Ear Problems (Including hearing) Archives

Conductive vs. Sensorineural Hearing Loss

Dr. Stoll,
I am sorry to hear of the situation in which you find yourself professionally and commend you on still helping people with their medical questions. I would appreciate any help you can offer with the following problem.
Over the last 2-3 months I noticed decreased hearing in my right ear, accompanied by a feeling of fullness in my ear. In addition, I noticed that I felt unable to clear the same ear by pinching my nose and blowing to "pop" my ears. Since I was not congested and have no history of allergies, we decided to have a hearing test conducted at a hearing center owned by an audiologist. Video otoscopic inspection indicated a normal typanic membrane,no blockage by wax, and no obvious fluid behind the eardrum. The results of the air conduction audiogram were 50db at 250hz(35db below my left ear),45db at 500,40 at 1000,20 at 2000, 10 at 3000, etc. until going back down to 40 at 8000. These findings were at approx 20db lower than an audiogram done 5 years prior at age 26. He then performed a bone conduction audiogram which indicated normal nerve performance. He pronounced my hearing loss "conductive" but referred me to an ENT. We even had a second free audiogram by our GP's office which mirrored these results. The well-respected ENT did not give me a hearing test, but looked at the results I brought with me, inspected my ear with an otoscope then with a very large microscope. To sum up what I could understand from my hurried visit: the problem of my ears clearing was unrelated to my hearing loss, my hearing loss was still conductive due to a problem with my middle ear bones, most likely otosclerosis, and would require surgery "lifting my eardrum, and tapping on the bones to see if the stapes was fixated" to even determine the problem and then doing a stapedectomy. For my ear clearing he gave me a prescription for Prednisone for 3 days and said it was a test to see if it would help me to clear prior to my plane flights for an upcoming trip. Needless to say I was concerned at the thought of opening my ear drum for exploratory surgery so we asked an audiologist friend of the family who sent us to the university speech and hearing clinic to have their audiologist do a tympanogram. The results of this test indicated "normal middle ear function bilaterally", ie no eustachian tube dysfunction, no otosclerosis. Further acoustic reflex show the problem to be sensorineural. Now (finally) to my question(s). Why the contradiction between what are supposed to be fairly straight forward tests? From our research it seems that low frequency loss as seen in the air conduction audiograms is associated with conductive loss, and bone conduction audiograms that are normal indicate no sensorineural loss. However, this is totally contradicted by the typanogram results which show sensorineural loss but no conductive dysfunction! We are so tired of this roller coaster ride and each new professional we see seems to contradict the previous' findings. Can you help, please? Thank you and apologies for the lengthy case history.

Follow Ups:

• Re: Conductive vs. Sensorineural Hearing Loss (Archive in ears.) Walt Stoll 09:32:29 10/24/02 (0)

In Reply to: Conductive vs. Sensorineural Hearing Loss posted by Confused by conflicting information on October 23, 2002 at 11:44:36:

Hi, Confused.

This is an example of how primitive our current testing procedures really are. Allopathic medicine has vastly oversold it's expertise.

It is time for you to go outside the allopathic paradigm and see a good acupuncturist. This just might resolve the problem without any further procedure at all.

Let us know what happens. Your results will likely suggest the next step to try.

Walt