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Thursday, July 24, 2014
Ear, Nose, and Throat Disorders
Re: Dizziness and pressure behind the right ear
For the past two months I`ve been having a feeling of dizziness (not true vertigo, more like a sense of wearing the wrong prescription glasses) and pressure behind my right ear and in my neck on the right side. Occasional mild ear pain and occasional, very short episodes of ringing (hearing a tone) in my right ear. I have had a neurological evaluation, a head CT scan and also been checked by an ENT doctor, and no abnormalities were found. My hearing test was normal, although I did hear somewhat less well on the right side. I have chronic sinusitis and have had several external ear infections on the right side, many instances where my ear was full and I couldn`t hear out of it for a couple of days and lots of itching. I also used to let shower water run into my ears often, because it helped with the itching, and my sense is that the dizziness is made worse when I get water in my ears. Is it possible to have a perforated ear drum or some kind of chronic infection that is not picked up by a regular ear examination?
At this point, its definitely worth getting another evaluation by an ENT physician. Sometimes, exams can change over time and something that wasn't apparent at an initial evaluation can now be more evident. Also, observing a patient over time can provide you with additional history that can make the diagnosis clearer. Symptoms of dizziness, difficulty hearing, pressure in the ear and tinnitus are part of the symptoms complex that be involved with things like meniere's disease, inner ear inflammation, viral inner ear infections, etc. Work up for such problems might include specific balance and inner ear vestibular tests such as an electronystagmography, platform posturography and rotary chair testing. A thorough microscopic ear exam is also fairly routine for your symptom evaluation. Its clearly worthwhile to continue pursuing medical attention and a diagnosis.
Daniel Choo, MD
Associate Professor and Director, Division of Otology/Neurotology
College of Medicine
University of Cincinnati