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

Discussion in 'Introduce Yourself' started by scotty03874, Apr 23, 2019.

    1. scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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...!
       
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    2. Daniel Lion
      Ape-like

      Daniel Lion Member Podcast Patron Benefactor Hall of Fame

      Location:
      SE Asia
      Tinnitus Since:
      2017
      Cause of Tinnitus:
      Noise trauma, hearing loss
      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
       
    3. Daniel Lion
      Ape-like

      Daniel Lion Member Podcast Patron Benefactor Hall of Fame

      Location:
      SE Asia
      Tinnitus Since:
      2017
      Cause of Tinnitus:
      Noise trauma, hearing loss
      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?
       
    4. Contrast
      No Mood

      Contrast Member Benefactor Hall of Fame

      Location:
      Clown World
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      noise injury
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    5. lymebite
      Vegged out

      lymebite Member Podcast Patron Benefactor

      Location:
      United States
      Tinnitus Since:
      2013
      Cause of Tinnitus:
      Unknown
      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.
       
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    6. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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
       

      Attached Files:

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    7. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      From explaining to him what happened to my ear and also my hearing tests results. No CT scan though.
       
    8. GregCA
      Jaded

      GregCA Member Benefactor Hall of Fame

      Tinnitus Since:
      03/2016
      Cause of Tinnitus:
      Otosclerosis
      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").
       
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    9. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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.
       
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    10. Daniel Lion
      Ape-like

      Daniel Lion Member Podcast Patron Benefactor Hall of Fame

      Location:
      SE Asia
      Tinnitus Since:
      2017
      Cause of Tinnitus:
      Noise trauma, hearing loss
      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.
       
    11. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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?
       
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    12. Bill Bauer
      No Mood

      Bill Bauer Member Hall of Fame

      Tinnitus Since:
      February, 2017
      Cause of Tinnitus:
      Acoustic Trauma
      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
       
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    13. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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
       
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    14. sakrt
      Barefooter

      sakrt Member

      Tinnitus Since:
      2013
      Cause of Tinnitus:
      Specific issues
      @scotty03874 - That's quite unfortunate and not uncommon. Abstinence :arghh:

      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.
       
    15. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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...
       
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    16. sakrt
      Barefooter

      sakrt Member

      Tinnitus Since:
      2013
      Cause of Tinnitus:
      Specific issues
      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?
       
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    17. JohnAdams
      Festive

      JohnAdams Member Benefactor Hall of Fame

      Location:
      Vatican
      Tinnitus Since:
      May 1st 2018
      Cause of Tinnitus:
      Aspirin Toxicity/Possibly Noise
      Yeah it is absolutely crazy.
       
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    18. Nick Ml

      Nick Ml Member

      Location:
      London UK
      Tinnitus Since:
      11/2019
      Cause of Tinnitus:
      cranial pressure from exercise, or water pressure
      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?
       
    19. Nick Ml

      Nick Ml Member

      Location:
      London UK
      Tinnitus Since:
      11/2019
      Cause of Tinnitus:
      cranial pressure from exercise, or water pressure
      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.
       
    20. Backpacker

      Backpacker Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      SSHL
      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)?
       
    21. AUTHOR
      AUTHOR
      scotty03874

      scotty03874 Member

      Location:
      Boston / Miami Beach
      Tinnitus Since:
      04/2019
      Cause of Tinnitus:
      Slap to the ear / Leading to more issues
      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...
       
    22. Backpacker

      Backpacker Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      SSHL
      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.
       
    23. Brian Newman

      Brian Newman Member

      Tinnitus Since:
      12/2016
      Cause of Tinnitus:
      Shooting/loud noise
      Is there anybody on these forums who actually has a PLF? I cannot find anybody.
       
    24. krs

      krs Member

      Tinnitus Since:
      07/2021
      Cause of Tinnitus:
      Barotrauma
      To my knowledge Dr. Sudhoff does that (Germany):

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