Ear Congestion and Low-Frequency Hearing Loss After a Cold

Ear fullness, low-frequency hearing loss?

Hello Doctor, I had a severe cold in mid-December last year, during which my nasal discharge was very thick (yellow-green like jelly).
At the same time, I experienced a feeling of fullness in my left ear, difficulty hearing, and low-frequency tinnitus.
When I visited a general clinic, the doctor believed it was caused by the cold and prescribed medication.
Two weeks later, the cold symptoms disappeared, but the ear fullness and tinnitus persisted.
The doctor recommended that I go to the hospital for a hearing test.

After the hospital examination, I was unable to hear at low decibel levels of 125, 250, and 500 Hz, requiring about 30 dB to hear; other frequencies were normal, similar to my right ear, and I had no headaches or dizziness.
The doctor diagnosed two possibilities: sudden sensorineural hearing loss or endolymphatic hydrops (Meniere's disease).
They mentioned that sudden sensorineural hearing loss was more urgent, so treatment was initiated based on that possibility.
I took steroids for two weeks, but there was no improvement in hearing upon follow-up.

Subsequently, treatment for endolymphatic hydrops was started, and I was prescribed oral diuretics, which I have been taking for over a week now.
The feeling of fullness is not as severe as it was initially, but the low-frequency tinnitus and hearing loss remain.
I had another hearing test in the past two days, and I still can only hear at 30 dB.

I would like to ask the doctor:
1.
How long does it typically take to feel improvement when taking diuretics?
2.
If there is no improvement, does that indicate it is not hydrops? Could it be more related to inflammation and swelling caused by the cold?
3.
Are there any recommended treatment options or areas to monitor moving forward? The sensation of ear fullness and tinnitus has persisted for over a month, and I hope to have some direction.
Thank you.

Xiao Xiansheng, 30~39 year old female. Ask Date: 2024/01/22

Dr. Ji Zhaoyun reply Otolaryngology

Hello, whether it is sudden sensorineural hearing loss or inner ear edema (Meniere's disease), the chance of recovery from hearing loss is approximately 70-80%.
There is no guarantee of complete recovery, and the longer the duration since the onset of symptoms, the lower the chance of recovery.
In addition to the aforementioned treatment options, alternative therapies such as acupuncture or hyperbaric oxygen therapy may be considered.
It is advisable to discuss the suitability of these options directly with your treating physician.

Reply Date: 2024/01/22

More Info

Understanding ear congestion and low-frequency hearing loss after a cold can be quite complex, especially given the interplay of various factors that can affect ear health. Based on your description, it seems that your symptoms began following a significant upper respiratory infection, which is not uncommon. Let's break down your concerns and address them systematically.

1. Duration of Diuretic Treatment and Expected Improvement: Diuretics are often prescribed in cases of inner ear swelling, such as Meniere's disease, to help reduce fluid retention. The timeframe for improvement can vary significantly from person to person. Some patients may notice changes within a few days, while others might take weeks to see any noticeable effects. If you have been on diuretics for over a week without significant improvement, it is essential to continue monitoring your symptoms and maintain communication with your healthcare provider. They may consider adjusting your treatment plan based on your response.

2. Differentiating Between Conditions: If your symptoms persist despite treatment, it raises the question of whether the underlying issue is indeed related to inner ear swelling or if it is more indicative of residual effects from the cold, such as inflammation or infection. Viral infections can lead to Eustachian tube dysfunction, which can cause a sensation of fullness in the ear and contribute to hearing loss. If the diuretics do not yield results, further investigation may be warranted to rule out other causes, such as chronic otitis media or other forms of conductive hearing loss.

3. Recommended Follow-Up and Treatment Options: Given that your symptoms have persisted for over a month, it is crucial to follow up with your healthcare provider. They may recommend additional tests, such as an MRI or further audiometric evaluations, to assess the status of your inner ear and auditory pathways. If the low-frequency hearing loss and tinnitus continue, treatments such as corticosteroids may be reconsidered, or other interventions like sound therapy or hearing aids might be explored to manage your symptoms effectively.

In addition to medical treatment, consider lifestyle modifications that can support ear health. Staying hydrated, avoiding allergens, and managing stress can all contribute positively to your overall well-being and may help alleviate some symptoms.
Lastly, it is essential to maintain a dialogue with your healthcare provider about your symptoms and any changes you experience. If your symptoms worsen or new symptoms arise, do not hesitate to seek immediate medical attention. Your health and comfort are paramount, and a tailored approach to your treatment will yield the best outcomes.
In summary, while the recovery from ear congestion and low-frequency hearing loss can be slow, ongoing communication with your healthcare provider and adherence to treatment plans are crucial. With time and appropriate management, there is hope for improvement in your symptoms.

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