Expert: Harriet B Jacobster, Au.D. - 8/13/2008

Question
on 7/25/2008 I woke up to a loud ringing & roaring in my ear and a feeling of pressure or fullness (blocked). On 7/28/08 I went straight to an ENT specialist here and told him my "symptoms". He looked into my ear and saw nothing. No infection or wax buildup. He tested me with the tuning fork and than on to pressure and fluid test...passed, no fluid or pressure out of ordinary. I than was on to the hearing test (audiogram). result turned out that I lost some hearing (frequency) in my left ear that was giving me problems. My right ear was normal. He can only assume for now sudden hearing loss with no known cause. I was given a steroid shot and than a 6 day prescription of methylpredisilone. This is do to assuming that it may be a viral infection in inner ear. with precautions i was also told to not drink caffine or eat salt. I was told to return in two weeks. I returned on 8/11/08 and had another pressure test done and once again normal. I was given another hearng test and it turned out that my hearing was normal in both ears once again. He sees nothing wrong with my hearing or ears anymore. I told him that I had some of the same feeling in both ears during the two weeks and that I didnt feel a change. He has done all the test he has done and all test show my hearing and ears are normal. He concluded that this could be some symptom of TMJ. I told him during the two weeks I saw a orthodontist who told me he didnt see that I had TMJ and my jaws looked fine, but my ENT doctor insisted that orthodontist usually dont specialize in TMJ to diagnose it. I was feeling better hearing wise and ear wise, but as of today 8/13/08...I once again woke up to roring and inging in my ear, but both ears this time...left ear (the one diagnosed first time to hearing loss) more than the right ear. I was also a little light headed but well balanced and the world was not spinning (vertigo). I was able to go to work, but the pressure I felt in my ears was distracting. I feel like the same thing happening all over again except this time with jaw feeling a little tight in muscle and a slight headache. I also seem to notice my teeth feeling a little more heavier. Should I still assume this is symptoms of TMJ or should I see my ENT once again about todays symptoms? I hear fine, but I feel slight uncomfortable feeling in ear as well as the clogged/fullness feeling. I just wan to be able to go back to how I was feeling three weeks ago before I woke up to all this weird ear issues. Help with some insight?

Answer
Hi Erica,
It sounds as if you may be experiencing the classic symptoms of cochlear hydrops (CH).  CH is characterized by fullness in the ears, fluctuating hearing loss and roaring tinnitus.  Vertigo may or may not be a symptom in the early stages.  Although these symptoms may also be caused by TMJ, you need a thorough evaluation to rule out CH.  This includes not just a hearing test, but also Otoacoustic Emission testing, Electrocochleography and Auditory Brainstem Response testing. These tests are performed by an audiologist. You need to tell your ENT that you want these tests done, if not already done so.  If it does turn out to be CH, it is usually treated with a low salt/salt free diet and diuretics.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology