Hearing Loss - Diagnosis and Patient Information 
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 Hearing Loss - Diagnosis and Patient Information

What are the possible causes of unilateral, limited, recent nerve
deafness, and to what lengths should doctors go in diagnosing the
cause and assisting the patient, as opposed to simply deciding
whether on not a hearing aid would be beneficial?

I presume the possible causes are: Tumour; Exposure to excessive
noise sometime in the past; Menieres's Disease; Infection - given
that a patient's record rules out mumps or measles, or drug
damage.

I hope this might lead to a discussion here that will both
benefit and warn others who might soon find themselves being told
that they have probably damaged their hearing through the use of
technology introduced in the last 20 years (powerful
amplification, the Walkman, computer mechanicals, etc) or that
they are simply suffering the effects of growing old (at some
ridiculously early age).

I'd also like to know if there are firm causes or treatments /
cures for Meniere's Disease, since my reference books don't
mention any.

Unaccountable hearing impairment has recently been diagnosed in
myself as permanent by a London teaching hospital, although I'm
not wholly convinced.

There follows a description of one particular case, for the
length of which I apologise.  Please skip it if you prefer to
keep to the generality; I'm trawling deeply for enlightenment.

I work in television and we recently started to produce in
stereo, which is why the impairment suddenly became apparent,
since I hadn't used a Walkman or other headphones for several
years.  I thought some new in-ear 'phones were faulty until I
switched ears and found it was me.

Unfortunately it is sometimes very difficult to follow speech in
certain environments, such as round a table in a pub or cafeteria
where there are sound-reflective surfaces, or around certain
machinery.  As a journalist and a producer I find this a social
and practical handicap, spinning me towards paranoia.  Cupping a
hand round my good ear is the only thing that seems to help then,
and, surprisingly to me, an ear plug in the defective ear gives
no assistance.  Previously I thought everyone else was having the
same difficulty but were not mentioning it.  I don't know of any
history of hearing impairment in my family.

After being referred by my General Practitioner (I couldn't hear
6kHz on her tester) there was a seven week wait for an hospital
appointment, which seemed excessive since I was quite frightened.
I first saw the department head who was brilliant and promised
they would put my fears of losing more hearing, especially in the
other ear, at rest by tracking down the cause.  He mentioned the
possibility of a tumour and having a scan to check for this.  But
my hearing and air pressure tests (done twice, two months apart)
went to a new registrar who simply said, in effect, despite my
persistent questioning, they did not know the cause and told me
to return for more hearing tests in 3 months, since I "could not,
yet, benefit from a hearing aid".  I presume the impairment being
only one sided ruled out possibly reversible drug related causes,
since they did not have access to my prescription records. I'm
trying to switch back to see the Head of Department but feel I
need to know more myself by then.  This is through the National
Health Service for no direct charge.

The registrar told me that I've permanently lost a fairly level
10db in one ear but presently have unusually good hearing in the
other, and high speech discrimination ability in both.  Although
the hospital Audiology department only test up to 6kHz (a series
of tones and words played at different volumes into each ear), I
know that I can hear a difference in frequency response between
FM radio (>15kHz) and CD/DAT (>22kHz), through the same sound
system.  The tests show that the loss has been stable in two
tests over six months, but I keep expecting to find that I've lost
the ability to hear some frquencies, especially those the hospital
don't have equipment to test.

Air pressure variation / membrane movement tests (shown me a
graphs) apparently indicate that there is not congestion present
in the ear drum. It certainly seems to feel as if I have some and
I have frequent "cracking" in both ears, and have had persistent
pharyngitis with post-nasal congestion for more than 20 years,
despite going to my GP for antibiotics around every ten or eleven
months.  Once these gave me severe vertigo and nausea.
Decongestant drops and sprays, such as Otrivine, have no effect.
Sometimes, for no apparent cause, I get a mild, non-throbbing
earache, or a faint whistling, on one or both ears, but with my
"deaf" ear always worst.  About 10 years ago, for about 2 weeks,
I had a severe pain somewhere around that same ear, which no one
was sure was my jaw joint, nerves (since I was under stress and
had cystitis too), teeth or ear, but it went away, after I cured
the cystitis.

I am wondering if this might be the effects of some infection
resident in my nasal or post-nasal cavity getting to my ears,
and, if so, whether something should not be done to stop it
affecting the other ear.  I can't help wondering now if a swab
check for Candidiasis and Staphylococci would not have been a
good idea, but there was clearly no equipment for this in the
hospital department.

I've always been fairly careful with my hearing, since I was
aware of the possibility of damage, so that, on the half dozen
occasions that I have attended rock concerts, I have always
either kept far from the sound systems or worn ear plugs.  I only
turn volumes up to the level at which I feel I can hear all the
components of a sound.  If my hearing is now impaired from that
cause then half my generation should also be at least equally
handicapped.  The only unknown in this respect is a noisy
external hard drive (Miniscribe 8051), which I've had for four
years (always on the same side as the affected ear) on my Mac.  I
don't know if, given the speed of rotation, that might be
producing a noise, above the hearing threshold, of enough volume
to do this damage, and I don't know how to have it checked.  The
registrar just said to throw it out, but that wouldn't tell me if
I'd located the cause and, it being reliable, this would
otherwise be an expensive waste.

About three years ago I had two bouts, three months apart, of
what I took to be cooking.net">food poisoning in which vertigo upon waking
(but lasting two or three days) was very instantly followed by
wretched vomiting.  I now wonder if that was an ear problem.
Earlier this year, between my two hearing tests, I had what
seemed to be a similar bout except that it lasted about half a
day.  All three times might have been connected with sleeping -
unusually - a whole night only on one side (that of my affected
ear).  But if these are indications of Meniere's Disease then I
presume that I have a prospect of more bouts and increasing
deafness, but the hospital did not mention it as a possibility.

I don't know if I'm experiencing less than arduous pursuit of the
cause of my problem because I'm (just) over 40, or whether
everyone gets the same attention, or whether I'm being neurotic
about wanting to know what is wrong with me.  But I would very
much like to hear if others have had different experiences, and
if diagnostic and patient information practice elsewhere is
different - by which I mean better - or changing.

Diane




Sat, 09 Mar 1996 05:07:11 GMT
 
 [ 1 post ] 

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