Normal Audiogram---What Should I Do?

[tripsplus6]

My Audiogram was normal.  I can't hear as well out of Rt. ear, but both fell within normal limits.  I had had sudden onset one day in June of pressure, fullness, extreme tinnitus, diminished hearing,some vertigo.  Antibiotics did not take symptoms away.  Saw ENT, no fluid, just pressure, and gave me steroid nasal spray to use for 2 weeks to reduce pressure for more accurate audiogram.  During that 2 weeks, I developed some slight numbness feeling around ear and Rt. face.  He said the spray would not cause that and was very concerned, as I also have some very slight drooping of rt. eyelid for several months, and one or two episodes of double vision, just for a minute or so, neck pain.  Have had the tinnitus for a few years though, and occasional very short (minutes) bouts of vertigo (the spinning), some bad headaches.  Anyway, ENT felt I would need an MRI, but when he saw normal audiogram, he said he would have a hard time ordering it with such a normal audiogram.  Said to keep him posted on symptoms, that he was depending on me to let him know how I'm doing and if I get worse, etc. 
     Ok guys, how many of you had good hearing and normal audiogram?  If this is anything worrisome, what should I look for, what can I expect would be getting worse, and for what symptoms would you call back about?   Thanks.         Terri

[jtd71465]

My hearing was muffled one day.  My ENT started my on Prednisone and my hearing returned to normal, I followed that with an MRI and my AN was discovered.  Please have an MRI to rule out an AN.  I didn't want to have the MRI done, but the ENT stated that he could tell me the closet was empty but until we opened the door we would never know for certain.

Joe-

[GM]

You would need an MRI with contrast to find a AN....if you are uncomfortable with the diagnosis...my suggestion would be to press for the MRI.  Until they do the MRI the findings are really inconclusive.  A good hearing test does not say why you’re having the other symptoms.

GM

[susier]

My symptoms were very similar to yours.  I was sent to an ENT by my GP to rule out inner ear infection.  My hearing tests came back 100%, but because of the dizziness, she ordered 2 MRI's (brain/iac).  After a week of fighting with my insurance company, the tests were finally authorized... and voila...a tiny white dot appeared on my right ear.  I would advise the MRI.

[linnilue]

My hearing was perfectly normal even wehn I had multiple symptoms of an AN.  My neurologist insisted on an MRI and the aN was diagnosed.  I continued to have normal hearing for four months after the linac radiationa nd then one night I lost most of my hearing out of the AN ear.  I took steroids but barely got anything back.  So, I say to you, insist on the MRI to rule out an acoustic.

[Sam Rush]

You may or may not have a AN, but you have at least 3 reasons for an MRI:

Double vision...droopy face...persistant vertigo..


You could have a meningioma of the internal jugular foramen,  Aneuyrism, Multiple sclerosis,   Benign positional vertigo with some element of Bell's palsy,  migraine variant,  myesthenia gravis.  or others.

You absolutely need an MRI, AND a good internal medicine eval. AND a good neurologist to review your case....soon.!!!  Waiting is not for you, because you don't know what you're waiting for.

Stand up for yourself, have your primary care fight for you.

Don't mean to scare you, but you need to know if you have something that requires treatment  now or not. If it's a small AN w/ normal hearing, then watch and wait. If nothing shows up, then you will be free of all this anxiety,

Show your DR. and ins. co. this post. If they can think of a reason not to do an MRI, let me know.

Best Wishes

Sam

[tony]

There is a compromise check that can be done - speech discrimination test
This is still a hearing test - but it checks what you can understand
The pure tone test is not that helpful where you have "distorted" sound
many ANers do quite well on the pure tone - but have trouble hearing
what people are saying
Cheaper than an MRI so less chance of Doc/Insurance/Cost issues ?
Just a thought
Best Regards
Tony

[4cm in Pacific Northwest]

Terri,

In 2002 I complained to my PCP about ringing in the ears, fatigue etc. All blood work came back normal- and he suggested I see a “stress therapist�. I asked he refer me to an ENT and he did not.

Now my insurance does not require a PCP referral to see a specialist. I also discovered I can just switch doctors… which I did.

This past year I still had symptoms … ringing in the ears etc. I became more proactive... My wellness check up with the ‘new’ PCP showed a very marginal hearing loss with there in-house-small-town-clinic type very-basic-tester. I asked to be referred to an ENT (I would have gone even if he did not comply- but this new PCP respectfully and happily did.) More advance audio tests still in normal limits with very slight loss in the higher frequencies of one ear. Word recognition was still 100%

ENT says lets just do an MRI and test for this rare bizarre rare thing “just in case� … May 2007 I get “the phone-call�… I have a 4cm Acoustic Neuroma (no typo of mm yes 4 'CM'). Radiation is no longer an option – just surgery from here on in … and out -as it is pressing into the brain stem. I also tested perfect for balance and facial sensations etc. so these were not outward or obvious signs either (just me feeling not so great and trying to convince a doctor of such).

Don’t repeat my big mistakes- but please learn from these. If you have a ‘gut feeling’ that something is not right listen to yourself (and your body). Find another doctor who will do the MRI. …

If you have it done, and you don’t get “the phone-call� of alarming news after MRI … then you can push forward with some 'peace of mind'.

Terri you wrote “If this is anything worrisome, what should I look for…?�

My reply would be “another doctor� ...

4CM in the PNW

[OTO]

Tripsplus6 - Get the MRI or get another ENT...  My ENT said my symptoms (sudden loss of hearing, fullness feeling in ear, tired feeling in cheek/face and tinnitus) were probably a viral inner ear infection, but just in case he ordered the MRI.   He said he just wanted to rule out an AN (eventhough it was rare), he just wanted to be sure...  and lo and behold there it was....

[sgerrard]

Maybe you can get your ENT to refer you to clinic for vestibular testing. I had it done after my diagnosis, and it revealed additional information about the vestibular nerve, the other branch of the VIII nerve. The balance nerve has two parts, and they can do tests that assess both parts. One test looks at a reflex in your neck, and tests the part of the balance nerve that is the most common origin of ANs. It is called VEMP, which stands for the grand title of Vestibular Evoked Myogenic Potential (I'm reading this off the report). There is also a Caloric test, where they put cold and hot water in each ear, and monitor your eye movements. A difference between the two ears can indicate something going on with the balance nerve.

It is really a counterpart to the hearing audiogram, and I assume it is less expensive than an MRI, so it might be worth finding out. If it shows something, that should provide enough basis for an MRI, I would think.

Steve

[Pembo]

Terri, I would definitely see another ENT and get an MRI. I think we've already talked by email?! I recommend my doc, Dr Megerian. At least get a second opinion from him about your symptoms.

[Richey]

Terri, I went to an ENT for a couple of months and he missed my AN, Thought it was something else and was recommending surgery for that condition. Well I went to an Ear specialist for a second opinion and the first thing he mentioned was that I could have an AN and that we needed to rule that out with an MRI with Contrast. Go see another doctor. We are all hoping that you do not have an AN but you sure do have a good number of symptoms. When I went to that ear spec. my hearing on the AN side was good but I was having the off balance and full headed feelings.

[tatianne]

chances are you dont have an AN, my doctor told me that out of 100 patients that present with these symptoms only 2 or 3 get a pausitive MRI. He told me that I would have more chances of getting into a bad car accident on the way home then having an AN...well I was one of the 2 or 3...He told me that with these symptoms its protocol to order an MRI and it would be irresponsible of him to not take the extra step. Chances are sweetie that your one of the 97, but I think its necessary to check it out anyways. These ANs are very treatable and the smaller it is the more options you will have. Dont wait, have it done.
Let us know when your negative results come in so we can celebrate with you.
T

[amymeri]

I had completely normal hearing on both sides one week before my surgery to remove a 4cm AN. 

Speech discrimination-Normal

ONLY symptom was very mild facial numbness on my right side near my chin, lip and cheek.  I completely passed the cranial nerve testing.  I could discriminate light and sharp touch, hot and cold, etc.

But I KNEW something was not right.  My doctors all thought I was imagining it.

I wish I had been 


Have the MRI.

[Jim Scott]

Hi, Terri:

I'll simply add my voice to the chorus advising you to convince either your ENT or PCP to order an MRI.  Your symptoms certainly warrant having this scan performed.  Apparently, some ENT physicians are reluctant to order MRI scans due to insurance company hassles and so on.  Don't allow that to be an insurmountable obstacle.  Talk to your doctor.   

I wouldn't allow a normal audiogram to deter you from seeking out the cause of your profound symptoms.  We all respect physicians here but in the final analysis, it's our health and our bodies at risk.  We must be proactive in seeking answers and not allow a detached physician, competent as he or she may be in their field, or an insurance company bureaucrat, for that matter, to decide whether our very real and troublesome symptoms can be basically ignored or explained away.  An MRI (with contrast) is the logical next step you must take to find out if you have an acoustic neuroma (or anything else) as the cause of your symptoms.  I trust you'll find a way to get this test performed as soon as possible.  Whether it shows good news (nothing) or not, at least you'll have the information you need to make an informed decision regarding your health care in this instance. 

Please do what has to be done, Terri.  We care about you and look forward to reading about your journey in this forum.  Try to stay connected.



Jim