Would The Balance Disorders More Likley Than Not Be A Result Of These Injuries?

Brief Answer:
Need to rule out other age related causes of imbalance

Detailed Answer:
Hi,

Thank you for reaching out with your query.

I have carefully reviewed your concerns, and I can provide you with some important insights.

1. It is quite rare for the symptoms resulting from a perilymph fistula, such as imbalance, to persist for an extended period. If the leak had been identified and treated promptly—whether medically or surgically—the symptoms of imbalance would typically resolve. However, in some cases, even after surgical repair, individuals may experience residual symptoms for many years. Therefore, a thorough re-evaluation is essential to determine the current cause of your imbalance.

2. If the fistula was well managed before and you were symptom-free, then, the present cause of your imbalance may be linked to a range of other conditions, such as cervical spine disorders, fluctuations in blood pressure/blood sugar levels, electrolyte imbalances, or positional vertigo. Hence, a comprehensive evaluation is crucial to identify the underlying issue.

I trust this addresses your query effectively. If you have any further questions, please don’t hesitate to reach out.

Best regards,
Dr. Naveen Kumar N
ENT Head & Neck Surgeon

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Brief Answer:
Ménière’s disease may be responsible for your symptoms.

Detailed Answer:
Hi,

Thank you for reaching out and sharing your concerns with me. I understand how distressing your symptoms can be, and I’m here to help.

Based on the detailed history you've provided, it seems clear what might be causing your symptoms. I want to take a moment to clarify my earlier thoughts.

The symptoms you’ve described align closely with a condition known as Ménière’s disease. This condition occurs when the fluids in the inner ear, specifically the perilymph and endolymph, mix. The cochlea in the inner ear functions like two tubes, one inside the other, each filled with different types of fluid.

Occasionally, due to pressure changes within the inner ear, there can be a rupture in the wall of the inner tube, leading to a mixing of these fluids. When this happens, it can cause an electrolyte imbalance, resulting in sudden dizziness, tinnitus, and a decrease in hearing. These episodes can vary in duration, lasting anywhere from 20 minutes to 24 hours. It's important to note that Ménière’s disease often presents itself during one’s thirties to fifties.

Considering your situation, including the history of trauma, your symptoms, and your age, it appears likely that you are experiencing Ménière’s disease. I genuinely regret any initial confusion in my response; with a clearer understanding of your case now, I see how the head injury you experienced may have contributed to your current condition. I can only imagine how challenging it must be to cope with tinnitus and hearing loss.

Moving forward, I encourage you to pursue further audiological evaluation to confirm this diagnosis and to discuss medication that might help prevent future episodes.

Additionally, adopting preventive measures, such as a salt-restricted diet, engaging in cognitive-behavioral therapy to manage stress, and avoiding strenuous activities, could be beneficial.

Please know that I'm here to support you, and I truly wish you the best. If you have any more questions or concerns, don’t hesitate to reach out.

Wishing you good health and comfort.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

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Brief Answer:
Tinnitus is a result of damage to the sensitive nerves in the inner ear

Detailed Answer:
Hi,

Welcome back!

Tinnitus is a result of damage to the sensitive nerves in the inner ear, usually following a perilymph fistula. Unfortunately, this damage is permanent, which means tinnitus can persist indefinitely after the trauma.

Additionally, age-related changes can lead to pressure variations within the inner ear. This can cause the weak wall of the innermost tube, which contains the endolymph, to rupture frequently. The mixing of endolymph and perilymph can create an electrolyte imbalance, resulting in dizziness.

Furthermore, damage to the hearing-sensitive nerves occurs due to the gradient variations caused by this fluid mixing. This, in turn, leads to tinnitus and a decline in hearing ability.

Once the wall of the inner tube is repaired and the pressure stabilizes, symptoms will begin to improve. This process can take anywhere from 20 minutes to 24 hours.

As your symptoms improve, you may experience a sense of fullness in the ear due to residual electrolyte imbalance. Rest assured, this will ultimately pass as your body works to normalize the electrolyte content in both the inner and outer tubes.

Our primary goal is to maintain stable pressure within the inner ear (cochlea). In my previous message, I outlined various methods to achieve this.

I hope this clarifies any questions you may have had.

Wishing you good health!

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

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