Uneven Hearing: Possible Causes and When to Seek Help - Otolaryngology

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Understanding uneven hearing can be a complex issue, as it may arise from various underlying causes. Based on your description, it seems that you are experiencing a significant change in your right ear's auditory perception, characterized by a sensation of fullness, altered sound quality, and difficulty hearing lower frequencies. These symptoms can be indicative of several conditions, and it is wise to seek further evaluation, especially since your symptoms have persisted despite initial treatment.


Possible Causes of Uneven Hearing
1. Earwax Blockage: While you mentioned that some earwax was removed, it's important to note that even partial blockage can lead to changes in hearing. If the ear canal is inflamed, it may also contribute to the sensation of fullness and muffled sounds.

2. Middle Ear Issues: Conditions such as otitis media (middle ear infection) can cause inflammation and fluid buildup, leading to hearing loss. This could explain the echo-like quality of sounds and the inability to hear lower frequencies.

3. Eustachian Tube Dysfunction: The Eustachian tube helps equalize pressure in the middle ear. If it becomes blocked or does not function properly, it can lead to a feeling of fullness and altered hearing.

4. Inner Ear Problems: Conditions affecting the inner ear, such as Meniere's disease or sudden sensorineural hearing loss, can also cause uneven hearing. These conditions may present with additional symptoms like tinnitus (ringing in the ears) or vertigo.

5. Acoustic Neuroma: Though less common, an acoustic neuroma (a benign tumor on the vestibulocochlear nerve) can lead to unilateral hearing loss and other auditory disturbances.


When to Seek Help
Given that your symptoms have not improved with initial treatment and considering the potential seriousness of some underlying conditions, it is advisable to seek further evaluation at a specialized facility. Here are some reasons to consider a visit to a larger hospital:
- Persistent Symptoms: If your hearing does not return to normal after a few days of treatment, further investigation is warranted.

- Worsening Condition: If you experience additional symptoms such as dizziness, balance issues, or severe pain, you should seek immediate medical attention.

- Comprehensive Testing: A larger hospital can provide more advanced diagnostic tools, such as audiometry, tympanometry, and imaging studies (like an MRI), to assess the condition of your ear and auditory pathways.


Conclusion
In summary, your symptoms suggest that there may be an underlying issue affecting your right ear's ability to process sound normally. While initial treatment for earwax removal and inflammation is a good first step, the persistence of your symptoms indicates that further evaluation is necessary. I recommend following your doctor's advice and seeking a thorough examination at a larger medical facility. Early diagnosis and treatment can significantly improve outcomes, especially if there is an underlying condition that requires specific management. Remember, your hearing health is crucial, and addressing these issues promptly can help prevent further complications.