Perilymphatic fistula

[Carl]

About a month ago I was finishing off volume day with 3x5 sets of weighted chin-ups. After the last set I experienced a sudden onset of tinnitus and a sensation of ear fullness in my right ear. Since then I am also quite sensitive to loud noises and sound hitting my right ear sounds like from a cracked loudspeaker. After several visits to different ENT specialists where hearing loss at 6 and 8 kHz was confirmed, I was diagnosed with Sudden Hearing Loss due to a perilymphatic fistula. This means that one of the membranes separating the inner ear from the middle ear has been torn. Increased intracranial pressure due to the Valsalva maneuver was considered a plausible cause. I was scheduled for an operation, but a subsequent hearing test showed improvement, and the surgery was canceled. The doc, who is also a professor in ENT, gave me restrictions on flying and weight lifting for two months. In terms of physical exercise, I was told that it was ok to ride a stationary bike, but that was it.

I have been idle now for a month, and I’ve lost several kilos of body mass already. However, I reckon I could do some training as long as I avoid the Valsava maneuver. Obviously this means avoiding squatting, heavy benching and deadlifiting. I would be happy to get any advice on suitable exercise to do instead. It would also be interesting to hear if anyone else has experience from perilymphatic fistulas. How long was your recovery period and wat kind of training did you undertake during this time? I still have tinnitus, but my noise sensitivity has diminished.

[Greg Esres]

Increased intracranial pressure due to the Valsalva maneuver was considered a plausible cause.

I've never felt any inner ear pressure when doing the Valsalva technique for weightlifting. However, when you do it the way you do when scuba diving (closing off your nose and blowing), you certainly do feel pressure in the inner ear.

[Carl]

Hi Greg,
I guess you cannot feel the increased pressure in the inner ear. What you feel in the scuba diving version (which increases the pressure in the middle ear), is likely the flexion of the ear drum. I'm also guessing that the transmission of pressure from the cerebrospinal fluid (CSF) to the inner ear is highly individual and relates to, e,g., how wide your cochlear aqueduct is (the canal which links the CSF to the inner ear). For most people (obviously since this injury seems to be quite rare) the pressure increase in the inner ear is moderate and benign.