Expert: Harriet B Jacobster, Au.D. - 7/1/2009

Question
About 9 months ago I had an infection that spread to my inner left ear that, at the time, my dentist thought was a wisdom tooth. He removed it and prescribed meds. A couple of days later, I started having dizzy spells until vertigo came full speed along with vision problems. Ended up going to a balance therapist and said that I had BPPV and vestibular weakness. I recovered with it's rehab. in 2 months. A couple of weeks later, the infection came back and it turned out to be an infected cyst next to my left bottom wisdom tooth and the dentist removed both. My vertigo came back along with my vestibular weakness. Went back to the balance rehab and nothing worked. I started to develope fluid in my ears that gradually increased and would move in both my ears constantly creating more dizzy spells along with ear pressure. I still have vision problems and seems to get worse with increased pressure. I've been to 2 neurologists, 2 ENT's and a chiropractor and I haven't had any relief nor answers. I've had MRI's and MRA's of the head and neck, along with countless bloodwork done from anxiety to my thyroid checked and everything's normal. My vision and hearing have been tested and that's fine too. I've been on Diamox for a few months to get rid of the fluid but I've built up a resistance to it and I've also been on Meclizine for the past nine months as well. I'm sick of popping pills without any answers. I want to have another baby and but this is putting it off. This can be very debilitating at times and being a singer and pianist for 20 years, it effects my work. The singing puts more pressure on my ears and I can't look at the piano keys because they start to sway. Any help would be enormously appreciated.

Answer
Hi Jennifer,
You may want to discuss the possibility of Superior Semicircular Canal Dehiscence (SSCD),an inner ear fistula or cerebral spinal fluid fistula with your physicians.  All three of these conditions can cause the symptoms you described.  They are very rare, and usually go undiagnosed for years. Cerebral spinal fluid fistula especially mimics a middle ear infection as the fluid builds up in the middle ear cavity.  The conditions require special testing and imaging techniques for diagnosing.  I have seen several patients with these conditions.

You may also want to consult with your ob-gyn and/or endocrinologist and have your hormone levels evaluated.

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