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List of Questions Respected doctor,
Thanks. For the past few days I have been regulary reading your site. I am really elated by your service.
As you told me in the previous mail to send my photos, i hereby send the scanned photos of my CT for your kind perusal and kind guidance.
I am aged 36. No history of HT,DM. Known MVPS-No MR. Tall,thin built structure. Had episodes of vague chest pains, anxiety, panics, breathlessness, dizziness before. Everything attributed to my MVPS be docs and nothing to worry..
Tested at the age of 15 (in 1987) for hearing, when I can't listen over phone in my RIGHT ear.
Dr. S in chennai tested me and told it is may be sensorineural due to ototoxic drugs taken by me during childhood nothing can be done other that vitamin tablets. I don't remember test done by him.
In 1993 had severe nasal block due to congestion and unable to breathe through nose. Suffered for nearly 5 years and got relieved by anti-allergic drugs. No sniffling, running nose, itching other
than enlarged turbinates as told by ENT docs. Never minded about my ear problem as I my loss is moderate.
In 2003 took PTA recommened by Dr.SV which should right ear moderate conductive hearing loss with high frequency slope.
NO significant difference in hearing loss noted by me. Typanogram revealed "B" type with reflex
absent in the right ear.(left ear "A" type). ENT Doc prescibed anitbiotics for few days. No ear pain,
fever, otorrhea, otalgia.
I repeated in 2005 and 2007 took PTA showed the same result with right ear,tympo again showing "B" type. Doc said nothing to
worry other that antibiotics. No symptoms at all related to ear.
Recently tested in 2009 december which showed mixed hearing loss(moderate to severe - actually I find no difference in hearing) and flat "B" type in right ear.
Dr.SV told nothing to worry other than taking neurobion tablets. Due to my persistent enquiry he
advised me to check in an ENT hospital. There in the ENT hospital a lady ENT doc checked my ear, and advised to repeat PTA,tmpo and CT Para nasal sinus and temporal bone. Her initial diagnosis was otosclerosis.
After a week i took the above mentioned CT. The results are as follows:
TEMPORAL BONE
HRCT study of temporal bone in the axial and coronal plane
Soft tissue densities noted in right tympanic cavity.
Mastoid air cells on right side are sclerosed
Epi, meso and hypotympanum appear normal on left side.
scutum appears normal
The middle ear ossicles appear normal bilaterally. No evidence of bony destruction/discontinuity.
Bony cochlea, Vesitbule and semicircular canals appear normal on both sides. No evidence of bony destruction.
Internal auditory canals and internal auditory meati appear normal.
carotid and facial nerve canals appear normal on both sides
cerebellopontine angle cisterns appear normal. No evidence of mass lesion seen
Eustachian canals appear normal bilaterally
The carotid canal appears normal bilaterally
External auditory canal appears normal bilaterally.
The nasopharynx appears normal
Soft tissue appears normal.
IMPRESSION
Soft tissue densities in tympanic cavity with sclerosed mastoids air cells in the right side -
suggestive of chronic otomastoiditis
PARANASAL SINUS
Plain axial and coronal study of the paranasal sinuses.
Mucosal thickening noted in bilateral sphenoid sinuses.
Mucosal thickening noted in bilateral maxillary antrn.
Mild nasal spetal deviation in the left.
Paradoxical convexity of left middle turbinate
The hiatus semilunares, uncinate processes, infundibula bullae ethmoidales are normal on both sides.
The anterior and posterior ethmoidal air cells are normal.
The frontal sinuses and their recesses are normal.
The cribriform plates, crista galli and fovea ethmoidales are normal.
The optic canals and the position of the cavernous carotids with respect to the sphenoid sinus
are within normal limits.
The orbits and their contents are normal.
No significant anatomic variations seen.
IMPRESSION
Mild nasal septal deviation to the left.
Mucosal thickening in bilateral maxillary and sphenoid sinuses likely inflammatory.
PHYSICAL FINDINGS
AS TOLD BY THE DOCTORS SO FAR MY TM IS NORMAL
PRESENT CONDITIONS
NO EAR DISCHARGE, PAIN TILL DATE
NO PAIN OR SWELLING IN THE MASTOID REGION TILL DATE.
VERY RARE TINITTUS(NOT PULSATING) FELT IN THE RIGHT EAR FOR A FEW SECS.
YESTERDAY AND TODAY NOTICED TINNITTUS MODERATE FOR FEW SECS IN THE NORMAL LEFT EAR. FEELING OF VERY VERY LOW HISSING SOUND IN THE LEFT EAR WHEN FOCUSSED ON THE SOUND OR WHEN CLOSING BOTH EARS ALONG WITH GENERAL NOISE HUSH NOISE WHEN EARS ARE CLOSED (ONLY FELT TODAY - MAY BE I WOULD ALWAYS HAD IT. BUT NEVER NOTICED IT)
ON AND OFF HAD A FEELING OF JERKY OR FALLING DOWN SENSATION (YEARS TOGETHER) AS IF WHEN WE FEEL WHEN WE MERRY-GO-ROUND (MOSTLY WHILE COMING OUT LIFTS AND OTHER TIMES) THOUGHT IT MAY BE DUE TO MY MYPS OR LOW B.P. BY DOCTORS
NO UNSTEADY GAIT OR CLASSICAL SPINNING VERTIGO TYPE. NO FELL DOWN SO FAR.
NO FREQUENT HEADACHES OTHER THAN MILD DUE TO JOB STRESS.
CURRENT TREATMENT PRESCRIBED FOR ME IN THE ENT HOSPITAL
FLUXINASE NASAL SPRAY 2 PUFFS TWICE DAILY
DESLOR 5MG IN THE NIGHT.
ADVISED TO COME AND MEET AFTER A MONTH (LET US TAKE TYMPO TO FIND A TYPE) AND NOT TO WORRY ABOUT THE CT.
MY QUERIES
1. DO I HAVE CHRONIC MASTOIDITIES? IF SO WHAT IS THE TREATMENT?
2. WHAT IS MENTIONED AS SOFT TISSUE DESITY? NEITHER THE ENT DR NOR THE RADIOLOGIST SAID IT IS NOT A MASS OR LESSION. THEN WHAT IT IS ?
3. WHY MY TMPO ALWAYS SHOWS B TYPE IN THE RIGHT EAR?
WHAT SHOULD BE MY NEXT COURSE OF ACTION?
ATTACHING MY SCANPHOTOS AS ZIP FILE
with regards
m.venkatsuresh
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