A patient comes to you complaining of hearing loss. He says that ever since he "caught a cold which worsened his allergies," he feels like his hearing is muffled, almost like he's under water. He can "pop" his ears and then they sound normal for a while. On exam, you see that the tympanic membrane is retracted without moving properly.
Challenge: What's your treatment of choice?
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Hear Hear
This is eustachian tube dysfunction, which is a cause of perceived hearing loss. Initial treatment is with a decongestant, and possibly an oral antihistamine or a topical nasal steroid.
Sources: UpToDate; Wikipedia.
Craig- if ET dysfunction continues inspite of decongestants, antihistamine and topical nasal steroid, I will go to P.O. prednisone(10mg dose pach) and IM Kenalog.. Also I just had a 40 yr old male with retracted TM/ hearing loss (suspect ET dysfunction) but after 6 months without improvment and ^ed hearing loss- I obtained a CT of head which revealed a acoustic neuroma!..
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