Hearing Loss, Ringing In The Ears, Ear Infection, Antibiotics, Steroids, MRI Of Head. Causes ?

Posted on Sun, 3 Jun 2012

Question: Hello, I am a 26-year-old female. I'm 5'3" and weigh 124 lbs. I had some hearing loss and ringing in my ears starting in about February, so I went to the doctor and was given antibiotics because he said I had an ear infection. The pain seemed to lessen from it, but the ringing and hearing loss never went away. My head has also continued to feel swollen. It almost feels numb and like there is water under my skin from a little above my ear and into the ear. I went back in about May and was told that I had water behind my ear, but no infection. He put me on another round of antibiotics and wanted me to visit an ENT. The antibiotic did nothing. At my appointment with the ENT, she said there was nothing she could see, so her guess was that it was a tumor. I was also given a hearing test, which showed that I had lost some hearing in my right ear. She said it was just high frequency though. She prescribed me 10 days of steroid and sent me to get an MRI. I had an MRI of my entire head with and without contrast, which showed nothing. I went back to the ENT to get results and the right side of my face down by my jaw was swollen. She said that was possibly something to do with an abcessed tooth. I went to my dentist and was x-rayed, which ony showed that I have a wisdom tooth possibly pushing into my jaw. I have no idea where to go next or what to do. My eyesight in my right eye feels fuzzy currently too, but when I close my left eye, I can see clearly out out of it. Any ideas?

Answered by Dr. Tulasi Raman.P (1 hour later)

Hi,

Thanks for detailed query submitted to us.

Based on your description, I can think of few possible conditions
1. Chronic otitis media - symptoms like the ear pain and hearing loss as been started by an infection along with inflammation causing fluid accumulation. This fluid is infectious initially and with course of antibiotics the fluid has rendered the non infectious. They remain inside the ear cavity without an exit and slowly and gradually gets absorbed. Hearing loss is probably due to this fluid.
2. Sinusitis and mastoiditis can also cause all these symptoms. both follow an infection.
3. Eruption of wisdom teeth is painfull in most of them. You need to use hot compression, and which may help in this along with painkiller.

The vision problems may or may not be related to the above conditions.

A proper physical and clinical examination would be needed. A thorough examination by another ENT surgeon with the test will confirm / rule out the aforementioned conditions.

I hope the answer clears all your doubt. If you have any other queries please write back to me.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Tulasi Raman.P (9 hours later)

Would the MRI have shown fluid or mastoiditis? My ear still feels swollen and like it is sticking out a little, and the part that is the most irritating is the swollen feeling all around the ear in my head. Also, the round of steroids did seem to alleviate the swollen feeling somewhat, not sure if that's important at all. Could the MRI have missed a tumor? From what I've read, I was under the impression that with the contrast that is very unlikely.

Answered by Dr. Tulasi Raman.P (8 hours later)

Hello,

Thanks for writing back to me.

Your doubt is very genuine one. The MRI is an investigation with very good precision available in the present day. It reveals the fluids and mastoiditis. Even though it is an investigation the reports are interpreted by radiologist with the computers aid. If your radiologist is very good at interpreting MRI (Magnetic Resonance Imaging) than he can detect fluids, inflammations and tumors clearly.

These interpretations are based on abnormality in structure, shape, size, color, contrast, texture of MRI and applying it to the normal MRI. when this is done the abnormality stands out clearly. Only few rare tumors goes against this law but they dont grow fast.

Steroids sometimes helps in treatment of the disease for which the cause is not identified. But take it cautiously under medical guidance and never overuse it.

Tumors, if fast growing alarms the patient by its increasing frequencies of symptoms and signs.
slow growing tumors cause vague symptoms and signs. Any tumor becoming malignant has many factor to trigger.

In your case, if the symptoms gets relieved on medication then probably it is inflammation of the inner ear which presents like this. Inflammation subsides with time when proper care is given during its healing.

As per your doubt, if the MRI slices are taken far apart or if the tumor is too small then only an MRI can miss the tumor. I hope it is adequate in your MRI.

I hope I have answered your query.

If you still have any queries feel free to write back to me.

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. Jyoti Patil