I’m sorry to hear about your situation. Given your history of trauma and the persistence of hearing loss and tinnitus (noise inside the ear) despite the healing of your eardrum, several possibilities could be considered:

1. Sensorineural Hearing Loss (SNHL):
– Cochlear Damage: The trauma from the assault could have damaged the hair cells within the cochlea, leading to sensorineural hearing loss. This type of hearing loss is often permanent and can be accompanied by tinnitus.
– Otic Capsule Injury: If the trauma was severe, it might have affected the otic capsule, which can result in profound sensorineural hearing loss. This is usually permanent and not amenable to surgical correction.

2. Ossicular Chain Disruption:
– Although your eardrum has healed, there could be an issue with the ossicles (the small bones in the middle ear) that transmit sound from the eardrum to the inner ear. Disruption or fixation of these bones can lead to conductive hearing loss.

3. Perilymph Fistula:
– Trauma can sometimes cause a perilymph fistula, which is an abnormal connection between the middle ear and the inner ear. This can lead to hearing loss and tinnitus.

4. Chronic Middle Ear Effusion:
– Although less likely given the time elapsed, persistent fluid in the middle ear could contribute to hearing loss.

5. Tinnitus:
– The persistent noise you hear could be due to damage to the auditory pathways or the cochlea itself. Tinnitus often accompanies sensorineural hearing loss.

Recommendations:

1. Audiological Evaluation:
– A comprehensive hearing test (audiometry) is essential to determine the type and degree of hearing loss.

2. Otolaryngology Consultation:
– An evaluation by an ENT specialist is crucial. They may recommend imaging studies, such as a CT scan or MRI, to assess the middle and inner ear structures.

3. Management Options:
– Hearing Aids: If sensorineural hearing loss is confirmed, hearing aids may help improve hearing and manage tinnitus.
– Cochlear Implants: In cases of severe sensorineural hearing loss, cochlear implants might be considered.
– Tinnitus Management: Techniques such as sound therapy, cognitive behavioral therapy, or tinnitus retraining therapy can be beneficial.

4. Protective Measures:
– Protect your ears from further trauma and avoid exposure to loud noises to prevent exacerbation of hearing loss.

It is important to follow up with healthcare professionals for a tailored management plan based on your specific condition.

Experiencing sharp pain in the nostrils, especially when it feels dry and cold, can be quite uncomfortable. This type of pain can be attributed to several potential causes, and understanding these can help guide appropriate management strategies.

Potential Causes:

1. Nasal Dryness and Irritation:
– Environmental Factors: Exposure to dry air, particularly in heated indoor environments during colder months, can lead to nasal dryness. This can cause the mucous membranes to become irritated and painful.
– Dehydration: Inadequate fluid intake can exacerbate dryness in the nasal passages.
– Medications: Certain medications, such as antihistamines or decongestants, can dry out the nasal passages.

2. Nasal Vestibulitis:
– This is an inflammation of the nasal vestibule, the area just inside the nostrils. It can be caused by bacterial infections, often due to Staphylococcus aureus, and can result in sharp pain and tenderness.

3. Nasal Trauma or Foreign Body:
– Minor trauma from nose picking or the presence of a foreign body can cause localized pain and irritation.

4. Allergic Rhinitis:
– Although typically associated with congestion, allergic rhinitis can sometimes cause irritation and a sensation of dryness, especially if there is frequent nose blowing or sneezing.

5. Chemical Irritants:
– Exposure to irritants such as smoke, strong odors, or pollutants can cause nasal discomfort and dryness.

Management Strategies:

1. Humidification:
– Use a humidifier in your living space to add moisture to the air, which can help alleviate dryness in the nasal passages.

2. Nasal Saline Sprays or Rinses:
– Regular use of saline sprays or rinses can help keep the nasal passages moist and clear of irritants. This can also aid in soothing irritation.

3. Hydration:
– Ensure adequate fluid intake to maintain overall hydration, which can help keep mucous membranes moist.

4. Avoid Irritants:
– Minimize exposure to known irritants such as smoke, strong perfumes, or harsh cleaning chemicals.

5. Topical Treatments:
– Consider using a nasal emollient or ointment, such as petroleum jelly, applied gently inside the nostrils to provide a protective barrier and reduce dryness.

6. Medical Consultation:
– If the pain persists or is accompanied by other symptoms such as fever, swelling, or discharge, it would be prudent to consult a healthcare professional. They can assess for conditions like nasal vestibulitis or other infections that may require specific treatments, such as antibiotics.

Considerations:

– Monitor Symptoms: Keep track of any additional symptoms that may develop, such as changes in discharge, swelling, or systemic symptoms like fever, which could indicate an infection.
– Specialist Referral: If symptoms do not improve with initial measures, a referral to an otolaryngologist (ENT specialist) may be warranted for further evaluation.

By addressing the underlying cause, you can effectively manage the symptoms and alleviate the discomfort. If you have any concerns about specific treatments or if symptoms worsen, seeking professional medical advice is recommended.