Ear issues (Pain, ringing, tinnitus, tubes, perforations)

[Guest Bushmaster]

Dear Flight Doc,

I have a question,

I think when I was little I had an inner ear infection (I was told by my parents that some sort of fluid leaked from my left ear)

When I was going thru the medical exams for the flight school (that was in Turkey), the doctor saw something in my left ear and instructed me to do some valsalva maneuvers. He examined a little bit more and then told me that I previously had my eardrum had a perforation but it healed itself and the perforation was gone... That explains the click sound in my left ear when I do the valsalva...

I flew for 233 hours in Turkey (under ICAO rules) and 45 hours in US with a FAA Class I medical. Didn't have any type of sickness or discomfort because of that. Knowing that the USAF medical standards are whole alot different, what do you think about the situation?

Could this be a problem for the military medical?

[Guest Flight Doc]

A perforated eardrum that has healed (either on its own or after an operation) is not disqualifying. It is disqualifying if the hole is still there. As long as it's healed and your hearing is normal, you're OK.

A7.3.1.4. Perforation of the tympanic membrane. Surgery to repair perforated tympanic membrane is disqualifying until healing is complete and hearing is normal.

[Guest sleepy81]

I'm going to start at ENJJPT in August this year.

About a year ago I woke up one day and discovered a very low constant "ringing" sound in my left ear. I was at a disco the night before.

It has neighter increased nor decreased since then.

When it was time for my anual medical check (here in norway we have checks every year, even if the pilot education hasen't started yet, but we have to satisfie the same requirements as operational pilots do), I didn't mention anything about it, and I passed the hearingtest with no problem.

However I have read a bit about tinitus lately, and I se that it can be a symtome of bad things, like brain tumors...

So I would like to check that, but I'm afraid if I tell them about it next medical check, I'll get DQed from ENJJPT.

SO here are my questions:

- Is Tinitus disqualifying for ENJJPT?

- How likely is it that teher is something "dangerous" going on (tumors)?

[Guest F16PilotMD]

Tinnitus has many causes. It CAN be associated with brain tumors, but certainly most of the time it is NOT. I think the most common is called an acoustic neuroma which is a benign tumor that causes a variety of symptoms including hearing loss, dizziness/vertigo, tinnitus, headache, other neurologic abnormalities of the face.

You likely have nothing. Why your ear rings, I don't know. The only way to be sure would be to see an otolaryngologist (ear, nose, & throat doc) and likely get a head CT scan or MRI. That's probably overkill, but...?

I understand your concern about being DQ. Your fears are justified. If you can pass the hearing tests and you are not having any other symptoms, you are likely safe and I wouldn't DQ you. If your symptoms persist I would have you see the ENT. If they get worse or you develop other symptoms, you likely would be DNIF/DQ while the testing was done.

I don't know if that helps or not. I highly doubt you have a brain tumor. As with all medicine, I can't prove that to you beyond the shadow of doubt. When I was in your shoes--just prior to pilot training--I probably would have played the odds that this was nothing to worry about and kept my mouth shut about it until I was well into training. Being a little older, wiser, etc, I'm inclined to say things like ignoring your health and risking a problem isn't worth flying a jet.

[Guest sleepy81]

Thanks, you have eased my conserns a lot!

Since I'm young and stupid I think I'll shut up!

I don't have any other symptomes (diziness, vertigo etc. etc.), and IF it is a tumor, don't you think that some of these symptomes would appear after a year since the tinnitus began?

As I said I was at a disco the night before, and for a period before that I hav been on a vacation in greece (also lot's of discoes there ), and a rock festival in Denmark (Roskilde), so my ears probably took a pounding last summer...

The strange thing is it's only one ear, but that's probably just a coincidense...

I'm glad I found this site! Here I can ask questions without worriing that my doctor will ground me! Someone once said "The medical proffesion is the true enemy of the aviation proffesion!" I guess most pilots feel that way sometimes... This site can help a lot!

Well enough ramelings from me!

Thanks!

[TheGreatWaldo]

I went civilian flying the other day and when we got on the ground, I could pop my left ear, but not the right. I tried everything: yawning, chewing gum, holding my nose and blowing. Nothing seemed to help. When I would hold my nose and blow, my left ear would pop again. I just left it alone and it finally equalled out in a few hours. Is this a problem I should look more in to? Has this ever happened to anyone else, only being able to relieve the pressure in one ear and not the other? Also, is there any danger in holding your nose and blowing to pop your ear? That's usually the trick that works best for me. Any input would be appreciated.

TheGreatWaldo

[Guest C-21 Pilot]

I'm by no means a flight doc, but the technique you are describing is called the Valsava.

What you are simply doing is putting pressure on your Eustachian Tubes (sp?), which is why you get the "popping" sensation. If you have some congestion of a cold of some sort blocking the sinus cavity, that could have been a problem.

I can usually clear within 15-20 minutes if I haven't done so in the air.

I would definately bring this up on the AViation Medicine forum and ask F16FlightDoc, he'll have the answer.

[ripster]

What if there is water in your ears that may cause inability to hear some frequencies to the range preferred?

Pop some sudafed a few days before? Then stop cause it could lower blood pressure?

[Guest F16PilotMD]

Huh????

Water in your ears should run out onto the pillow when you sleep. Fluid in your middle ear (inside the eardrum) has to clear-up just like a cold. Sudafed may help that...it may not. Sudafed will make your blood pressure go UP if anything. If you really have a head cold I would not recommend taking the hearing test. It's much better to delay because of an obvious cold than beg for a re-take after you fail. Most won't accept the "head cold" excuse AFTER you fail the test...otherwise everyone would use that excuse and we would never get anywhere.

[ripster]

Yes "fluid" and I did not have a head cold. Thanks for clarifying, I knew it would do something to the blood pressure but wasnt sure which way it went. Thanks.

[CD512]

I am in the process of doing my commissioning physical at MEPS. In the intial paperwork that you document your medical history I stated that I had tubes in my ears at approx. age 5. They are wanting to see documents which are next to impossible to produce since it was 23 years ago, so I have to provide a notorized statement that I can not access the records.

My question are tubes something that can lead to a DQ, or are they being difficult at MEPS. By the way I have had no futher issues.

Chip

[Scooter14]

I had 'em when I was 5, and I never had a problem. It was never an issue for me, but then again, it all depends on the doc.

On a side note, do you remember when they fell out? I picked one out of my ear sitting at my desk in first grade. The school nurse, this retired old lady at my school, taped it to a piece fo yellow paper, ear wax and all, and sent me home with it with a note attached saying "This THING fell out of Jeffrey's ear today"

[Guest F16PilotMD]

MEPS wants documentation on everything. It will not affect your IFC1.

[Guest hockeymv]

I had two sets of tubes, one at age 5 and one at age 7. All I did was annotate the doctor and approximate dates of the surgery on my medical history and the Air Force was fine with it. I got more crap for getting a concussion 10 years ago than I did for the tubes.

Many people out there have had this procedure and have flown just fine with it. (IE clearing ears, etc.)

Best of luck!

However, there was a guy who commissioned a few years ahead of me who couldn't get his ears to val salva properly at high altitudes in the Tweet and had to wash out of UPT.

Moral of the story: Take care of your ears. Don't ever push flying w/ a cold, etc. Common sense, I know, but given your history, no reason to tempt fate.

[Guest BigWebs]

I just got my IFC 1/1A and the doc put down an abnormality in section c. Drums(perforation). In the comments they wrote VNB. What does this mean?

They told me i was al set and didnt have any problems other than I needed to get a cavity sealed.

[Guest F16PilotMD]

That stands for "valsalva normal bilaterally". You're fine.

[Guest rmrz]

Hello.

Is tinnitus (ringing ear) a disqualifier for flight I or flight II physical? The tinnitus doesn't affect my hearing; my hearing is excellent.

[Guest F16PilotMD]

No way to know you have it unless you tell then you have it.

[Guest mcclesm]

Since Christmas, I've had a slight ringing sound in my right ear...I only hear it in quiet rooms (at night in bed, right now typing on my computer, etc.). It's actually pretty annoying, I went to the Dr. about a month or so ago thinking I had ear wax buildup, but I didn't. She thought the tubes in my ears might have had fluid in them from two colds I had in a row. Anyways...my ear is still ringing. I keep hoping it will go away, and I worry that I won't be able to pass a FCI hearing test, even though I think I hear fine. Anybody ever heard of this?

[Guest Broncopilot943]

I'd say if you can still here normal conversations and you dont notice any hearing loss, you're probably OK. I've had a little ringing ever since a concert I went to in high school, and I passed mine no prob.

[Guest javelin150]

so people have posted info on how to possibly improve your vision (MagicEye, See Clearly, etc.), but is there a way to help improve your hearing? It's obvious that you can protect it, but is it possible to actually make it better?

[Guest Thriller]

Last year I had a Tympanoplasty performed on my right ear. It was a personal decision of mine. I needed to correct a perforation in order to pass the DODMERD. The procedure was performed 220 days prior to the DODMERD (minimum allowed by regs is 120 days). I took the DODMERB and passed. I got my PPQ and was sent up to the pilot board. I'm now categorized as pilot and will be heading to Brooks in August.

Here are the stats on my right ear....

Hearing is within the allowable 15-decibel difference; the procedure was done last August (well within the 120 day AF reg. restriction). I received my final checkup with my ENT and after an examination and pressure test, the perforation is healed.

Question: Do you see this posing a problem for me at Brooks?

THRILLER

[ 08. April 2005, 20:54: Message edited by: Thriller ]

[Guest F16PilotMD]

no

[Guest Thriller]

F16PilotMD,

One of my worries is that I will get there (to Brooks) and they will want documentation on the surgery. It was performed by a local ENT specialist.

Here is the catch, back when I took my DODMERB, they sent me back a letter requesting all documentation on the surgery. I did...

About 3 weeks later, DODMERB came back and said that I was good and gave me the PPQ.

I'm just worried that the same thing will happen at Brooks. Since DODMERB has the files on hand, and after review, gave me a PPQ, will Brooks also go through the same process?

I figure that if the ear is healed and all is well, then they will not need my documentation.

What do you think?

Thanks for the help,

THRILLER

[ 10. April 2005, 17:51: Message edited by: Thriller ]

[Guest doctidy]

the re-look at Brooks will not even look at your hearing