Unilateral Hearing Loss, Tinnitus, and Dizziness: Causes and Solutions

Unilateral hearing loss, occasional dizziness, and tinnitus?

Hello, Doctor! I would like to inquire about the issue of unilateral hearing loss and tinnitus.
It seems that my left ear has not been able to hear for a long time, and sometimes I experience dizziness, where I feel very dizzy while walking and often need support.
This is usually accompanied by tinnitus, which occurs almost every day.
However, the dizziness lasts only a few seconds before I return to normal, and the tinnitus also disappears.
Since I have not been able to hear from my left ear for a long time, I cannot confirm which ear the tinnitus is coming from.
I am quite worried that this might eventually lead to hearing loss in my right ear as well.
Recently, I visited a large hospital for an examination, where I underwent otoscopy, CT scans, and pure tone audiometry.
After the tests, the doctor said that structurally there were no issues, but I have a hearing loss of 120 decibels.
The reason for my inability to hear remains unresolved, and the doctor suggested it might be congenital.
I asked the doctor if there is any way to restore my left ear's hearing, but the only suggestion was to try hearing aids, which may not be very helpful.
Thank you for your assistance!

Niming, 10~19 year old female. Ask Date: 2020/08/04

Dr. Ji Zhaoyun reply Otolaryngology

Hello, here are the basic points regarding unilateral tinnitus and hearing loss:
1) Eustachian tube dysfunction: This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing the nose or bending over.
2) Sudden sensorineural hearing loss.
3) Otitis media:
a) Acute otitis media: Often occurs alongside upper respiratory infections (such as colds) and sinusitis, and in severe cases, there may be ear discharge.
b) Chronic otitis media with acute exacerbation: Usually occurs when there is a pre-existing perforation in the eardrum, which can be caused by unclean water or improper ear cleaning, leading to inflammation.
All of the above conditions can be appropriately treated with medication after consulting a healthcare provider.
If you have already undergone a pure-tone audiometry test (which requires headphones in a soundproof booth, where you respond to sounds by pressing a button, rather than just using a tuning fork), and it has been confirmed that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not had a pure-tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
The golden treatment period for sudden hearing loss is within two weeks, and early treatment yields better outcomes.
As you mentioned, if it is confirmed to be chronic sensorineural hearing loss, the mainstream approach is to use hearing aids.
A small number of individuals may consider cochlear implants, but this requires evaluation.
It is recommended to continue visiting an otolaryngologist if symptoms persist.
Wishing you peace and good health.
Sincerely,
Dr.
Chi Chao-Yun,
Director, Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2020/08/04

More Info

Unilateral hearing loss, tinnitus, and dizziness can be distressing symptoms that significantly impact daily life. Understanding the underlying causes and potential solutions is crucial for managing these conditions effectively.
Unilateral hearing loss refers to a significant reduction in hearing ability in one ear, which can be caused by various factors, including congenital issues, infections, trauma, or exposure to loud noises. In your case, the fact that you have experienced hearing loss in your left ear for an extended period, along with episodes of dizziness and tinnitus, suggests that there may be a more complex underlying issue at play.

Tinnitus, often described as a ringing or buzzing in the ears, can accompany hearing loss and is frequently associated with damage to the auditory system. The perception of sound in the absence of external stimuli can be a result of changes in the auditory pathways or the brain's response to hearing loss. Dizziness, particularly when it occurs alongside hearing issues, may indicate a problem with the vestibular system, which is responsible for balance. This could be due to inner ear disorders, such as Meniere's disease or vestibular neuritis, which can affect both hearing and balance.

Given that you have undergone various diagnostic tests, including otoscopy, CT scans, and pure-tone audiometry, and that the structural examination revealed no abnormalities, it is essential to consider other potential causes. The high degree of hearing loss (120 dB) you mentioned suggests profound hearing impairment, which can be challenging to treat. If your doctor indicated that this might be congenital, it implies that the hearing loss may have been present from birth and not due to any acquired condition.

While your doctor suggested hearing aids as a possible solution, it's important to understand that their effectiveness can vary significantly, especially in cases of profound hearing loss. Hearing aids amplify sound but do not restore hearing to normal levels. They can help improve the perception of sounds, particularly in environments with background noise, but they may not be as beneficial for individuals with severe to profound unilateral hearing loss.

In terms of managing your symptoms, here are some strategies you might consider:
1. Hearing Aids: While you mentioned that your doctor indicated limited benefit from hearing aids, it may still be worthwhile to explore different types or models. Some advanced hearing aids are designed to enhance specific frequencies and can be tailored to your unique hearing profile.

2. Tinnitus Management: Cognitive Behavioral Therapy (CBT) and sound therapy can help manage tinnitus. These approaches focus on reducing the perception of tinnitus and improving your coping strategies.

3. Vestibular Rehabilitation: If dizziness is a frequent issue, vestibular rehabilitation therapy (VRT) may help. This therapy involves exercises designed to improve balance and reduce dizziness.

4. Regular Monitoring: Since you are concerned about the potential for your right ear to also experience hearing loss, regular follow-up appointments with an audiologist or an ear, nose, and throat (ENT) specialist are essential. They can monitor any changes in your hearing and balance.

5. Lifestyle Adjustments: Avoiding loud environments, managing stress, and ensuring good overall health can also contribute to better auditory and vestibular function.

6. Support Groups: Connecting with others who experience similar challenges can provide emotional support and practical advice on coping strategies.

In conclusion, while unilateral hearing loss, tinnitus, and dizziness can be complex and frustrating conditions, understanding their potential causes and exploring various management strategies can help improve your quality of life. It is essential to maintain open communication with your healthcare providers and advocate for your needs as you navigate these challenges.

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