Hearing and Balance Issues: Symptoms and Solutions

Q: Hearing and Balance Issues: Symptoms and Solutions

Hello： In response to your question, there may be some damage to your ear ventilation system. <br>Please consult an otolaryngologist for evaluation and treatment.

Issues related to hearing and balance?

Hello Doctor: I have the following symptoms, could you please help me with them: 1.
When I answer the phone, if the other person is too loud, my ear and head feel very uncomfortable, and I experience mild dizziness.
2.
When I wake up at night, I have tinnitus in my right ear, a low humming sound, which disappears after I get up and move around.
3.
Riding a bike up and down steep slopes, or being on an incline for too long, makes my head feel very uncomfortable, and my breathing becomes irregular; I don't know whether to inhale or exhale.
This discomfort lasts about half an hour to an hour before gradually easing.
4.
Sudden loud noises cause a moment of panic, and both my head and body feel very uncomfortable; I cannot tolerate excessively loud and prolonged sounds for too long, as it makes me feel intensely uncomfortable.
Previously, I had many symptoms, and after seeing a doctor, I was diagnosed with mitral valve prolapse combined with autonomic nervous system dysfunction.
I was prescribed some medication.
Due to a job change, my insomnia has decreased, and the frequency of tinnitus in my right ear has significantly reduced unless I wake up suddenly at night.
However, my ear feels fine unless I am suddenly exposed to high-decibel noise or talk on the phone for too long, which triggers the aforementioned symptoms.
Sometimes I rely on medication to alleviate the discomfort.
The issue with riding my bike up and down slopes is very troubling for me, as it is part of my daily commute, and I don't know what to do about it.
Could you please provide a rough diagnosis of what might be causing these issues? Should I see a neurologist or an otolaryngologist? Thank you.
P.S.
I visited an otolaryngologist about seven or eight months ago regarding my tinnitus issue.
They did a simple examination of my ears, and a hearing test showed a loss of 19 dB, but there were no major problems.
These symptoms have appeared in the last couple of years.

Niming, 20~29 year old female. Ask Date: 2007/02/08

Dr. Xu Jiazhen reply Otolaryngology

Hello: In response to your question, there may be some damage to your ear ventilation system.
Please consult an otolaryngologist for evaluation and treatment.

Reply Date: 2007/02/08

More Info

Understanding hearing and balance issues can be quite complex, especially when symptoms like tinnitus, sensitivity to sound, and dizziness are involved. Based on the symptoms you've described, it seems that you are experiencing a combination of auditory and vestibular (balance) disturbances, which can significantly affect your quality of life.

Symptoms Overview
1. Sensitivity to Loud Sounds: Feeling discomfort or pain when exposed to loud noises, such as during phone calls, can indicate a condition known as hyperacusis. This is often associated with underlying auditory processing issues or ear-related problems.

2. Tinnitus: The low-frequency ringing or buzzing in your right ear, particularly when waking up, is a common symptom of tinnitus. Tinnitus can be caused by various factors, including hearing loss, exposure to loud noises, ear infections, or even stress.

3. Dizziness and Breathing Issues: The discomfort you experience while riding on steep slopes, along with feelings of breathlessness, may suggest a vestibular dysfunction. This could be related to the inner ear's balance mechanisms being affected, possibly due to changes in pressure or fluid dynamics in the ear.

4. Panic Response to Sudden Noises: The psychological response to sudden loud noises, leading to panic and discomfort, may be linked to anxiety disorders or heightened sensitivity due to previous auditory experiences.

Possible Causes
Given your symptoms and the history of mitral valve prolapse and autonomic nervous system dysregulation, it’s possible that your symptoms are interconnected. The autonomic nervous system can influence both heart rate and the body's response to stress, which may exacerbate your auditory and balance issues.

Recommendations
1. Consultation with Specialists: Since your symptoms involve both hearing and balance, it would be prudent to consult both an otolaryngologist (ear, nose, and throat specialist) and a neurologist. The ENT can assess your ear health, perform audiometric tests, and evaluate for any structural issues. The neurologist can help determine if there are any central nervous system factors contributing to your symptoms.

2. Hearing Tests: A comprehensive audiological evaluation, including pure-tone audiometry and tympanometry, can help determine the extent of any hearing loss and the functionality of your middle ear.

3. Vestibular Assessment: If balance issues persist, a vestibular assessment may be necessary. This could include tests like the Videonystagmography (VNG) or the Vestibular Evoked Myogenic Potential (VEMP) test to evaluate how well your inner ear is functioning.

4. Management of Tinnitus: Cognitive behavioral therapy (CBT) and sound therapy can be effective in managing tinnitus. These approaches help in retraining the brain's response to tinnitus and can reduce the distress associated with it.

5. Lifestyle Modifications: Reducing exposure to loud environments, managing stress through relaxation techniques, and ensuring adequate sleep can help mitigate some symptoms.
6. Medication Review: Since you mentioned using medication for symptom relief, it’s essential to discuss with your healthcare provider whether these medications are appropriate or if adjustments are needed.

Conclusion
Your symptoms are multifaceted and could stem from a combination of auditory and vestibular dysfunctions, possibly exacerbated by anxiety and stress. A thorough evaluation by both an ENT specialist and a neurologist will be crucial in identifying the underlying causes and developing an effective treatment plan. Remember, early intervention can often lead to better outcomes, so seeking further medical advice is a wise step.

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