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Intolerance to high noise levels, headache in cold weather, sensitivity to ear buds, discharge from ear. Problem?

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patient 32yrs female, complains of having intoleration to high noise levels eg child's cry, heavy music etc., gets headache when travels in cold weather without covering ears, feels sensitive to use ear buds frequently to clear the wax, have noticed some discharge from the ear. complains of partial hearing loss. what could be the problem and is PTA test mandatory for the correct treatment.
Posted Tue, 1 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 1 hour later

Thanks for the query

Intolerance to loud sounds could be due to either hypermobility of the incudo-stapedial joint in the middle ear or due to middle ear infection (with or without perforation of the ear drum). Apart from this, there could be a mild component of Migraine also, which is evidenced by intolerance to sound and straining of the eyes on going into the sun.

Sensitivity to the cold air is mainly due to gushing of the air into the exposed middle ear through the perforated ear drum, leading to irritation of the sensitive nerve endings in the middle ear. The partial hearing loss is also noticed in those conditions with tympanic membrane perforation.

You can continue with the ear drops that you are using at the present and also go for regular follow-ups with your ENT specialist. You will require a Pure Tone Audiometry (PTA) Test to assess the amount of damage in the ear and also to differentiate any nerve damage in the inner ear from that of the middle ear pathology.

I would suggest you to avoid water into the affected ear while taking a shower and cover the ear only when exposed to wind.

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
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