Expert: Dina Q Goldin, Ph.D. - 11/10/2008

Question
Dear Dina,

I have had some mild hearing loss for about 3-4 years even though a hearing test at my ENT centre came back pretty much negative - no distinct hearing loss. However, I still feel my hearing in one side has deteriorated.
I have had no other accompanying symptoms apart from dizziness which over the last few weeks has become effectively permanent. The dizziness does not make me nauseous and is simply a very light headed feeling like when you get up too quickly. I don't get any sensation of spinning at all but its debilitating never the less. The dizziness at first was intermittent but know its become very worrying and only abates when I sit still.

Could these be signs of an AN? I am due for comprehensive balance testing this week where I expect I'll find out the cause of the dizziness.
I do have some neck problems (nothing major) and I have had cases of pneumoparotid on the same side as my bad ear.

Any help would be appreciated.

Answer
Your symptoms are consistent with AN.  Standard hearing tests, which ask you to listen to beeps, are not useful for ANs. The problem with these tests is that ANs often distort the way you hear different frequencies, rather than simply reduce the amount hearing as happens in old age. A better test is hearing comprehension.  An even better test, that is still easy and inexpensive, is BSER (also called ABER), which checks more directly whether your hearing nerve is distorting sounds or not.  Of course, a definitive test is MRI (performed with gadolinium contrasting agent), though it's expensive, so it's sometimes avoided when there is not sufficient indication of AN.

Balance testing can confirm whether or not you have dizziness and what kind, but it cannot confirm whether or not you have AN.  If your doctor does not feel that MRI is warranted, please you insist on having BSER done, so as to rule out AN.