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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Menieres Disease. Had Rods Inserted In Nose. Having Severe Earpain. Cannot Eat. Suggestions?

Hello, I m looking for some advice and guidance in relation to my husband. He is 43 years old has recently been diagnosed with menieres disease . Although he does suffer from some of the symptoms I am of the opinion their is something else going on. He was diagnosed with this diseas and told there is nothing that can be done for him and showed him the door. This however is not good enough for me. To put a long story short, about 20 years ago he and an operation in the army to fix a broken nose. His nose was butchered by the army surgeon and as a result required a second operation a few years later in an attempt to fix the first op. This operation, required two steel rods to be place at the top of his top front teeth and the rods go up into his nose. Over the last four years he has experienced on going pain in his left ear. He has had a grommet placed in his ear which was unsuccessful and feel out. He had a further operation, where cartilage was removed from his ear in an attempt to rebuild his nose. He has a great spooking nose now, but no relieve from the pain. The last 12 months the pain has become constant and severe. It is so severe he can no longer eat, as it is too painful to chew his food. He does not eat for days at a time. He can go up to ten days without going to the toilet. He s lost so much wieght he can not talk properly a he can not open his mouth to pronounce the words. He can not fly, swim and when he showers he showers on his right side as he can not get his ear wet. If I take him to the doctor for pain relief he gets given a prescription for panedine forte and gets treated like a drug addict. I am at wits end of what to do. No doctor will help treat him. They are only worried about writing reports to blame the army surgeon from the operation. We only want help to try and stop the pain. It s that bad now, he said he would rather be deaf in his ear than suffer the pain. Any guidance or advice would be greatly appreciated. Thank you for your time.
Wed, 7 Aug 2013
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Otolaryngologist / ENT Specialist 's  Response
Hi,

Thank you for your query.

1. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus (abnormal sounds in the ear)
d. Fullness in the ear
There is usually nausea (feeling sick) or vomiting, the hearing usually worsens during an attack and the tinnitus also worsens.

2. You should get a PTA (Pure Tone Audiogram) done to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially ( an Audiogram sloping to left).

3. Get a Tympanogram done to check middle ear pressures and Eustachian Tube function. If this Impedance Audiogram is normal, it may be Meniere's Disease as it does not affect the middle ear. He may have had these tests done before the Myringotomy and grommet insertion.

4. Meniere's disease should normally respond to a salt restricted diet, acetazolamide (Diamox) and betahistine (Vertin).

5. If fluid or negative pressure detected again in the middle ear by a Tympanogram ('B' or 'C' type graph), the initial treatment will include anti-allergic, decongestant medication and steam inhalation.

6. The fuzzy / disoriented feeling is common in dizziness. Unsteadiness must be differentiated from true spinning vertigo. Positional Vertigo must be ruled out by direct examination. Is there any nystagmus (abnormal movements of the eyes) noted by your doctor? Is there any headache or are there any visual disturbances?

7. Get a CT PNS (Para Nasal Sinus) Scan done. If there are too may artifacts due to the metal rods, get X-rays done. Upload them here at bit.ly/Dr-Sumit-Bhatti

8. He may also be suffering the side effects of Panadeine, including dizziness and constipation.

Regards.
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Diagnosed With Menieres Disease. Had Rods Inserted In Nose. Having Severe Earpain. Cannot Eat. Suggestions?

Hi, Thank you for your query. 1. Meniere s disease is diagnosed on the following criteria: a. Vertigo b. Fluctuating hearing loss c. Tinnitus (abnormal sounds in the ear) d. Fullness in the ear There is usually nausea (feeling sick) or vomiting, the hearing usually worsens during an attack and the tinnitus also worsens. 2. You should get a PTA (Pure Tone Audiogram) done to document any hearing loss. Meniere s disease usually causes low frequency hearing loss initially ( an Audiogram sloping to left). 3. Get a Tympanogram done to check middle ear pressures and Eustachian Tube function. If this Impedance Audiogram is normal, it may be Meniere s Disease as it does not affect the middle ear. He may have had these tests done before the Myringotomy and grommet insertion. 4. Meniere s disease should normally respond to a salt restricted diet, acetazolamide (Diamox) and betahistine (Vertin). 5. If fluid or negative pressure detected again in the middle ear by a Tympanogram ( B or C type graph), the initial treatment will include anti-allergic, decongestant medication and steam inhalation. 6. The fuzzy / disoriented feeling is common in dizziness. Unsteadiness must be differentiated from true spinning vertigo. Positional Vertigo must be ruled out by direct examination. Is there any nystagmus (abnormal movements of the eyes) noted by your doctor? Is there any headache or are there any visual disturbances? 7. Get a CT PNS (Para Nasal Sinus) Scan done. If there are too may artifacts due to the metal rods, get X-rays done. Upload them here at bit.ly/Dr-Sumit-Bhatti 8. He may also be suffering the side effects of Panadeine, including dizziness and constipation. Regards.