auditory-problem

[Albert Llanas <allanas@xxxxxxxxxxxxx>]

I have a profesor in the Conservatory of music in Barcelona (Spain)  and a
student has an auditive problem which she is trying to solve. I send a
description of her sympthomatology and diagnostic. I would appreciate very
much any suggestions if someone could help her.
allanas@phonos.upf.es
http://phonos.upf.es/~allanas/

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        The following paper is an explanation of a problem that I have on
my left ear. I am a lyrical singer and this problem disturbs my auditive
perception. Since what happens to me is not a big disturbance for
non-musicians, doctors in Spain don't seem to have experience (I have gone
to the best doctors during a year). I would appreciate very much any
suggestions or information to be able to solve it (either by an auditive
apparatus, surgery, etc.).
Olga Guerrero



Adresse:
c/ Perez Galdos 10 ent 1-A
Barcelona 08012  Spain
Tel. 34-3- 2185552




        Symptomatology:

On my left ear only:

1. I feel pain when I sing high frequencies and loud notes. I hear an
extremely loud inner resonance, an amplification of the sound which is very
uncomfortable. I hear very differently from one ear to the other when I
sing in the high register.

2. No tolerance to loud musical sounds from the exterior, especially when
somebody else sings in a small room.

3. I don't feel comfortable either when I play the piano. The sound annoys m=
e.

4. No tolerance to pressure changes: I notice altitude differences. I feel
uncomfortable when I travel by train through tunnels and in the subway. I
feel a lot of pain when I travel by plane, especially when it starts
landing. I can also notice the pressure change when a door is closed in a
small room (or a car) and I am inside.



        Diagnostic:

The tympanum membrane of my left ear is too loose. Its convexity is too
big. The membrane is too thin.

Otoscopy: ^P bulging out (convexity) of the posterior quadrants without
occupation of the box (0.7). (Left ear).

Impedance test of 27.12.95. Left ear: (See paper enclosed)

ear canal  ml. 1.4
tymp peak  ml. 6.0; pressure daPa +40

=46req            Ipsi            Contra
Hz                      dB      Hl

500             75              80
1000    95              90
2000    85              110
4000    85              100


Right ear: normal.

Other results of impedance tests (different dates) are also enclosed.

Results of other tests:

Audiometry: normal. Both ears perfect, no difference.
TAC: normal.
Magnetic Resonance: normal.
Evocate potentials: normal.
Allergies: weak positive reaction to acari.
=46ibroscopy: fine

No damage in inner ear. My hearing is good.

The only thing that is not normal is the tympanum.


Treatments without positive results:

1. Anti-histaminics during three months.
2. A Cortisone injection: Celestone cronodose, 1 vial.
3. Vitamin B during two months.
4. Forced opening of the Eustachian tube with Politzer-ball and exercises
to allow air to pass through the ears.


Doctors say:  (Dr. E. Perell=F3 and Dr. J. Marco)

1. The bulging out of the tympanum produces distortion and pain in the
perception of sound.

2. The problem might be also due to an irregularity of the Eustachian tube.

3. The bulging out of the tympanum might be due to a previous infection (if
it is so I didn't realize).



Possible solutions:

1. Paracentesis: Making a small incision in the membrane to force it to
close up tighter and stronger.

2. Drainage: Making a small incision in the membrane and inserting a tiny
tube to equilibrate pressure changes. In this case, it would not be to
drain anything.

3. Injecting "teflon" directly to the Eustachian tube to make it narrow.

4. Building up a new membrane (or reinforcing the membrane) by means of an
injert from the outside ear tissue.

I have been told that these three possibilities don't assure me an improveme=
nt.


With this problem I cannot sing. It seems it gets worse. I am ready to do
anything that could improve it. I would like to know if there are better
solutions or if I could wear some kind of auditive apparatus that could
filter high frequencies to be able to sing comfortably.

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Albert Llanas
allanas@phonos.upf.es                                                     ()
http://phonos.upf.es/~allanas/                                       +
Conservatori Superior Municipal de Musica de Barcelona  ()
Bruch, 110
08009 - BARCELONA                                                       ()
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