearing and hence must be treated. What do you mean by that ? .. do I have chronic ETD or just allergy ?
And what is Chronic ? when I have blocked ears for like 1 month or ??
I have had this for like 6 years; comes and goes; and the hearing is the same as the first week it happened. But I really need a perfect and endless explanation on this.
Hearing loss in my situation: I mean dull hearing.

Thanks for helping me with this.

sincerely
XXXXXXX


doctor
Answered by Dr. Sumit Bhatti (19 hours later)
Hi,

Thank you for writing back.

1. As you get a blocked nose at the same time as the dull hearing, there is an ETD. However the fact that your ears open up means that you have functioning Eustachian Tubes with a a mild ETD.

2. Another possibility is a Temporary Threshold Shift (TTS) which usually returns to normal in 24-72 hours.

3. If you get a blocked nose during a weather change, when tired or angry, you may have an Intrinsic (Vasomotor ) Rhinitis. Get a nasal endoscopy done.

4. Any medical problem which persists beyond six to eight weeks is termed chronic.

5. If you have chronic ETD leading to attacks of otitis media or glue ear, progressive damage to hearing may result. Usually Tympanosclerosis (white patches) are seen on the ear drums in such cases. Hence your eardrum examination is important.

6. If you can share your examination and investigation results, further treatment options can be discussed.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (1 hour later)
ok good.

I have done the Vasomotor ) Rhinitis; and the doctor said there was not a big problem there; i had a little swelling ; which could indicates allergy somehow.

The tube opens can closes ofcourse; someday are good and some bad. And my ENT doctor told me that this was not gonna hurt my hearing or give me hearing damage; that I had pressure of blocked ears from time to time.
The only important thing for me; is to know if a mild ETD will damage my hearing; or it will just give me a bad day once in a while.
Because When I sing for like 2 hours straight or I make hard sport, or dring a lot of water; the tube opens little and I get air through;

Ofcourse I will share the investigation results and examination later on; if I have some questions.
doctor
Answered by Dr. Sumit Bhatti (15 minutes later)
Hi,

Thank you for writing back.

1. Mild ETD is unlikely to cause any permanent hearing loss.

2. Both Vasomotor and Allergic Rhinitis will respond to treatment with a nasal steroid spray such as Mometasone, Ciclesonide or Fluticasone (once a day, each nostril), an anti-histamine and an anti-leukotriene such as Levocetrizine & Montelukast (once a day), along with regular steam inhalation (one or twice a day).

3. Take a trial of the above for at least two weeks.

4. Let me know the response.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (6 minutes later)
yes you have answer me perfectly; and I only have one question more; and I feel happy :)

When I have blocked ears and nose ( ETD ) The Threshold of my hearing rises and I hear sounds when it's quiet, and when they open I feel normal and don't hear sounds even when it's quiet;.

is this normal ?
Did you mean I should take this all together once a day:

anti-histamine = loratadin ratiopharm 10mg
steroid nasal = Nasonex 50 mikrog
Levocetrizine
and Steam .

just to be sure ?
sincerely
XXXXXXX
doctor
Answered by Dr. Sumit Bhatti (51 minutes later)
Hi,

Thank you for writing back.

1. When your ears are blocked, it is like sitting in a sound proof room. You will hear sounds that are drowned out in normal ambient (background) noise. This is normal.

2. I must emphasize that you should take this medication under the strict medical supervision of a doctor. Take either loratidine (non-sedating) or levocetrizine (not both). Try to get a prescription for Montelukast 5 or 10 mg in addition.

3. Nasonex (Mometasone) 50 mcg is fine.

4. Together, these three work better than each taken alone.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (12 days later)
Hello :)
I promise to return when I had taken those tests you talk about; and I also had a professional hearing test again; and testing of ear pressure.

The doctor said I had more than perfect hearing; and I didn't have negative pressure; so I had nothing to worry about.
I have also taken the medicine you requested and I have been free of ear-block for almost a week now; or I almost totally free :) so... it shows that a mild ETD maybe is the only explanation :) so thank you.

The only thing the doctor told me; is that I have a little sensitive hearing;
and I totally agree on that; but I think the biggest problem for me is that; I am scared of sounds; loud sounds. I am scared of damage my ears everyday; and of that reason I think every sound gets loud for me; and I had this problem from first day I got ETD; of the reason I didn't know what is was( I just thought I had damage my ears somehow); ; then I started to protect my ears extremely well; but sometimes we as people just can't protect our ears; when a dog bark or a car horn sounds; or a baby screams; or we drop big things to the ground; sounds like this could ruin my day; just out of scariness somehow.

Even though I have sensitive hearing and the sound hurting point is lower in dB; than other people; some sounds feel really XXXXXXX and loud to me; but for people around me; then don't even think about this sounds. Is this something I just can teach myself to don't be scared of; because this sounds won't damage my hearing through time. A simple dog bark; or car horn or loud phone ringing tone;; this is exposure of like 1-10 seconds; but they're scary for someone with sound scariness; and sensitive hearing.

For some people a single sound of 85-100 db; don't ruin a day; or don't even get attention as a loud sound; because it just lasted for 3 seconds or less. But for me this is really loud and I everytime think of hearing loss;
is the decibel range more XXXXXXX for someone with sensitve-hearing than someone with non sensitive hearing ?

I think I have got answer on everything I want to know; but I just want this problem to be answered so I can go on with life and take care of my problem; I wear hearing protection everytime I play music or when I am around loud sounds; but sometimes you just can't wear them; and you also can't isolate yourself from the environment.
The doctor also told me that Hypnosis; and teaching my brain to filter sounds and afraidness will improve my health and sound problems.
is this something you think is good ?
thank you doctor

sincerely
XXXXXXX
doctor
Answered by Dr. Sumit Bhatti (9 hours later)
Hi,

Thank you for writing back.

1. It is good to hear that your ETD has improved. I suggest that you do not discontinue the medication, but taper it off over a couple of months. Also, do not hesitate to start again as soon as you suspect any ETD.

2. Along with a Tympanogram, a set of Acoustic Reflex Recordings is usually done. If these were carried out, what was the result? The Acoustic reflex protects the ear from loud impulsive sounds. Hence I would like you to undergo this test if this has not been done.

3. If your Acoustic Reflexes are within normal limits, there is no fear of ordinary loud sounds damaging the hearing permanently.

4. Absent Acoustic Reflexes may explain why you are more sensitive to loud sounds.

5. Self Hypnosis and Cognitive Behavioral Therapy will definitely help. Use hearing protection whenever possible if it makes you feel secure, till you can re-learn acoustic freedom. Your ears and eyes are not as delicate as you think!

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Have Eustachian Tube Dysfunction. Using Hearing Protection. Do I Have Hearing Loss Or Cold Allergy?

Hi,

Thank you for your query.

1. Continuous exposure to more than 80-90 dB sound for more than 8 hours may be associated with noise induced hearing loss and hence it is good that you use hearing protection.

2. Get a Tympanometry / Impedance Audiometry done when you have a blocked feeling due to myringotomy and grommet insertion done.

4. If you have temporary hearing loss, get a PTA (Pure Tone Audiogram) done.

5. Since you seem to have a normal PTA at other times, there seems to be either a conductive hearing loss due to ETD or a Temporary Threshold Shift (TTS). The sounds that you hear may be due to ETD or Tinnitus.

6. ETD is treated with anti-histamines, anti-leukotrienes, nasal steroid sprays and regular steam inhalation. Chronic ETD may damage your hearing and hence must be treated.

7. Unless you test your ears at the exact moments when you have the discomfort and hearing loss, it will be difficult to evaluate the exact cause of your hearing loss.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.