Ask a doctor on the topic of Otorhinolaryngology

Sudden deafness and neck problems with potentially serious causes?

October 3, 2015 | 50,00 EUR | answered by Christian Welsch

Hello,
I was diagnosed with sudden hearing loss on the left side, initially about 80% hearing loss at high and mid frequencies.
Unfortunately, I neglected it quite a bit because I also had significant neck problems around the same time as the hearing loss, and my neck always affects my ears - neck pain for me usually comes with ear pain or a dull pressure in the ears. I initially tried to manage the neck problems with massages and chiropractic care, but without much success. I only thought about visiting an ENT doctor for my ear after about 3 months, initially thinking I just wanted to get it checked out, but it turned out differently.
I am being treated with Prednisolone in decreasing doses, starting at 200mg, and I am now at 25mg today.
In the last hearing test this past Tuesday, there was a slight improvement, but only by (depending on the frequency) 10-15%, and I don't subjectively notice it yet.
I am very satisfied with my doctor and feel well taken care of, but I am currently experiencing significant anxiety that there could be a more serious underlying cause, and since it is the weekend, I wanted to ask for advice here.
The symptoms continue to be those of sudden hearing loss, worse hearing on the left side, some ringing in the ear, as if holding a seashell to it, and a dull feeling.
I also hear high voices somewhat metallic and slightly doubled, but high tones in myself are fine, while low tones are slightly doubled (I noticed this when whistling). I have the impression that this is already improving somewhat.
At the same time, the neck problems persist (especially in the area where the neck muscles attach to the skull) - and both conditions affect each other. Both are better in the morning and worsen throughout the day, just a few hours after waking up. Heat, for example through bathing or rubbing, temporarily improves the symptoms. Of course, it could also just make you feel more comfortable and therefore less noticeable.
Sometimes I also have a momentary sensation as if "something is popping in my ear."
At the same time, I also feel a bit sluggish, which I attribute to the side effects of Prednisolone. Initially, in the first two days, Prednisolone made me more jittery, but after that more sluggish, and I also experienced stomach problems (for which I was given Omeprazole 40mg for stomach protection).
I am also a bit unfocused, although compared to days 3-5 of treatment, this has already improved.
In addition to the medication for sudden hearing loss, I take Thyroxine 175mg daily for hypothyroidism and Levetiracetam (2x1000mg daily) for newly diagnosed epilepsy four years ago.
I am male, 38 years old, and significantly overweight.

Now I have the following questions:
1. As mentioned above, I suddenly

Christian Welsch

Dear inquirer,

1. I always tell my patients that I have been practicing ENT for 16 years, and I often have to deal with such fears. I may have treated a few thousand patients during that time, but I have never seen a patient develop tinnitus from a malignant brain tumor. A glioblastoma would definitely come with additional neurological impairments. Benign tumors of the auditory nerve (such as acoustic neuromas) are extremely rare as a cause, which is why a brainstem auditory evoked response test (ABR) should be done for every tinnitus patient to rule out an organic cause. If the results are inconclusive, the next step would be a head MRI, which in 99.9999999999999% of cases also does not show anything. I follow this protocol with almost every patient and in the aforementioned time, I have only found about 5 patients who have something like this. Ear noises and sudden hearing loss have a high psychosomatic component both in their development and processing; the more attention they pay to the symptoms, the worse they are perceived.

2. It is often debated whether cervical spine problems can lead to tinnitus. From my personal experience, psychological issues, especially stress, can lead to neck tension, hearing impairment, and tinnitus. It is therefore a cause of 2 symptoms. Loosening the tension with massage would be beneficial, but usually one would need to find a doctor first (unless they are privately insured) who still provides this service in times of cost controls (you could ask an orthopedist). If medication does not help, infusion therapy or cortisone injections into the middle ear are still possible. Sometimes acupuncture can be helpful as well. However, mental health is the most important.

Do you have any further questions? Regards, C. Welsch