Expert: Harriet B Jacobster, Au.D. - 9/15/2008

Question
QUESTION: I wrote to you in the past. Thanks for the info. I am still having issues. I am experiencing hyperacusis (I believe its called), vibrations seem really loud, and autophony, sounds like i'm talking inside my head or underwater, and decreased hearing in my right ear. It still feels full as well. This is after an ETD diagnosis, a tube placement and removal to treat the full feeling and which "caused" the other problems. Or at least they didn't start until after the procedure. I've had a CT and it didn't show anything, per the MD, except sinusitis on the left side. What else could cause these symptoms? And what else can I do? I've seen 4 ENT's, an allergist, and an er physician. The last ENT said I should get surgery to close the perforation in my ear (that still hasn't closed in two weeks) and to reduce my middle turbinate that is very swollen. Another ENT said it was swollen too. I am taking nasal sprays, sinus washes, and deconsal for it. What else could be causing these symptoms. Is it possible something important was injured during the ear tube placement? Or could these be attributed to something else? Do you think these symptoms will go away? Please advise. Thank.

ANSWER: Hi Rachael,
Very often, the symptoms you describe can be caused by a Patulous ET, that is, an ET that is continuously open rather than closed.  This condition is often missed because its symptoms are very similar to middle ear effusion. Although tube placement is used in these cases, occasionally it will have no affect or may make symptoms worse.  A patulous ET can occur after weight loss or a pregnancy, or by several other factors.  Here is a site that can explain this condition:  http://www.emedicine.com/ent/topic208.htm
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology

---------- FOLLOW-UP ----------

QUESTION: Thanks. I have asked an ENT about PET in recently and he ruled it out. (I can't remember on what basis). I have read that the symptoms are relieved by laying supine or with head between knees, bent forward, and my symptoms are not relieved by these things. Should I ask another ENT? Is there anything else to rule out? And how long does it take a hole made for a ear tube to close? Also, would the current meds I am taking make this situation (if it is PET) worse? Thanks again


Answer
Hi Rachael,
At this time, without seeing you clinically, I really cannot think of anything other than the conditions we already discussed.  If you feel comfortable seeking a consult with another ENT, then by all means do so.  Depending on the size and location of the perforation, it could take a long time or maybe never, to heal.  I really do not know of any medications that would make your PET worse; I would consult either a physician or your pharmacist.
Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology