Unexplained Tinnitus: Seeking Answers for Persistent Ear Symptoms

Tinnitus of unknown origin?

Last year, at the end of November 2016, I experienced tinnitus and visited a pediatric clinic, where I was told it was due to a bacterial infection and post-nasal drip.
After taking the medication, there was no improvement.
I then went to a traditional Chinese medicine practitioner, who treated my chronic pharyngitis in just a week the previous October.
To my surprise, based on my trust in this doctor, my symptoms were suppressed just one hour after acupuncture; however, the symptoms persisted afterward.
The doctor was skilled with medications but had an average pulse diagnosis, so she didn't truly understand my condition and was merely guessing.
I mentioned her proficiency with medications because, the year before, she listened to the patient's self-diagnosis and prescribed medication based on the pulse findings.
I was lucky to guess the cause correctly.
Eventually, I decided to visit a large hospital, where I underwent hearing tests and endoscopies of my ears and nose; all results were normal.
The doctor stated that my Eustachian tube function was normal, my hearing was fine, and there were no signs of parasites, neurological degeneration, or fluid in the inner ear.
He suggested that my issue might still be related to post-nasal drip and advised me to ignore it, consider desensitization therapy, or even undergo cognitive testing.
This has been troubling me for almost two months, and with the cause still unknown, I fear that if the above doctors' suggestions are ruled out, it could only leave nasopharyngeal cancer or cortical degeneration of the brain as possibilities.
Honestly, aside from occasionally louder sounds, the frequency of the sounds is increasing, and there is slight itching and pain, but it doesn't significantly hinder me.
However, I am still very concerned.
Is there any way to determine the cause? I have read articles where patients had normal results after examinations, yet the doctors still attributed it to Eustachian tube dysfunction.
I have tried to insist on my views with doctors, only to be reprimanded with comments like, "Don't just believe what you read online." As a result, my condition hasn't improved regardless of what I eat.
I forgot to mention that my symptoms include a sound of water flowing in my right ear, and sometimes a popping sound, which is more pronounced when lying in bed.
When I asked the doctor why it only affects one side, he couldn't provide an explanation.
I admit I have severe nasal allergy issues, and I know that sometimes even if mucus isn't flowing, it doesn't mean there is none in the nasal cavity.
However, I have already used nasal sprays and taken medication, so it doesn't make sense that the frequency of symptoms is increasing instead of decreasing.

Miss Ni, 20~29 year old female. Ask Date: 2017/01/09

Dr. Zheng Jueyi reply Otolaryngology

Hello, if a detailed hearing examination has been conducted and various issues have been ruled out, common tinnitus is still often related to anxiety, insomnia, or excessive stress.
It is recommended to temporarily divert attention or use other music to mask the tinnitus, and to avoid focusing too much on it.
Maintaining a regular routine may help it gradually diminish.
If there is no improvement, you may need to visit a hospital for further evaluation.
Wishing you peace and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/01/09

More Info

Tinnitus, or ringing in the ears, can be a perplexing and frustrating condition, especially when its underlying cause remains elusive. Based on your description, it seems that you've been through a series of evaluations and treatments without finding a satisfactory resolution to your symptoms. Let's break down some potential causes and considerations regarding your persistent tinnitus.

Firstly, it’s important to understand that tinnitus can arise from various sources. Common causes include exposure to loud noises, ear infections, earwax buildup, age-related hearing loss, and even certain medications. In your case, you mentioned a previous diagnosis of a bacterial infection and post-nasal drip, which can indeed contribute to ear discomfort and tinnitus. The Eustachian tube, which connects the middle ear to the back of the nose, plays a crucial role in equalizing ear pressure and draining fluids. If it becomes dysfunctional, it can lead to a sensation of fullness in the ear, which might explain the "water flowing" sound you experience.

Your experience with traditional Chinese medicine and acupuncture suggests that you are open to alternative treatments, but it’s essential to ensure that any treatment aligns with evidence-based practices. While acupuncture can be beneficial for some conditions, its effectiveness for tinnitus is still debated in the medical community.
The fact that multiple specialists have conducted thorough examinations, including hearing tests and endoscopic evaluations, and found no significant abnormalities is reassuring. It suggests that more serious conditions, such as tumors or significant structural issues, are less likely. However, the persistence of your symptoms indicates that there may be other factors at play.

One possibility is that your tinnitus could be related to your allergies. Allergic reactions can lead to inflammation in the nasal passages and Eustachian tubes, potentially causing fluid buildup and pressure changes in the ears. Since you have a history of severe nasal allergies, it might be worth revisiting your allergy management plan. This could include discussing the effectiveness of your current medications with your healthcare provider or exploring other options, such as allergy shots (immunotherapy) if appropriate.

Another consideration is the psychological aspect of tinnitus. Stress and anxiety can exacerbate the perception of tinnitus, making it seem more prominent. If you are experiencing significant stress related to your symptoms, it might be beneficial to explore stress management techniques, such as cognitive-behavioral therapy (CBT), mindfulness, or relaxation exercises.

If you feel that your current healthcare providers are not addressing your concerns adequately, seeking a second opinion from an otolaryngologist (ENT specialist) with experience in tinnitus management could be beneficial. They might suggest additional diagnostic tests, such as imaging studies, to rule out other potential causes or recommend a specialized tinnitus management program.

In summary, while your tinnitus is likely multifactorial, focusing on managing your allergies, exploring psychological support, and ensuring you have a comprehensive evaluation from a specialist can help you find relief. Remember that tinnitus is a common condition, and many people find ways to cope with it effectively. Don’t hesitate to advocate for your health and seek the answers you deserve.

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