Deafness, tinnitus, otosclerosis and stapedectomy operation help needed.

[sparklefrog]

Hi.

I have otosclerosis in one ear, the other ear I had a stapedectomy operation on in 1988.
I have an employment tribunal coming up, due to developing tinnitus from working in an environment where there was a constant drone of an air conditioning unit where I worked. Since I have not been in the environment, my tinnitus has greatly improved, but I am worried about it worsening if I go back without ear defenders. (My ENT consultant told me it was probable that it would get worse if I returned without ear defenders)

My employer refused to provide me with ear protection of any kind, hence the tribunal.

Is it possible for tinnitus to be triggered by working in an environment of constant drone sort of noise for only 8 hrs, even if the noise levels are apparently within legal limits?
If someone is deaf in one ear, can they hear almost as well as a person with good hearing in two?
Are you supposed to refrain from exposing yourself to loud noises, and if so, for how long following a stapedectomy?
Can working in an environment of constant noise of minimum of 70dB trigger tinnitus, albeit temporarily after only 8 hrs?
How loud is 70dB equivalent to?

If you have any links to any answers on the above, it would be much appreciated.

Also, are you deaf in only one ear?
How does this affect your day to day living?

Hope you can help.

Thanks in advance.

I am an audiologist and will try to answer some of your questions.

"Is it possible for tinnitus to be triggered by working in an environment of constant drone sort of noise for only 8 hrs, even if the noise levels are apparently within legal limits?" - The level of the noise may be within the legal limits but this does not mean that it will not trigger your tinnitus. Also stress will make tinnitus worse and working in a noisey environment where you are straining to hear what others are saying will be a cause for your tinnitus being worse. So it might be that it is not the noise making it worse. But it also could well be the noise, some people have worse tinnitus when in silence and some get worse with noise. A helpful website would be british tinnitus association

If someone is deaf in one ear, can they hear almost as well as a person with good hearing in two? - In terms of level of hearing yes one ear is as good as two, but you lose the directionality ability of two ears. So if someone calls from behind or side you might mistake where the sound is coming from. With long-term unilateral (one-sided) hearing loss people can adapt very well and miss little, but in noisey situations unilateral hearing can be a big disadvantage, as it is harder to filter out the background noise from what you are trying to listen to. So although the level of hearing is ok, the ability to cope in a noisey envirionment is worse when you only have one ear to listen with. Bilateral hearing is a big advantage over unilateral hearing in this situation. see this website for information.

Are you supposed to refrain from exposing yourself to loud noises, and if so, for how long following a stapedectomy? - Ironically the otosclerosis, may actually be protecting your hearing!!! The otosclerosis reduces the amount of sound getting through and thus your noise exposure is less in the inner-ear (this is putting a little simplistically). In terms of refraining from loud noises, this should be done by everyone to protect their hearing. With a stapedectomy you should follow your doctors instructions regarding activities following the operation.

How loud is 70dB equivalent to? The level for noise is determined not only by the level but by the length of time you are in that noise level. So an impact noise level is different from an on-going level. this website might help or this government website might give you more information on the legal aspects. If you are being exposed to an overall daily personal noise exposure of less than 80 dB (A-weighted); then your employer does not have to act to provide protection. As described in this website

It is a bit complicated as the levels that are measured in industry are at dB (A) but when you are measured in hospital with your hearing test they are measuring dB (HL) HL standing for hearing level. To give you an idea of hearing levels in your hearing test, 20dB would be the level of a whisper at 1 meter away, 60dB is the level of normal spoken voice at the same distance, and 110dB would be the sound of a airplane jet engine at the same distance. 120dB would be the point at which it would be painful to listen.

I hope this is helpful.

Audiologistmum,

Thank you so much. That is so very very helpful.

I only wish I knew how to word my response. Looks like I'll be poring over my pc all weekend.

But thanks so much.

audiologistmum,

Sorry to bother you again

I wonder if you could clarify a few other points the Dr has made in his report?

He has said:
'cranial nerves were intact on both sides'.
'Rinne tuning fork test was positive in the left ear but negative in the right ear'
'Weber test was deviated to the right'

Impedance Studies

Tympanograms showed normal compliance on both sides. Ipsilateral reflexes were absent on both sides.

Oto-acoustic Emissions

Screening emissions were absent on both sides

Hope you can make some sense of this. I am baffled!

thinks how much easier this would be on msn

Cranial nerves testing - means that he checked for your nerves not showing damage that could indicate anything like a brain tumour. So them being intact means all is ok.

Rinne and weber tuning fork tests - these need to be interpreted alongside other tests, but this audiology website explains in detail, but basically as summarised there is either showing a false negative rinne test due to a mixed sensori-neural hearing loss or mixed (sensori-neural and conductive) loss on the left and a relatively normal cochlea (hearing organ) on the right side.

Tympanograms are looking at how mobile your eardrums are, and with normal compliance means that they are moving normally. Ipsilateral reflexes are looking at how the little bones (including the stapes) in the ear are moving, the fact that these reflexes are absent says they are not moving like they should do, in your case this is apparently due to otosclerosis, where the bones are fused and not moving correctly.

Oto-acoustic emissions - this is the test that is done on newborn babies to screen for any hearing loss, any hearing loss even very minimal will make them absent. so this suggests a hearing loss of some description in both ears, however some people have no oto-acoustics emissions naturally.

Looking at these results and from what you have said, I am guessing you have otosclerosis in the left ear!
Yet another website for you: this one is a general description of otosclerosis, I assume this has been explained to you, but just in case it has not this should help explain it.

I hope this has helped slightly, but feel free to ask more questions if it helps.

rainbowdays

That is so informative. Thank you so so much. This is so important to me.

I need to work out what the medical expert is saying in the report, so I can contest it. That is so helpful, far more helpful than the Dr who did the report has been.

You are right too, I have otosclerosis in my left ear. I had a stapedectomy in my right ear in 1988. Works really well!!

I wish you could see this report

The Dr said he does not believe the cause of my tinnitus was due to working in the noisy environment, because the noise levels were within the legal recommendations. (The employer carried out their own noise level survey)
Dr says he believes my tinnitus was caused by my susceptibility to having tinnitus anyway, due to my hearing loss, which I understand, but then he states that I do not have otosclerosis in my right ear. So what caused the tinnitus in that?

He says in his opinion, working in an alleged noisy environment only for one day is not long enough to cause damage.

My tinnitus is drastically improved, which it also says in the report, and has been much much better since I have not been at work.

I am trying to prevent myself getting tinnitus, which is why I wanted ear defenders in the first place. The comapny however will not provide the ear defenders.

Dr also says that because I have good hearing in my left ear, I am at no disadvantage to a person with 2 good ears. He has failed to mention that I find it difficult to hear in noisy surroundings or where there is background noise.

He also says "She has no hearing loss in either ear which could be attributed to noise or any other illness. Although she believes that her hearing had deterioration after working with her employer, the audiogram does not support this assertion"

PS: I have never experienced tinnitus before to my knowledge. The first time I realised I had tinnitus was after working in the environment all day. I'd not noticed any problems before then since I'd had my stapedectomy, and possibly not even before.(can't really remember )

I think that you might like to agree with him that the levels are not enough to damage your hearing, but point out that it is enough to trigger your tinnitus which in turn increases stress levels. Whether it is the noise directly or the strain of trying to hear in a noisy environment, it is clearly making your tinnitus worse and therefore your employers should enable you to be able to wear ear defenders safely if possible.

His statement is true that your hearing loss is not attributed to noise. Your hearing loss is due to otosclerosis! If he states you do not have otosclerosis in your right ear, for what reason would he give for you to have a stapedectomy in your right ear? It is a progressive condition, and having a stepedectomy does not necessarily stop the progress of the condition in the inner ear.... I am not sure under what grounds he could state this....

You are on dodgy ground trying to say that the working environment caused your tinnitus, this is probrably not true. I think that the docs statement that working in an alleged noisy environment for one day is not long enough to cause damage, is a fair statement for him to make.

Tinnitus is caused by loud noise, but it is not only caused by this. I think that it is more likely that you had the suseptability to tinnitus as the doc said. However, I think that you having tinnitus was instigated / made worse through the stress of having to deal with a hearing loss in an environment with background noise is a real one. The doc really should be taking into account the fact that you have a unilateral loss and that this does make a difference in background noise even if this noise is at a low (ish) level. Stress is a clear cause of tinnitus, and stress of straining trying to hear/listen is high.

hi
I had a stapedectomy about 8 wks ago and have a horrible metalic? numb sort of taste on my tongue and I find it hard to taste anything ...it feels like its never going to go away ? anyone else had this ...please tell me ! thanks Anne marie

I think that is fairly common annemarier, but it's been so long since I had my stapedectomy that I have long since forgotten.

Have you asked your ENT consultant about it?

ok thanks ...for how long ..omg its yuk ! I dont have an apt for anothe month ...maybe will go to the gp and see what he thnks before then

I'm not sure tbh.

Can you ring your ENT department and speak to a nurse there?

Hi ....Yeah I will once I get a day off ....I will post again when i hear more

well had my follow up and results are great except the taste is a complication that is quite common and they were surprised i wasnt warned or told prior ! and it is quite likely to be permanent ! omg I dont even want to believe that ...but the nerve thats affected is about ten cm long and it takes about 10 wk for it to grow 1 cm ! so I'm counting !!!