Increased Ear & Sinus Symptoms

[beeinformed]

Hi,

I've had increased hearing loss since my rheumatologist lowered my medrol medication (in July) from 12 to 10 mg. I saw my ent specialist on Oct 11th and after I took a hearing test, he told me I had increased hearing loss (conductive and neurosensal) in my left ear. He attributed it initially to a possible cold/flu but I told him I've had no cold or flu symptoms recently.

I saw my rheumatologist on Nov. 27th and he felt that the increased hearing loss was due to lowering the medrol medication. I recently saw my ent. specialist (Dec. 27th) and he concurred with what the rheumatologist said (that decreasing the medrol caused increase hearing loss).

After removing a lot of wax from the left ear, the ent. doctor discovered that I had severe inflammation of the ear canal and he gave me steroid/antibiotic drops to use in that ear. He told to come back in ten days so that I can take a hearing test. On a side note, I also would like to add that he said that an inflammation in the ear, would look the same whether or not it was caused by an infection or an autoimmune process as there is a strong possibility (he said) that the "infection" I'm having, might be be part of a flareup that I'm currently having. I also want to add that I have been on cellcept (250 mg) for approximately two months or so and was told recently by my rheumatologist to increase it to 500 mg.

I've also had increased sinus pain/congestion for the past three or four weeks and my ent doc said that he might perform another ct. scan of my sinuses and/or scoping (last ct. scan showed inflammation in all the four sinus cavities) at the next office visit.

I would like to know if anyone has had similar symptoms (esp. inflammation of the ear canal) as me as I'm not sure if I having a flareup of the ears & sinuses and/or combination of both a flareup/infection and would your would love to hear your thoughts/comments on my situation. Thanks!

[Pete]

At the onset of my WG, I presented initially with an infection in my right ear, followed quickly by a dry cough, night sweats, fatigue, loss of appetite and weight loss. In addition to the hearing loss resulting from being in noisy environments without hearing protection, WG further degraded the hearing in my right ear.

[pberggren1]

My case is nothing like yours but I have heard of cases like yours before.

I know one lady that got tubes in the ears along with steroid injections and she said it helped but now says her hearing is going down again.

My hearing loss was sudden with Wegs involvement, if that is what it really was. We don't know for sure. It could have been the methotrexate as well. Either way most of my hearing went in 4 episodes involving dizzy black outs and when I woke up my hearing was less.

[drz]

During one of my flares both ear drums ruptured from infection. It was very painful. In my last flare I got by with just sinus infections and was able to get it treated in time to avoid any other infections like ear, eye, bronchitis, pneumonia etc. I have only a small bit of hearing in one ear so wear a regular hearing aid in that ear and a BAHA on other side. Wegs cause my hearing loss on BAHA side. The other ear lost hearing from repeated infections and surgeries. My hearing gets much worse on the hearing aid side during any congestion or infections and improves greatly as they clear up or get better.

I don't know for sure if infections cause the flares or if flares cause the infections but for me they generally seem to go together.

[JeanMarie]

Ben, I've been told the same thing - the ENT can't tell if the inflamation is caused by Wegs or an infection. My thouroughly unscientific thought is to be suspicious of a flare, especially if your meds have been changed recently. Of course it could also just be a reaction to the reduction in medrol.

[beeinformed]

Ben, I've been told the same thing - the ENT can't tell if the inflamation is caused by Wegs or an infection. My thouroughly unscientific thought is to be suspicious of a flare, especially if your meds have been changed recently. Of course it could also just be a reaction to the reduction in medrol.

According to my rheumatologist and ent specialist, when I had decreased my medrol medication (from 12 to 10 mg.) back in July, it resulted in increased hearing loss (both conductive and neurosensal) in my left ear, meaning that I had a flareup due to lowering the medrol dose.

On Dec. 27th, when I saw my ent doctor, he said that I had severe inflammation in the ear canal in the left ear and gave me a topical combination (antibiotic/steriod) ear drop. He also said that the inflammation could be part of a flareup as well, since it's impossible to distinguish an infection from an autoimmune flareup, as they would both have the same appearance.

If the inflammation of the ear canal is part of a flareup, I am curious to find out if anyone has ever had this and/or knows of someone who has? I have seen
research articles online stating that is possible to have it but would love to find someone who has had this symptom.

[JeanMarie]

Yes, that is what happened on one of my flares. It started with my ears (felt clogged up,if I remember correctly) My ENT was unable to say for sure that it was a flare. Within a short time I started having joint pain & then my blood test started going crazy & it was on to treatment.

Unfortunately, I didn't keep very good records back then, so I don't remember what the ENT did besides remove a lot of wax buildup. I didn't have a hearing test that time. My original bout with wegs did result in a hearing loss of about 20% & I don't think that has changed. My ears or sinus never got as bad as they were when first diagnosed & they cleared up very quickly when a pretty high dose of pred was started.

I can't say for sure that your problem is part of the flare--we are all so different, but something similar did happen to me.

I hope you quickly gwt better!

[annekat]

Beeinformed, I have had inflammation of the ear canal, by which I think you mean the outer ear, the part where ear wax builds up, as opposed to the middle ear, where troublesome ear infections typically occur. I think mine came about because of a small hole in my eardrum which allowed stuff to get into the outer ear and become infected. I'm not sure if this happened before or after my Wegs dx, I think it was before, but I'm sure I already had WG at the time, as I'd been having uncharacteristic ear and sinus infections for months. I was treated with drops for the outer ear infection. Since then, it seems like it has taken forever for the irritation in the outer ear to clear up, even though other things in my body seem to heal faster than I might expect being on immunosuppressants. There has been crusty stuff in there for a couple of years. I went in once and had some wax removed from around the eardrum, but the ENT left the crusty stuff and said it was "healing"... as if to imply that to disturb it at that point would cause more irritation by exposing any raw areas. Well the crusty stuff is still in there, though I think the infection is gone. As for my hearing, I wear aids in both ears due to both neurosensory and conductive loss, but have to wonder how much the crusts are impeding my hearing in that ear. Lately that eardrum has been flexing and trying to move a little, making me wonder if the crusts are loosening up and allowing more movement. I guess I'm due for another visit to the ENT. Don't know what similarities there are between our two cases.

According to my rheumatologist and ent specialist, when I had decreased my medrol medication (from 12 to 10 mg.) back in July, it resulted in increased hearing loss (both conductive and neurosensal) in my left ear, meaning that I had a flareup due to lowering the medrol dose.

On Dec. 27th, when I saw my ent doctor, he said that I had severe inflammation in the ear canal in the left ear and gave me a topical combination (antibiotic/steriod) ear drop. He also said that the inflammation could be part of a flareup as well, since it's impossible to distinguish an infection from an autoimmune flareup, as they would both have the same appearance.

If the inflammation of the ear canal is part of a flareup, I am curious to find out if anyone has ever had this and/or knows of someone who has? I have seen
research articles online stating that is possible to have it but would love to find someone who has had this symptom.