High-Frequency Hearing Loss in the Right Ear

High-frequency hearing loss in the right ear?

Hello Doctor,
Symptoms: I have high-frequency hearing loss in my right ear, with hearing thresholds at 2000 Hz (40 dB), 4000 Hz (60 dB), and 8000 Hz (80 dB).
Recently, during weight training while holding my breath and squatting with my right ear down, I noticed a feeling of fullness in my right ear (similar to the ear pressure experienced during an airplane takeoff).

Medical history: I had otitis media 15 years ago (during elementary school), which resolved, but my right ear's hearing was slightly impaired, though my family did not pay much attention to it.
Five years ago (during college), I had a cold that led to another episode of otitis media, and after recovery, I noticed a trend of declining hearing in my right ear.
In mid-March of this year, I underwent bone conduction testing, which yielded similar results.
I also had auditory brainstem response testing, and the doctor mentioned that the response from the right ear's nerve was weaker and suggested an EEG, but I declined further follow-up due to work commitments in the south.
I plan to return for a follow-up appointment at a hospital in Taichung at the end of June.
I would like to ask:
1.
How should I describe my condition to the doctor at that time?
2.
What could be the possible causes of my right ear symptoms?
3.
Most importantly, is there a possibility for my right ear to regain hearing?
Thank you for your assistance!

Li Xiansheng, 20~29 year old female. Ask Date: 2020/05/09

Dr. Li Jiaxuan reply Otolaryngology

The hearing in the right ear is 2000 Hz (40 dB), 4000 Hz (60 dB), and 8000 Hz (80 dB), while other frequencies are normal, indicating sensorineural hearing loss, which is unlikely to recover.
It is recommended to maintain a regular lifestyle and avoid further deterioration of hearing.
Brainwave tests or further examinations are usually conducted to rule out some rare causes of hearing impairment, such as acoustic neuroma.
It is advised to follow up with hearing tests at Taichung Hospital, and further evaluations may be necessary.
Wishing you well.

Reply Date: 2020/05/09

More Info

High-frequency hearing loss, particularly in one ear, can be a complex issue with various underlying causes and implications. Based on the symptoms you've described, including the specific frequencies at which you are experiencing hearing loss (2000 Hz at 40 dB, 4000 Hz at 60 dB, and 8000 Hz at 80 dB), it appears that you may be dealing with sensorineural hearing loss in your right ear. This type of hearing loss often affects the ability to hear higher frequencies and can be caused by a variety of factors, including previous ear infections, exposure to loud noises, or even age-related changes.

1. How to Discuss with Your Doctor
When you visit your doctor, it’s essential to provide a clear and comprehensive account of your symptoms and medical history. Here’s how you might structure your discussion:
- Start with Your Symptoms: Explain that you have been experiencing high-frequency hearing loss in your right ear, specifying the frequencies and decibel levels from your recent audiogram. Mention the sensation of fullness or pressure in your ear, especially when performing activities like heavy lifting or bending over.

- Detail Your Medical History: Inform your doctor about your past experiences with ear infections, particularly the middle ear infections you had 15 years ago and 5 years ago. Emphasize any changes in your hearing that you noticed after these infections.

- Mention Previous Tests: Discuss the results of your previous tests, including the bone conduction test and the brainstem auditory evoked response test, and any recommendations that were made regarding further testing.

- Express Your Concerns: Clearly articulate your concerns about the potential for further hearing loss and your desire to understand the prognosis for your right ear.

2. Possible Symptoms of Right Ear Hearing Loss
The symptoms you are experiencing can be indicative of several conditions:
- Eustachian Tube Dysfunction: This can cause a sensation of fullness or pressure in the ear, especially during changes in altitude or when straining. It may also contribute to fluctuating hearing loss.

- Chronic Otitis Media: Given your history of ear infections, there may be residual effects from past infections that could be contributing to your current symptoms.

- Sensorineural Hearing Loss: This type of hearing loss can result from damage to the inner ear or auditory nerve, often leading to difficulties in hearing high-frequency sounds.

- Tinnitus: The sensation of ringing or buzzing in the ear, which can accompany hearing loss, particularly in cases of sensorineural damage.

3. Possibility of Hearing Recovery
The potential for recovery of hearing depends on the underlying cause of your high-frequency hearing loss. In cases of sensorineural hearing loss, recovery is often limited, as damage to the hair cells in the cochlea is typically irreversible. However, there are several avenues to explore:
- Medical Intervention: Depending on the findings from your upcoming appointment, your doctor may recommend treatments such as corticosteroids if there is a suspicion of sudden sensorineural hearing loss.

- Hearing Aids: If your hearing loss is confirmed to be permanent, hearing aids can significantly improve your ability to hear high-frequency sounds.

- Regular Monitoring: Continuous follow-up with audiometric testing can help track any changes in your hearing and allow for timely interventions.

- Lifestyle Adjustments: Protecting your ears from loud noises and managing any underlying health conditions (like allergies or sinus issues) can help prevent further deterioration.

In conclusion, it is crucial to approach your upcoming appointment with a clear understanding of your symptoms and history. While the prognosis for recovery may vary, there are options available to help manage your hearing loss effectively. Your proactive approach to seeking medical advice is commendable, and I encourage you to continue advocating for your health.

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