Can Throat Reflux Cause Persistent High-Pitched Tinnitus?

Is it possible for laryngopharyngeal reflux to cause persistent high-frequency tinnitus in both ears?

Hello Doctor, I would like to ask if laryngopharyngeal reflux could potentially cause tinnitus? I have been experiencing tinnitus for about two years, characterized by persistent high-frequency ringing in both ears, which occurs 24/7.
I have undergone various examinations, including nasopharyngoscopy, external auditory canal X-ray, neck ultrasound, sleep EEG, neck MRI, brain MRI, and other tests, but no specific cause has been identified.
I was ultimately informed that it is neurogenic tinnitus, and I can only coexist with it.
I had almost given up, but recently I noticed something: when my tinnitus first started two years ago, I also experienced symptoms of throat tightness and difficulty swallowing, along with frequent throat clearing.
The condition fluctuated, but since it was not as severe as the impact of the tinnitus, I did not pay much attention to it.
However, I have recently discovered that the severity of my tinnitus seems to be related to the throat symptoms; specifically, when I feel particularly tightness in my throat, the tinnitus seems to be louder, and when the throat tightness is less pronounced, the tinnitus appears to be slightly quieter.
After a bit of research, it seems that the throat tightness could possibly be related to laryngopharyngeal reflux or reflux laryngitis.
I have not pursued this direction in my examinations over the past two years, so I would like to ask if this could be laryngopharyngeal reflux? If so, could laryngopharyngeal reflux be the primary cause of my persistent high-frequency bilateral tinnitus?

Chen Mike, 20~29 year old female. Ask Date: 2017/09/02

Dr. Li Jiaxuan reply Otolaryngology

The neck has three layers of fascia from the outside to the inside, and the nasopharynx is connected to the oropharynx.
Therefore, when the larynx swells and tightens the fascia, it can cause tension in the nasopharyngeal fascia, potentially leading to partial or complete closure of the Eustachian tube, which may result in tinnitus.
However, continuous observation may be necessary.
Wishing you well.

Reply Date: 2017/09/02

More Info

Throat reflux, also known as laryngopharyngeal reflux (LPR), can indeed contribute to various symptoms, including persistent high-pitched tinnitus. Your experience of tinnitus coinciding with throat discomfort and swallowing difficulties suggests a potential link between these conditions.
LPR occurs when stomach acid flows back into the throat and larynx, leading to irritation and inflammation. This condition can cause a range of symptoms such as a sensation of a lump in the throat (often described as "globus sensation"), chronic cough, throat clearing, and even changes in voice. The connection between LPR and tinnitus is not fully understood, but there are several mechanisms that may explain how throat reflux could lead to or exacerbate tinnitus.

Firstly, the auditory system is closely linked to the structures of the throat and neck. Inflammation or irritation in the throat can lead to increased sensitivity in the auditory pathways. This heightened sensitivity may manifest as tinnitus, particularly if the auditory nerves are affected by inflammation or irritation from the reflux.
Secondly, the presence of acid in the throat can lead to muscle tension and spasms in the surrounding areas, including the neck and jaw. This tension can contribute to a condition known as temporomandibular joint (TMJ) dysfunction, which is often associated with tinnitus. The muscles and nerves in the jaw and neck are interconnected with those in the ear, and any dysfunction in this area can potentially lead to auditory symptoms.

Additionally, chronic inflammation from LPR can lead to changes in the mucosal lining of the throat and potentially affect the Eustachian tube, which helps regulate pressure in the middle ear. Dysfunction of the Eustachian tube can lead to a sensation of fullness in the ears and may contribute to tinnitus.

Given your history of persistent tinnitus and the timing of your throat symptoms, it would be prudent to explore the possibility of LPR further. A thorough evaluation by an ear, nose, and throat (ENT) specialist, along with a gastroenterologist, may be beneficial. They can perform specific tests to assess for reflux, such as a 24-hour pH monitoring study or an esophagogastroduodenoscopy (EGD) to visualize the esophagus and throat.

If LPR is confirmed, treatment options may include lifestyle modifications such as dietary changes, weight management, and avoiding triggers like caffeine, alcohol, and spicy foods. Medications such as proton pump inhibitors (PPIs) or H2 blockers may also be prescribed to reduce stomach acid production and alleviate symptoms.

In conclusion, while the exact relationship between throat reflux and tinnitus is complex and not fully understood, there is a plausible connection between the two. Addressing the underlying reflux may help alleviate your tinnitus symptoms. It is essential to work closely with your healthcare providers to develop a comprehensive treatment plan tailored to your specific needs.

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