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Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 7556
Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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hello, I recently suffered a head injury - high pressure blow

Resolved Question:

hello, I recently suffered a head injury - high pressure blow to the ear and have since sensed a slight change in hearing (as if through a tunnel) and some dizziness when changing positions. I assume this is an inner ear problem but wonder if I should expect things to resolve or need to seek medical attention
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Hasan replied 1 year ago.

Dr. Hasan :

HI, Thanks for your question. My name isXXXXX and I am here to help you today. I will be happy to help you with your follow-up questions also. I need few details.

Dr. Hasan :

When exactly you had this injury?

Dr. Hasan :

Any ear ringing?

Customer:

3 days ago

Dr. Hasan :

Do you feel spinning while being dizzy?

Customer:

no ear ringing

Customer:

yes, spinning

Dr. Hasan :

How long the spinning sensation lasts?

Customer:

a few seconds - if I stay still, my balance usually resumes

Dr. Hasan :

Thanks a lot for your input.

Customer:

5-10 seconds typically

Dr. Hasan :

I am sorry to hear about your problem.

Dr. Hasan :

I am an ear, nose and throat specialist myself.

Customer:

that's great =)

Dr. Hasan :

Spinning sensation is characteristic of inner ear disorders.

Dr. Hasan :

There can be two possibilities.

Dr. Hasan :

Inner ear problem causing hearing loss.

Dr. Hasan :

damage to ear small bones called ossicles.

Dr. Hasan :

Yes you need immediate medical attention.

Dr. Hasan :

because the damage to inner ear can be reversed with steroid tablets.

Customer:

if there is physical damage to the ossicles, will they not resolve?

Dr. Hasan :

The more you delay, the less will be the chances of recovery.

Dr. Hasan :

No it can be resolved, i mean ossicle damage.

Dr. Hasan :

However ossicle damage is less likely in your case.

Dr. Hasan :

The spinning is due to disturbance of crystals in your inner ear.

Customer:

this is definite due to physical trauma...because it happened since

Customer:

do you think I will need surgery or just steroids?

Dr. Hasan :

Your doctor can address this with a maneuver called Eply's Maneuver in one sitting.

Dr. Hasan :

You will just need steroids.

Dr. Hasan :

But the point is that you should go now.

Dr. Hasan :

TO ER.

Dr. Hasan :

because early treatment matters here.

Customer:

ok, I really appreciate the feedback

Dr. Hasan :

Thank you.

Customer:

thank you for your help

Dr. Hasan :

Any question in your mind?

Dr. Hasan :

:) most welcome.

Customer:

do you know how much eply's maneuver typically costs

Customer:

and what type of steroid is likely

Dr. Hasan :

It needs to be done by an ENT.

Dr. Hasan :

It will not have any additional cost.

Dr. Hasan :

You can see it on youtube

Dr. Hasan :

But it must be done by ENT or neurologist.

Customer:

can I just walk into an ENT center?

Customer:

or go to the ER first?

Dr. Hasan :

but you should go to ER now to get steroids after doctor's examination.

Dr. Hasan :

You can later visit ENT.

Dr. Hasan :

Eply's is just for your spinning sensation and that too when your doctor confirms the problem.

Dr. Hasan :

But for hearing loss immediate steroids are required.

Dr. Hasan :

Anything else you want to ask?

Customer:

since its been three days, am I at risk for permanent damage alrady in your opinion?

Dr. Hasan :

I have treated many patients presenting to me after 3 to 5 days and getting full recovery.

Dr. Hasan :

So don't stress yourself.

Customer:

my hearing is not so much loss, as changed - do you still think I need steroids?

Dr. Hasan :

Ideally your doctor should do a hearing test but in ER that would not be possible.

Customer:

lastly, is there a difference if I go to urgent care center vs emergency room?

Dr. Hasan :

However he can look for any blood or damage in your ear drum and middle ear.

Dr. Hasan :

If that is normal then he must assume that inner ear damage is likely and without hearing test he should go for steroids

Dr. Hasan :

and steroids in that case are just required for 2 to 3 weeks in tapering dosage.

Dr. Hasan :

Yes you can go to urgent care.

Customer:

i am a dentist and am tempted to write myself a steroid rx per your recommendation until i can get into to see an ENT rather than go to the ER...

Dr. Hasan :

LOL

Dr. Hasan :

Ok

Dr. Hasan :

So let me guide in a doctors way now.

Dr. Hasan :

It can be inner ear damage.

Dr. Hasan :

it's most likely.

Dr. Hasan :

it can be due to fluid or blood in middle ear.

Dr. Hasan :

but it's less likely.

Dr. Hasan :

you know that short course of steroids has no major side effect.

Dr. Hasan :

The dose should be 1mg/kg body weight and should be tapered in 3 weeks.

Dr. Hasan :

Other thing required is tab betahistine.

Dr. Hasan :

It increases the blood flow to inner ear.

Dr. Hasan :

and for spinning tab stemetil thrice daily for three days is needed.

Dr. Hasan :

It contains prochlorperazine.

Dr. Hasan :

But spinning that lasts for few seconds is known as benign paroxysmal positional vertigo and needs Eply's

Dr. Hasan :

for symptomatic control, prochlorperazine or OTC meclizine can be taken.

Dr. Hasan :

Your thoughts now?

Customer:

wow, I've never written that type rx before...how would you call that in exactly...it would be 50mg of ...

Customer:

what is the steroid you are recommending

Dr. Hasan :

your weight?

Customer:

110

Dr. Hasan :

prednisone

Dr. Hasan :

in kg?

Customer:

and how would you taper it

Customer:

110 lbs

Customer:

50 kg

Dr. Hasan :

i am just guiding you and not asking you to treat yourself :)

Dr. Hasan :

If your ENT write it, he will write it like this.

Customer:

thank you :)

Dr. Hasan :

Tab prednisone 5mg ,

Dr. Hasan :

3 + 3 +3 for five days

Dr. Hasan :

2+2+2 for five days

Dr. Hasan :

1+1+1 for five days

Dr. Hasan :

1+1 for three days

Dr. Hasan :

1 tablet once daily for two days

Customer:

what about tab betahistine and stemetil

Dr. Hasan :

Tab ranitidine one tablet twice daily till you are taking steroids

Dr. Hasan :

Betahistine (16) thrice daily for two weeks

Dr. Hasan :

and then 8mg twice daily for one week

Dr. Hasan :

Prochlorperazine one table thrice daily for three days

Customer:

you mean tab ranitidine till i'm DONE with steroids

Customer:

that is a lot to take...

Dr. Hasan :

Yes to avoid stomach ulcers

Dr. Hasan :

but have to save hearing.

Dr. Hasan :

I strongly suggest you to see a doctor to get ears examined first.

Customer:

ok

Customer:

i will

Customer:

thank you for your help greatly

Dr. Hasan :

Even i would not treat myself if i am injured.

Customer:

im glad i didn't just ignore it waiting for it to heal

Customer:

yes, i don't think its a good idea for me to write this rx

Dr. Hasan :

You are most welcome. I wish you good luck that you get well soon, please ask if you have any question because our discussion always remains open so you can always ask more till you are satisfied, You can click the smiley to rate the answer. You can come back here to ask anything even after you have rated the answer. I will be glad to help you always.

Dr. Hasan :

Yes because hearing is precious.

Customer:

i thought i would be a simple prednisone dosage taper

Customer:

but i may lose my license over this

Customer:

thanks again, you have been most helpful

Dr. Hasan :

Yes please don't do this but with my suggestions, you can talk to your ER doctor in a better way.

Dr. Hasan :

He might not be well trained in ENT

Dr. Hasan :

but now you are :)

Customer:

=)

Customer:

have a great day

Dr. Hasan :

Thank you and same to you

Dr. Hasan :

Please rate my answer as per level of your satisfaction.

Dr. Hasan :

Any question?

Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 7556
Experience: MBBS, FCPS, with experience in all fields of medicine and surgery
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