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Having vertigo and ringing in ears. Vomited several times. Had sinus surgery. What are the other test I should undergo?

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ENT Specialist
Practicing since : 1991
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I have been having vertigo and ringing in my ears for the past year. About 8 months ago I had a severe episode of vertigo for 4 hours during the night and vomitted several times. I went to the ENT and he did a couple of tests by moving my head, moving my eyes etc. They also gave me a hearing test and I do have some minor hear loss in my left ear. Since then, I have been having XXXXXXX episodes of vertigo and ringing in my ears without vomitting. Right now I have been also have discomfort on the left side of my face. In 1994, I had sinus surgery to fix a deviated septum, reduce turbinates and opened bot front nasal passages. From time to time I still have sinus infections, but current I feel heavy pressure on the left side of my face. What additional types of tests do you think I should explore with my ENT. Since the vertigo comes out of nowhere I am concerned that it can occur while I am driving.

Posted Sat, 28 Sep 2013 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later
Brief Answer:
Meniere's Disease, Sinus CT/ MRI Temporal Bones

Detailed Answer:

Thank you for your query.

1. Your history seems suggestive of Meniere's Disease. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus
d. Fullness in the ear
There is usually nausea and vomiting initially, the hearing usually worsens during an attack and the tinnitus also worsens. This condition develops suddenly or slowly and erratically and the progression varies from person to person.

2. Meniere's disease usually causes low frequency hearing loss initially (Audiogram sloping to left). Check if this is so in your Left ear Audiogram.

3. Meniere's disease should normally respond to a salt restricted diet, Acetazolamide (Diamox) and Betahistine (Vertin).

4. Regarding the heaviness in the lrft side of your face, get a plain Sinus CT done. If it shows chronic sinusitis, it will explain the symptoms. If, however, the Sinus CT is normal, get an MRI Temporal Bones (+ Brain) and an HR (High Resolution) CT Temporal Bones done.

5. I am assuming that Positional Vertigo has been ruled out and that you have no nystagmus (abnormal eye movements) at present.

6. There are many other treatment options that may be discussed if Meniere's Disease is confirmed.

I must emphasize that most Scans are normal and they help avoid missing other rare causes.

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

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