Tinnitus After a Smack in the Ear, Perilymphatic Fistula, Blood Patch Treatment, Advice?

Hello everyone. My name is Scott. On April 7th me and my girlfriend were rough playing in bed and she smacked me in my ear. I immediately heard a very loud ringing. We finished having sex and quickly dismissed it and I had the music on. The next morning I woke up and I could tell that I had hearing loss in my right ear and I had a constant humming noise.

I waited a few days and I finally went to the emergency room four days later. They could not see any internal damage, they referred me to an ENT. I went to the ENT last Wednesday (4/17), they also could not see any internal damage. They ran a series of hearing tests on my ears and he diagnosed me with perilymphatic fistula.

He recommended that I should do a blood patch procedure which he wrote a publication on with high treatment success. His name is Dr. Peter Foster in South Beach Miami. What they actually do is withdraw blood out of your arm and inject it in your inner ear in hopes that it will clot and close up the microscopic fistula hole. My only two symptoms are hearing loss and tinnitus. Most people with perilymphatic fistulas have dizziness and vertigo, I do not have that. I am scheduled to go back to see him on Wednesday evening again he may want to do an additional blood patch procedure. Do you think I should go to another ENT doctor to get another opinion?

I'm looking to see if anyone has had similar symptoms due to a slap in the ear. Today will be day 15 since the trauma and I do not feel any better at all, the same I would say. If this blood patch procedure works, he was not able to tell me how long the recovery time is. But I will have to ask him again on Wednesday to give me some type of date or timeline to follow. I'm very scared my tinnitus will not subside...

If anyone out there has any words or advice, please help me, I'm suffering tremendously...!

 

Hi, I'm sorry you're suffering. It's early days, so try and stay calm, easier said than done.. I know.

By blood patch... do you mean Platelet Rich Plasma, PRP, which is your own blood spun on a centrifuge. I ask this, because this is supposed to be very good for healing injuries, and I would say you're lucky to have it early on, the timing is good.
Find out what the blood patch is... please.

How were you diagnosed with a fistula? A CT scan?

It's early days, ears take a long time to heal, so understand it may take 3 months or even a year. This doctor sounds very interesting.

I hope some other members will give you some sound advice...

Stay strong and report back on the " blood patch" if you can.

Sincerely, Daniel

 

I tried to Google your ENT, no luck, could you provide a link to this doctor's publication please. His thinking may be very progressive and spot on... how were you referred to this ENT?

Getting PRP, blood, to an injured place as fast as possible makes sense to me from what I have read.

Hang tight, and if you got the money or coverage, get a consult with another ENT, you have nothing to lose. This Dr. Foster sounds very interesting.

Good luck man, keep us posted on your health and if you're really freaking out try some relaxation techniques, massage, and possibly meds to calm you down.

What does your family, girlfriend, friends think would be a good course of action?

 

If your hearing comes back your tinnitus will back off.

It's always fun reading the occasional weird ways one can develop tinnitus from.

 

The standard treatment for PLF is round and oval window reinforcement surgery. I have never heard of the blood patch option before - that is really interesting. If you have a link would be great to see the publication written by the ENT you visited.

I just did a quick search on blood patches. There seem to be a lot of posts about blood patches and quite a few people in the group seem to have done it. The sense I gather from the posts is that the blood patch is less invasive than round and oval window reinforcement surgery, and it is used as a first line treatment for PLF. If the blood patch doesn’t work, then people seemed to follow up with the surgery.

 

It's actually Paul Foster. I'll attach his publication. They withdraw blood from your arm and inject it into the middle of your ear basically

 

From explaining to him what happened to my ear and also my hearing tests results. No CT scan though.

 

It is surprising to me that he'd diagnose a fistula with only that information. I'd have expected some imaging tech too.

If I were you, I'd ask for a second and third opinion (from doctors that do not belong to the same "medical network").

 

my plan is to get another couple of opinions obviously before I intend to get some type of surgery. He told me that the hole would probably been microscopic and you not be able to see from any type of scan.

 

Do everything asap...

Dr. Foster sounds impressive... get another opinion, and if surgery is advised... do it asap... timing is important generally with ear traumas...

Good luck man... sorry about your situation... be strong.

 

So update on April 7th I was slapped in the face and have experienced minor hearing loss (right ear only) and hissing tinnitus. I'm on my second set of steroids but minor improvement so far. I have seen two different ENTs so far. They both told me they think it's middle ear damage, the one I saw yesterday thinks I need rest/time to heal and he re-confirmed that I have no visual damage to my ear drum.

He gave me some confidence by letting me know that because this is due to a specific trauma and not "hearings hearing loss" that 75% of his patients have recovered their hearing and their tinnitus will hopefully subsided.

Is there anyone else that can comment on my situation or similar circumstances?

 

If you have had some improvement during your first month, it is a good sign. Also, the fact that your tinnitus is a hiss (and not a high-pitch tone) means you haven't been hurt as much as many here. It might take a year or two, but your T will hopefully get to the "can hear it only in quiet rooms" stage. You might even get to hear silence again. Just make sure to not get another acoustic trauma before you have had time to heal.

Check out
https://www.tinnitustalk.com/thread...eone-else-who-has-tinnitus.26850/#post-307822

 

I posted here in mid April. I was slapped in the ear by my girlfriend when we were having rough sex. Completely accidental but what an unfortunate turn of events. So fast forward two and a half months later, I have taken two more hearing exams in my hearing is in fact improving per the exams.

However the tinnitus in my right ear is still there and very, very noticeable in dead silence.

The first ENT diagnosed me with a perilymphatic fistula. I went to another ENT in my home network 1300 miles away and he is not 100% sure that is the case, he feels it is just an upset nerve. His hope is as the nerve relaxes the tinnitus will subside.

Every time I burp and yawn my damaged ear rings very loud and then stops.

So I have all sorts of sound machines and windows open and fans on in every room in my house. That is my only escape as per now.

It is my understanding from following this forum that it could take at least six months to a year or longer for my ear to calm down if it ever does.

Trying to stay positive but it is difficult. I guess I'm only 2 and 1/2 months in which is not a long time for a trauma to the ear to heal itself.

If anyone has had any similar situations regarding a slap to the ear please reply to my post...

Scott

 

@scotty03874 - That's quite unfortunate and not uncommon. Abstinence

Did any of your ENTs explain what kind of surgery they would do to help the PLF?
Did they do any specific tests to check or find out beforehand? Advice?
It's good your hearing is improving - an indicator that it must be healing.

 

He told me in the earlier days people would do surgeries on that nowadays it is not the extreme vertigo etc. Which I'm not just slight hearing loss and fing tinnitus...

 

Steroids, that's it? I think you may benefit from this bloodpatch, regardless if they know or not. From my understanding, it's quite a simple in-office procedure that takes under a half hour to do. @Bill Bauer @JohnAdams, @AZ Glenn - The PRP concept sounds very similar to this (but more concentrated). I don't understand why the ENTs are not providing this to people right away in critical situations like this and those suffering!? It's better than nothing isn't it? It seems to have no negative side-effects, non-invasive and promotes healing. Correct me if I'm wrong.
I wish I was informed of this treatment and provided it right away. What's the harm?

 

Yeah it is absolutely crazy.

 

hi, has anyone had the blood patch done, please let us know your results and experience of this treatment.

I suspect i have PLF - due to dizziness when i blow my nose or tilt my head forwards.
How is this diagnosed - is there a scan that can see PLF, or does it require surgery to even find out for sure?

 

Oh, i have found some science to answer my own question about diagnostic tests.

This one is very interesting if you suspect you might have PLF:
https://www.hindawi.com/journals/ijoto/2012/163691/

Key extract: The sideways stepping test. (a) The patient is asked to stand with feet together and hands by the sides. They are then asked to close eyes or are blindfolded. A positive test is an involuntary lean to one side and hip sway. Sometimes the hand is lifted out to compensate. (b) The patient is asked to take two steps sideways and stop, first with eyes open and then with eyes closed or blindfolded. A positive test is an involuntary sway and/or taking a step to compensate. (c) The patient is asked to jog on the spot for 30 seconds with eyes closed or blind-folded. There should be no deviation. A positive test is an involuntary drifting, to one side, and sometimes forward or back. A positive test should be repeatable on subsequent occasions.

 

How old is your injury?
I have not heard about anyone doing intratympanic blood patch in Europe yet.
Did you try the "six weeks of bed rest" protocol for PLF (keep your head elevated at all times, no bending over, no straining, etc)?

 

No I did not do any bed rest, my doctor thought it was a waste of time. I did two different blood patches about 10 days apart, they did not seem to do anything, the only thing that helped me was 15 treatments of clinical laser. I would say my tinnitus went from an 8 down to like a 4. Thank f-ing god.

You can probably tell I do not float around these forums anymore because it is not as damaging to my life on a daily basis anymore. Still there, just a lot more muddled...

 

Good it went down whatever worked. I was actually commenting on @Nick Ml 's post about blood patches in Europe. I suggested "bed rest" to him because no matter if they work or not, as far as I know no one does intratympanic blood patches in Europe. I remember you said your symptoms reduced after the laser. It's just I know PLF can sometimes heal spontaneously with "bed rest", so that's why I said he should try it.

 

Is there anybody on these forums who actually has a PLF? I cannot find anybody.

 

To my knowledge Dr. Sudhoff does that (Germany):

https://www.klinikumbielefeld.de/klinik-fuer-hals-nasen-ohrenheilkunde-kopf-und-halschirurgie.html

 

Sounds similar to me, only I had a left ear barotrauma. I would like to try a blood patch or PRP. My left ear has been tormenting me for years with bad tinnitus. I would give anything for relief.

 

PLFs typically heal on their own within a few months. Blood usually has to be given in the first week of the trauma. I did it ten days after my trauma and it didn't improve anything.

 

My noise in my left ear has been getting worse and worse. I couldn’t sleep last night and had to take Zolpidem plus Diazepam. I see a doctor in India does repeated PRP injections for tinnitus. I did get my bad left TMJ fixed with fat from around my belly button, but no help with the tinnitus.

An IV of Lidocaine knocks out tinnitus but it’s not practical. I know my C2 is bad according to my report from Piper. I guess the neck nerves can crossover to the hearing nerves somehow and cause tinnitus. I still have a terrible high pitched static when I woke up primarily in my left ear.

 

I know the feeling, I have tinnitus and severe hearing loss in my right ear. I also have tinnitus in my left ear with mild/moderate hearing loss.

 

I have high frequency hearing loss in both ears but my problem ear is the left one where I had the airplane barotrauma in 2008. I have a loud solid tone sound right now. I scheduled another appointment with an ENT in the Twin Cities on 12-6. Hopefully I can get some better answers or recommendations from this doctor.

 

I see another ENT tomorrow, hope to get some decent advice. I would like to try IT PRP injections even though others have tried them with no help. I only had IT steroid injections years ago. I keep hindsighting on my airplane barotrauma years ago. I was fine in Chicago, but not when I landed at MSP. My eardrum was 2/3rds full of fluid according to my primary physician.

In the past on shorter flights my ear would be plugged up for about 3 days but no chronic tinnitus. This plane seemed noisy and maybe wasn’t pressurized as well as other planes. I should have used a nasal spray as well as a decongestant but it’s all hindsight now.