Dear Dr. Roach: Last November, I complained of pain in my right ear. I went to the emergency room and was, oddly, treated for diarrhea. (I will not return to that ER ever again.)
A week later, I was struck with Bell鈥檚 palsy and was treated at another ER (correctly, per a local ENT doctor). But the Bell鈥檚 palsy resulted in 100 per cent deafness in my right ear, and I am told that nothing can be done for it (no explanation has been offered as to why the deafness).
Is there any way to rid myself of the constant noise in that deaf ear? It sounds like an industrial vacuum or waves pounding against rocks, and at times a trillion grasshoppers. I am getting mighty frustrated.
A.L.
Bell鈥檚 palsy is a weakness of the facial nerve on one half of the face. There are many causes of facial weakness, but it is called Bell鈥檚 only when no cause can be identified. Most cases of Bell鈥檚 palsy are thought to be caused by viral infection, especially viruses in the Herpes family.
However, in hindsight, I think it is more likely that you had the related condition Ramsey-Hunt syndrome, in which there is both ear pain and facial paralysis. This is caused by reactivation of the varicella zoster virus and thus it is a localized form of shingles. Vesicles are sometimes but not always seen in the ear. Some degree of hearing loss is about 50 per cent likely in Ramsey-Hunt syndrome, whereas it is rare or nonexistent in Bell鈥檚 palsy.
Ramsay-Hunt syndrome usually is treated with antiviral medications such as acyclovir, despite a lack of proof that it helps.Unfortunately, the damage done by the virus to the auditory nerve, which is right next to the facial nerve in the brain, is likely to be permanent at this point.
Hearing loss from any cause can lead to the noise sensation you have, which is called tinnitus. There are several possible treatments, none of which is likely to cure the problem entirely but might help to a significant extent. One is a cochlear implant. Studies have shown a reduction in tinnitus in people with hearing loss and severe tinnitus. Tinnitus retraining therapy, cognitive behavioral therapy and biofeedback all are potentially useful tools.
