Help Interpreting my Audiogram Results and associated symptoms

Hi everyone,

I have currently inexplicable hearing loss and I was wondering if you could tell me what you think might be going on? My audiologist said I MIGHT be seeing an ENT if they want to see me, but I am a 35 year old woman who has no clue what is going on with my hearing. It started at about 30, went to audiologist at 32. Was told I had sensorineural loss mild to moderate, more pronounced in my right ear. Had an MRI to confirm that I didn’t have an acoustic neuroma. Just went back for my 3 yearly check up and had the following audiogram results:

Air conduction - 250 500 1k 2k 3k 4k 6k 8k

R - 45 50 45 40 50 45 50 65

L - 45 55 55 45 40 40 35 45

Bone conduction - 500 1k 2k 3k 4k

R - 35 40 35 30 20

L - 35 35 45 35 25

I have tinnitus, mainly in my right ear and apparently my ear drums don’t move as freely as they should.

Any help you can give would be great thanks.

audiologist said I MIGHT be seeing an ENT if they want to see me, but I am a 35 year old woman who has no clue what is going on with my hearing.

Then see an ENT without the “approval” of the Aud

I don’t think that is possible without a referral unfortunately. I am going to another clinic to get a test on Friday as I just got a copy of my previous audiogram and according to it I will have lost quite a few decibels in most frequencies over three years. In one case, 25 dbl at 8k! I think maybe I was tired or not concentrating so I am going to see if I can do better haha

Most losses are age related and have a different profile from your relatively flat loss. It isn’t the ear drum but the fine hairs that gather noises. When they are damaged there is no method of repair/treatment. Loss like yours is often due to infections or ototoxic drugs. Ototoxic drugs include most that end with mycin to common OTC drugs like aspirin. Search the net to find a list of them. Doctors can ignore the ototoxic side effect and you need to be aware of them and try to avoid them in the future.

It would help to see an ENT annually. Also, see one immediately if you hearing quickly worsens. Treating a sudden/rapid loss must be done immediately. If your balance is affected, get referred to a neurologist.

sorry to be so blunt but you would rather take the advice of someone who has never seen you, have no idea of any of their qualification and posts anonymously on a internet board? well ok

Yes, that is very blunt and unnecessary. I am taking steps to find out what is going on through non ‘internet board’ channels, but was wondering if anyone had input in the meantime that I could use to help steer my research in a relatively new subject area.

I’m sure you had my best interests at heart instead of wanting to just come across as snarky…I think.

Thanks, I will have a look into that. I don’t normally take any sort of pills so I am not sure if it could be that, but I appreciate the steer. The audiologist seemed unconcerned and said in situations like this the hearing usually levels out. It was only when I plotted the two years on the same chart that I saw such a marked difference at many of the frequencies. He mentioned otosclerosis but that was before he did a tympanometry that indicated less mobility in my eardrums. It doesn’t look to me like that is related to otosclerosis and would more likely be fluid in the middle ear.

You can take a test and then retest and they can easily vary 10db for a variety of reasons. It can be fatigue, virus, allergies, and even time of day. With your loss level it is something to follow but don’t be overly concerned. Just watch it for future problems.

So how did you get the MRI without a referral from an ENT? If you haven’t seen one, do so. You have several red flags that should of gotten you a referral to an ENT when you originally went to the audiologist. If they don’t want to refer you, find another audiologist who will.

I know it sucks to lose some of your hearing especially at a young age. Anything you get on the internet is going to be mere speculation. I would recommend seeing an ENT ( usually you seen an ENT before seeing an audiologist, at least it was in my case…) Hopefully the ENT can rule out any medical condition that could affect your hearing. That would be step 1 IMHO. Are you currently wearing hearing aids? If not, that would be step 2. Then I would have my hearing tested every 6 months to a year to ensure there are no further DRASTIC changes. Hearing test results can vary for a number of reasons. The machine might not be properly calibrated, you could be congested, etc. Costco does free hearing tests and I’ve been told their machines are calibrated at least once a year.

I initially went to my GP with concerns about hearing 3 years ago, he referred me to the audiologist, because of the unilateral loss and tinnitus, she referred me directly for the MRI. That came back negative, so I went back to the audiologist and was fitted with hearing aids. I went back on Monday and the Dr I saw said that he would refer me to an ENT and they would look at my record and see if they want to call me in.

What red flags do you mean specifically? I am thinking the big dip in some of my air conduction thresholds was because of tinnitus, but I will see at my next test.

Thanks!

The red flags I was referring to was: sudden hearing loss at age 30 and the large difference between air and bone conduction. Have you had any children? If so did your hearing loss get worse during or after the pregnancy?

Hi,

No I haven’t had any children, but the audiologist mentioned that. To make the whole situation more peculiar, I went to look into private hearing aids yesterday and so had another hearing test. In my left ear, BOTH of my thresholds had changed significantly (from last Monday), bone threshold going from approx 35/40 to 20/25 and my air conduction going down by almost 20dbl at some frequencies , putting me around 60/70 I think (I am waiting for him to email me the results). Now, we ran out of time so we didn’t get to do the bone threshold for my right ear and no masking for my left so I don’t know what that would do to my bone threshold, but both results still seem impossible.

I even went in thinking that I would probably improve a bit in some frequencies because there were a couple of times I didn’t press the button at the audiologist last Monday when I wasn’t sure if I heard something (I have tinnitus). I was determined to press at any sign of a tone and I was beeping away like a mad woman haha We actually had to stop and do it again because I think I was beeping at nothing. The audiologist then did it again with a warbled noise (although to be honest it sounded no different to me) and he said those results were within 5dbl of the non-warbled he had just done. This was the air-conduction test.

I have NO clue how my b-c could have changed so much. I mean, it’s great, I would rather it be higher, but it makes me call into question anything that has been done. I told the second audiologist that the first said my ear drums didn’t move as much as they should had he hypothesised that perhaps because he was going from tone to tone quite quickly (he really was and quite predictably it felt) perhaps my ear drum didn’t have time to ‘reset’ (my word not his, can’t remember what he said exactly) before he went to the next tone, meaning I was missing some.

I am calling to see if I am getting an appointment with the ENT and if no, beg, but I feel a bit like a crazy woman! I now wish I had never gone to look at the private hearing aids. Any idea how on earth this can happen? The only think I read about that causes fluctuating sensorineural loss is Menieres, but I definitely don’t have that since I have no vertigo or dizziness.

Thanks for listening to my rant!

Where are you located? I never heard of an AuD ordering an MRI. Heres what i would do… go back to your primary care and tell your story and get a referral to an ENT. Tell about the MRI how was it done?

Hi, I am in Scotland. I am going to contact the audiology dept today to see if the ENT is wanting to see me and if they don’t know I will find out how to get referred or self refer. The MRI was held at one of the main hospitals in the area, just run of the mill MRI, I imagine, although there was no injection (if that is something that is done sometimes).

Did your MRI include being slid inside a large tube and then loud multiple pounding sounds?

Clinical scientists in the NHS have greater direct referral power - if the loss is fluctuating massively the MRI could be commissioned to rule out all unusual pathothogy/acoustic neuroma. The result would then be passed to an ENT consultant - it saves wasting an ENT appointment just for the ENT to request an MRI.

http://hearinginstitute.ca/2016/06/16/ent-vs-audiologist/

This is meaningless in the UK.

Yes, I thought that was the only kind?