Hearing Loss Following Strenuous Exercise

by Neil Bauman, Ph.D.

A mother explained:

My son has had a few bouts of tinnitus followed by a hearing drop in one ear. This always seems to be as a result of, or following, strenuous exercise. So far the ear has always recovered to its old level. I reported the last episode to my doctor who has now raised the question that it could be “labyrinthine hydrops.” The drugs that he recommended we consider are Betahistine or Cinnarizine, but the side effects seem severe. Up until now, these episodes only occur when my son has congestion, and this has thrown even more questions into the pot! I’d appreciate your advice.

Strenuous exercise can raise the internal pressure in the head, just like a blow to the head can. If your son has large vestibular aqueduct syndrome (LVAS), this can cause hearing loss. This is nothing new. Actually, it doesn’t even have to be exercise—any form of extreme straining can cause this in people with LVAS if they are susceptible. Fortunately, not all people with LVAS are susceptible to this.

It’s great that his hearing comes back after each episode. Of course, there are no guarantees that his hearing will always return, but it seems you can go by your son’s previous history—which is, it is a temporary hearing loss.

It could be labyrinthine hydrops or anything else, but if your son has LVAS, that would be the most likely cause. Maybe your doctor considers LVAS to be a form of labyrinthine hydrops?

Personally, I’d not take either Betahistine or Cinnarizine if I were in his shoes. To me, the solution is much simpler—just don’t strain so much when exercising. He should be able to find the level below which this doesn’t happen, and then limit himself to that much straining effort.

Incidentally, labyrinthine hydrops is an inner ear condition, whereas congestion is a middle ear condition.

If his hearing loss only occurs when he is congested, then it could be that the strenuous exercise is causing “gunk” (to use a fancy medical term), to clog up his Eustachian tubes and middle ears causing some degree of conductive hearing loss. When the gunk drains out, his hearing returns to normal. If this is the case, it has nothing whatsoever to do with LVAS.

One way to determine which is which is to go to an audiologist and have an audiogram done as soon as he loses some hearing from straining. If the audiogram shows only a sensorineural hearing loss, then it is LVAS (or another inner ear condition). If it shows a conductive loss, it is likely gunk in the middle ear or Eustachian tube. If he already has a sensorineural hearing loss from LVAS, and it is gunk in his middle ear, the audiogram should show an air-bone gap indicating the conductive component. Once you know what the audiogram shows, then you’ll better know how to proceed.