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Sudden hearing loss in one ear, MRI normal & corticosteroids no help

A few weeks ago, I felt what was like fluid in my right ear. It happens every once in a while especially when I come out of the shower since I typically rinse my ear with warm water. Generally a headshake or ear pop or ear drain via tilting is all it takes to recover hearing. Only this time, it didn’t recover.
I didn’t think much of it and figured it would go away on its own with normal chewing/yawning/etc… only it didn’t go away.

So I went to the doctor (head/neck/ear specialist). First we ran a set of tests that proved that my right ear is indeed hearing much less than the left ear (which - according to my doctor - hears “like a teenager”). Ear drum reacts well to pressure.

I thought I had fluid in the ear because of the sensation I get in that ear: orientation of the head makes a difference in the hearing and I can get better hearing for a handful of seconds if I stick my finger in my ear and wiggle semi-vigorously. Also I feel some “tickle” if I tilt my head, as if some fluid wanted to come out.

But the examination did not show any fluid at all. No infection, no wax, everything clean.
No pain, no loss of balance.

Moreover, the testing we did had a part where we would send stimuli through the bone (rather than the ear canal), to bypass the ear drum and middle ear. This is supposed to target the inner ear, and indeed it shows the same loss of hearing there, which led my doctor to prescribe Prednisone for 2 weeks (1 week @ 60 mg/day then taper 2nd week), thinking I could have an inflammation of the inner ear.

I did not feel any improvement, so after the treatment we did a test again, and indeed, exact same measurements. No changes (neither for the better nor for the worse).

Since that didn’t work, we decided to do an MRI. These are the (technical) results:

There is no evidence of mass within the cerebellopontine angles or
internal auditory canals. The cisternal portions of the seventh
and eighth cranial nerves are normal. The cochlear and vestibular
apparatus are fully formed. There is no evidence of high-riding
jugular bulbs or gross superior semicircular canal dehiscence.
Diffusion weighted images of the brain demonstrate no evidence of
acute infarction. There is no evidence of acute intracranial
hemorrhage, extra-axial collection, mass effect, midline shift,
herniation, or hydrocephalus. A perivascular space is seen
adjacent to the left anterior commissure.
The visualized paranasal sinuses and mastoid air cells are clear.
The surrounding soft tissues and osseous structures are
unremarkable.

According to the doctor, this means everything is normal, so we are in a dead end now. I can really _feel_ as if it was fluid, but then again the perception may be misleading. However it is very consistent with what I’ve felt in the past about having fluid in the ear, and yet my doctor never finds any fluid on the inside of the ear drum.
If I do shake my ear or rub it or pull it, I can sometimes feel it gets better, only to go bad again within a few seconds of “being stable again”, as if the movement had displaced some fluid to some outer areas, and stillness makes it go back to it’s obstructing location through gravity.

Any clues as to what it could be? Fluid “hiding” in some cavity in there that’s not visible with an otoscope? Something else?

Thanks in advance.

Best regards,

— Greg
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