Expert: Harriet B Jacobster, Au.D. - 12/26/2008

Question
Hi.  I have been experiencing daily dizziness, tinnitus, earache/pressure, swollen glands (including thyroid), and low body temperature (96.8).  My thyroid levels have come back normal, and I have been on several rounds of antibiotics since July, 2008 for ear and sinus infections.  I have also tried prenisone, which worked the first time, but hasn't worked since.  The meclizine prescibed this summer, has also stopped working.  I am lisinopril/hydrochlorothiazide for my high blood pressure, but have been taking this for a month, so I don't think it's a side effect of the meds.  I did take a course of Avelox for my last sinus infection, but stopped on the fifth day because I felt worse.  I do need to mention that I fell nearly a year ago (because of a slick parking lot), and hit my left ear on the bumper of the car pretty hard.  I had bruising, etc. for a while.  This happened in March, 2008.  In June, 2008, I flew to Seattle and then back home.  It was shortly after the flight that I began to experience the dizziness.  I went to the ENT, and was diagnosed with benign positional vertigo.  I was symptom-free for nearly 3 months after taking a round of antibiotics for what I believed was an ear infection.  Since October, 2008, I have been having the above-mentioned symptoms almost daily.  I also need to mention that I have pretty significant popping in my jaw on the same side that I hit my head and ear last March.  Any ideas?

Answer
Hi Lisa,
After experiencing your symptoms on a daily basis for three months, you need to return to your ENT and be re-evaluated. Your symptoms can fit any number of disorders such as endolymphatic hydrops, a fistula or fracture, an inner ear virus, etc. BPPV is very specific and occurs when turning, for example in bed.  It is not necessarily accompanied by tinnitus or aural fullness. Your evaluation needs to include a complete audiometric evaluation including the middle ear, plus Otoacoustic Emissions, which evaluates the inner ear, Electro/VideoNystagmography, which evaluates the balance system, and Auditory Brainstem Response, which evaluates the auditory nerve.  If these tests return normal, you should have an MRI with contrast.  You may also want to consider consulting a neurologist, especially since you had a head injury.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology