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Heading Toward Hearing Loss - Page #1
 

Author: Jill London, DO
Co Author #1: Julie Creech-Organ, DO, CAQSM
Senior Editor: Justin Mark Young, MD, FAMSSM
Editor: Kevin Chiang, MD, MEd

Patient Presentation:
A 21-year-old senior female collegiate soccer player presented to training room clinic after a weekend match. During the match, she took a routine header and immediately noticed loud ringing and muffled hearing in her right ear. When the symptoms didn't fade the next day, she went to urgent care, where she was diagnosed with tinnitus and advised to follow up with her primary care physician. At the training room clinic visit, she denied dizziness, imbalance, or any other associated symptoms, reporting only sudden right-sided hearing loss directly after heading the ball. She recalled having similar episodes after headers in the past, but those self-resolved within a few hours. She denied new medications or supplement use. She was started on prednisone 60 mg daily for ten days for presumed sudden sensorineural hearing loss (SSHL) and referred urgently to ENT for further evaluation.

History:
No pertinent medical history disclosed.

Physical Exam:
General: Well-appearing, alert, in no acute distress. <br>Skin: Warm, dry, intact, no lesions or rashes. <br>Head: Normocephalic, atraumatic. <br>Eyes: Pupils equal, round, and reactive to light and accommodation. Extraocular movements intact, conjunctiva clear. <br>Ears: External auditory canals are clear of debris or discharge. Tympanic membranes clear and pearly gray, with no evidence of perforation, effusion, or cholesteatoma. Unable to hear finger rub in right ear. <br>Nose/Throat: Nares patent, mucosa moist, oropharynx clear. <br>Neck: Supple, no lymphadenopathy or thyromegaly. <br>Neuro: Alert and oriented x 3, cranial nerves II - XII intact, strength and sensation normal. <br>Psych: Mood and affect appropriate.

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