Asymmetric Right Sensorineural Hearing Loss

hey everyone,

i've been experiencing a seashell-like sensation in my ear for upwards of 7 years. i have another post regarding my issues with that that can be found here: https://www.tinnitustalk.com/threads/another-pulsatile-tinnitus-thread.9764/#post-118600

over the last few years, i've experienced a few other other odd things:

1. occasionally when i'm on the phone and hold it to my left ear, my right ear (the same one that experiences the seashell sounds) pulsates like crazy. it's a very physical feeling - like my ear drum is being played like a bass drum. if it's happening and i move my phone to the ear that's spasming, it can make the problem go away.

2. i get random sensations of ear fullness and the sound of my own voice in the affected ear. this happens pretty sporadically and tends to be only noticeable when i'm in tight quarters like a car or when i'm sitting in corners close to walls (my guess is that it's when sound doesn't have a lot of places to go.) the sounds I hear are not complete sentences or words. it seems to be certain syllables or tones that cause the sensation. it can happen for a few seconds to a few minutes and then just goes away.

all of my symptoms wax and wane. sometimes it seems like a constant combination of the three, other times i almost have to force them to occur. they're never gone completely, but there are times that are better than others.

i recently got a hearing test that showed high frequency asymmetric sensorineural hearing loss of the affected ear. per the doctor's notes: "Audiogram from 6/6/18 obtained and reviewed with the patient shows normal hearing in the left ear. The right shows evidence of a noise induce hearing loss at 6000 Hz partially recovering to normal hearing at 8000 Hz."

an MRI with contrast has been ordered but they can't get me in for 2+ weeks and after a quick google search for "asymmetric sensorineural hearing loss" has absolutely terrified me. Anyone have any experience with this?

his full work up was as follows:

"On exam, patient is awake, alert, pleasant, in no distress. He is overweight. Neuro: Facial motion symmetric. House Brackmann Level 1. Respiratory: no audible stridor or expiratory wheeze, no acute distress. Face is non-tender, no swelling of the parotids. Facial motion symmetric. Eyes: no discharge. No nystagmus. Ear exam - pinna well formed. He has eczematoid changes with wax impaction of the right ear. Using this microscope, this is removed. No erythema noted. The left external auditory canal is clear. No signs for erythema or edema. Tympanic membranes intact. No retraction or effusion. Hand clap on the left did not evoke fluttering tinnitus on the right.
Audiogram from 6/6/18 obtained and reviewed with the patient shows normal hearing in the left ear. The right shows evidence of a noise induce hearing loss at 6000 Hz partially recovering to normal hearing at 8000 Hz.
IMPRESSION:
1. Right-sided tinnitus.
2. Asymmetric right sensorineural hearing loss.
3. Chronic otitis externa right ear with wax impaction
PLAN: I explained that his symptoms of right ear fluttering while on the phone left ear may be due to issues related to his auditory reflex. The tinnitus may very well represent a venous hum. We discussed further audiometric evaluation versus undergoing MRI and ultimately decided to pursue an MRI due to the hearing loss and tinnitus. This will be ordered today. I will call him regarding these results.

sorry for the length! thanks for your time, everyone!

 

One thing I notice about hearing loss in one ear is most people say it's at 6 kHz. That's the week point from 22 Hz - 8 kHz.

 

here are the results of my hearing test. i'm not really sure what any of it means.

 

@mtoafs - Your doc wrote that you are a drummer (you left that important fact out in your original post it seems): do you play acoustic drums?
If so, do you happen to have cymbals that could get a bit loud towards your right hand side when you play? Perhaps a crash more than a ride or splash...

 

sorry about that! i mentioned it in the original thread i linked to.

i am most definitely an acoustic drummer and have played in LOUD (think Black Sabbath) bands for 25 years. i also didn't start wearing any sort of hearing protection until around the time this started happening (to be completely honest i only wear isolation head phones at practice, not when we play live.) as i noted to my doc as well, i tend to turn my head to the left when I'm playing fast or hard so the affected ear is completely in line with my snare drum and hi-hat.

 

Is you hearing test a recent one? Did you do a hearing test 5 or 7 years ago?

 

the results are from last week. i was given a hearing test 3 years ago or so but never saw the results. was just told my hearing was "good for my age and what my hobby is."

 

ok. You might had a smaller dip at 6000Hz. I think it is a combination of chronic otitis externa and noise induced hearing loss.

 

Wow you must turn your head quite a lot to have your right ear align with your hi-hat! (unless you are left handed and your HH is on the right, or perhaps you like your HH closer to the 12 o'clock position)

I think it's the noise that has damaged some areas of your cochlea unfortunately. It's the most obvious culprit to me, especially given what you just wrote.

Take it easy on the ears for a while. The reason it may appear so localized is that the sound that damaged your cochlea may have had a lot of energy in those bands (that's why I was asking about high frequency percussion instruments like cymbals: the hi-hat is hi-freq too but quite "tame" compared to those crashes in terms of volume).

 

Ha! i actually AM left handed and do have a crash on the same side as my hi-hat. i should also add that I'm considered one of the loudest drummers in our region and at a show the other night, a concert player complimented me by telling me my snare drum sounded like a shotgun.

 

i meant show attendee. i have no idea what a 'concert player' is.