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Ear pain and ringing after hitting ear on water (and flying some days later)
Concerned1234 posted:
[a name=_GoBack> Hi.

A bit of history. I have had a minor level of tinnitus for over a decade, which came on suddenly after I ascended from a scuba dive (there was no obvious trauma that occurred).

In time, I became used to the tinnitus and only noticed when going to bed, and even then it caused little bother.

Just recently (28 Dec) I jumped into the water and slapped my right ear on the surface (from a low height, about 1m (3ft)). I immediately felt some pain.

From that moment it felt like my ear was slightly off, like it still had water in it. That feeling and some minor pain persisted. I swam continuously for a number of days after (with some duck-diving). There may have been some increased ringing, but I really don't remember particularly noticing it.

I eventually flew about one week after hitting my ear (2 Jan). To be honest, I had almost forgotten about the injury by that time. I don't recall having any problem equalising, but I do remember that I noticed my right ear hurt more when we landed and the ringing seemed louder.

This new distress caused me to go to the doctor the next day. He said the slap (or flying) did not puncture my ear drum (which looked fine), but that the canal looked a little red. He gave me ear drops (four days) for a likely infection (Kenacomb).

The drops blocked up my ear for some days and eventually when the drops were finished, a nurse syringed out any remaining drops that had stuck to my eardrum (11 Jan). This syringing also felt like it increased my ringing and disturbed me ear. They said at this point there was no real redness anymore.

Since this time, my right ear is still ringing much louder than my left ear and I am becoming quite bothered and concerned. I can hear it during the day, something I didn't have before. My right ear also hurts and I feel that it is more sensitive to loud noises. Hearing doesn't feel quite as good either - but I think it has improved.

I would love to know what might be going on? What damage could I have likely done and most importantly, when will the pain, sensitivity and ringing go down? The ringing is what is really bothering me.

Since I already have tinnitus, is this increased ringing just part of the original tinnitus that has flared up or it is from new damage? Does the fact I had already had tinnitus mean my chances of it returning to normal are better or worse?

I suspect, there are a number of questions that may not be answered, appreciate any input.

Thanks so much!
Rod Moser, PA, PhD responded:
In order for you to get closer to those answers, you are going to need to see an ENT specialist. Even then, it may be difficult for the ENT to determine the source (or sources) of your problem on a routine exam. The inner ear -- one possible source -- cannot be seen on exam. Sometimes, the "damage" is at a microscopic level and defies detection from even the prying eyes of an MRI.

There can literally be hundreds of causes of tinnitus, and tinnitus can change over time, even without new trauma. I would have absolutely no way of predicting if your symptoms will resolve since the source is unknown at this time. Making a tinnitus prognosis is even more challenging than finding a source.

You need a specialist on your team, so please see an ENT and start the evaluation process.
Concerned1234 replied to Rod Moser, PA, PhD's response:

Thank you so much for your response (and especially the speed of your response).

I have scheduled to see an ENT specialist.

Speaking generally, if there is no noticeable damage to the eardrum after slapping your ear on water (which is what started it all), how long might that recovery process take? At the moment it feels a bit tender, senstive to louder noise, little painful and a feeling of it being 'not quite right'. It also looks more red than the other ear at times (when it hurts the most).

Is this sort of trauma much different than a loud noise trauma?

Rod Moser, PA, PhD replied to Concerned1234's response:
Blunt force trauma is different than acoustic injury, but both can cause problems in the inner ear, or even rupture the round window (you can look this up to see a picture of this inner ear area). Both can rupture the eardrum, but yours is intact. That still does not mean there is not damage that cannot be seen. Just looking at the eardrum and trying to determine middle or inner damage is like looking at a window or door after a hurricane and trying to determine damage inside the house.

Because most of your symptoms seem to be related to recent events, you do have a good chance of a full recovery, but usually not from a medical intervention, but rather from natural healing over time. Many ENTs will suggest a short course of steroids, assuming that inflammation is involved (possible), so if this is suggested, try it.

Please keep me posted and I hope that your ENT visit is helpful.

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