Expert: Harriet B Jacobster, Au.D. - 6/6/2009

Question
In Feb 08 I woke up with extreme vertigo. I had someone drive me to the doctor and was given antibiotics for a probable ear infection.  I was on two different ones including Augmentin for about 6 weeks.  I only had little if any improvement and 3 months or so later went to an ENT.  My hearing was tested (tech said great) then tech did the Epley maneuver and told me to stay upright for 3 days.  I then saw the ENT doctor.  My vertigo was better immediately after the procedure but I still had buzzing in my R ear caused by certain sounds while I talked.  I told this to the ENT but he didn't seem to address that symptom so I figured it would probably clear up soon.  One year later it had only become worse.  Now sounds from the outside also caused the buzzing (dogs barking, people speaking loudly).  I describe it EXACTLY like a broken speaker cone sounds.  I went back to a different doctor  in Feb 09 and he said I probably had fluid behind the ear drum and had me take Musilex and a decongestant.  I did that for 3 weeks with no improvement.  I was then on antibiotics again for 3 or 4 weeks and have still had not improvement.  I am concerned that I will sustain permanent damage if this isn't effectively dealt with.  When I try researching I can only find "ringing of the ear" but no one seems to have "broken speaker" buzzing.  Help!!  I don't have insurance and hate to keep paying a lot with no success.  The ENT was over $250.

Answer
Hi Carla,
First, I really hope you were treated by an Audiologist and not just a tech. Next, has anyone tested you for a patulous (open) Eustachian Tube (ET)?  Normally, the ET remains closed except when swallowing or with autoinflation.  But, in rare instances, the ET remains open.  Major symptoms of patulous eustachian tube include fluctuating aural fullness, roaring tinnitus synchronous with breathing, audible respiratory sounds,nthe abnormal perception of one's own breath and voice sounds (autophony, with echoing occasionally severe enough to interfere with speech production, and sensation of plugged ear. Vertigo and hearing loss can also occur.

Unfortunately, a patulous ET is often misdiagnosed and treated like a middle ear infection.  Treatment of patulous ET consists of special nasal sprays.  IN very rare occasions, surgery may be indicated.  Here is a great site that is very informative:  http://emedicine.medscape.com/article/858909-overview  

You may wish to make one more trip to an ENT and discuss this with him.  

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology