Unilateral Tinnitus: Symptoms, Causes, and Concerns

Tinnitus issues - Description of tinnitus, unilateral?

Hello! I've read quite a bit about tinnitus, but I still can't clarify my doubts, so I have to take up the precious time of the doctor again! My tinnitus is a persistent, high-pitched hissing sound, and this is the second occurrence.
The last time was probably last year or the year before, and it disappeared after about two to three months.
I’m not sure if it was exactly two or three months; it just faded away without me noticing until it recently reappeared.
During daily activities, I don't pay much attention to it, and the sound isn't loud enough to cause any disruption in my life.
However, if I focus on it or when I go to bed at night, I can perceive the presence of the tinnitus.
Massaging around my ears seems to slightly reduce the volume.
My hearing test during a health check was normal, and I don't feel any blockage in my ears.

I perceive two types of tinnitus: the persistent type I mentioned, which feels like it's originating from within my brain, and another type that starts with a feeling of fullness, followed by a brief buzzing sound from my ear, lasting about ten seconds, which occurs infrequently.
I’m particularly concerned about the information I found online regarding unilateral tinnitus, which could indicate a serious condition.
The brief episodes, which last less than ten seconds, have only occurred on one side at a time, but it seems like both sides have experienced it at some point.
The persistent type is harder to distinguish between sides, and there isn't a clear point of sound origin, but it seems that the sound from the left side (left brain) is stronger.
In the quiet of the night, the tinnitus on the left side is more pronounced, but when I cover both ears, it seems indistinct between the two sides.
Does this count as unilateral tinnitus? The information online about unilateral tinnitus isn't very clear.

The last time I visited an ENT specialist, the doctor mentioned that my cervical spine was misaligned and that stiffness in my neck and shoulders was causing poor blood flow, leading to the tinnitus.
I was advised to do stretching exercises regularly.
After doing those for a while, it seemed to improve, but it has recurred recently, and I’m really worried! I also visited another clinic, where they checked my middle ear and said it was normal, and the medication I took to improve inner ear circulation didn’t help…

Da Dai, 40~49 year old female. Ask Date: 2017/12/15

Dr. Zheng Jueyi reply Otolaryngology

Hello, based on the current symptoms, they are not persistent, only noticeable during quiet moments, and the hearing test shows normal results without any sensation of fullness.
This type of tinnitus is mostly benign.
It is advised not to pay excessive attention to it; you can try to distract yourself or use other sounds or music to mask it.
Most cases will gradually diminish.
However, if there is no improvement or if it worsens, it is recommended to seek medical evaluation.
Wishing you health and happiness! Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2017/12/15

More Info

Unilateral tinnitus, or tinnitus that occurs in one ear, can be a perplexing and concerning symptom for many individuals. Your description of the persistent high-pitched ringing, along with the intermittent buzzing sensation, raises several important points regarding its potential causes and implications.

Symptoms and Characteristics
From your account, it seems you experience two types of tinnitus: a continuous high-frequency sound and a brief buzzing sound that lasts less than ten seconds. The fact that the continuous tinnitus is more pronounced at night and when you focus on it suggests that it may be linked to your overall state of relaxation or stress levels. Tinnitus can often become more noticeable in quiet environments, which is why many people report increased awareness of it when trying to sleep.

Potential Causes
Tinnitus can arise from a variety of causes, including:
1. Hearing Loss: Even if your hearing tests are normal, subtle changes in hearing can lead to tinnitus. Age-related hearing loss or noise exposure can contribute to this condition.

2. Eustachian Tube Dysfunction: This can cause a sensation of fullness in the ear and may lead to tinnitus.

3. Cervical Issues: As you mentioned, your doctor noted that cervical spine misalignment and muscle tension in the neck and shoulders could affect blood flow and nerve function, potentially contributing to your tinnitus.

4. Inner Ear Disorders: Conditions such as Meniere's disease or vestibular schwannoma (acoustic neuroma) can cause unilateral tinnitus. However, these conditions typically present with additional symptoms, such as hearing loss or balance issues.

5. Stress and Anxiety: Psychological factors can exacerbate tinnitus. Stress can heighten your awareness of the sound, making it feel more intrusive.

Concerns Regarding Unilateral Tinnitus
You expressed concern about the possibility of unilateral tinnitus being indicative of a serious condition. While unilateral tinnitus can sometimes be associated with more serious issues, such as tumors or vascular malformations, it is essential to consider the overall context of your symptoms. The fact that your tinnitus has been intermittent and has not significantly impacted your daily life is a positive sign. However, persistent or worsening symptoms warrant further investigation.

Recommendations
1. Follow-Up with an ENT Specialist: If you haven't already, consider a comprehensive evaluation by an ear, nose, and throat specialist. They may recommend imaging studies, such as an MRI, to rule out any structural abnormalities.

2. Cervical Health: Since your doctor suggested that neck issues might be contributing to your tinnitus, engaging in physical therapy or exercises to improve posture and reduce muscle tension could be beneficial.

3. Sound Therapy: Using background noise or white noise machines can help mask the tinnitus, especially at night.

4. Cognitive Behavioral Therapy (CBT): If stress and anxiety are significant factors, CBT may help you manage your reaction to tinnitus.

5. Lifestyle Modifications: Reducing caffeine and alcohol intake, managing stress through relaxation techniques, and ensuring adequate sleep can also help mitigate tinnitus symptoms.

Conclusion
In summary, while unilateral tinnitus can be concerning, it is essential to approach it with a comprehensive understanding of its potential causes and implications. Regular follow-ups with healthcare providers, along with lifestyle adjustments, can significantly improve your quality of life. If your symptoms change or worsen, do not hesitate to seek further medical advice. Remember, you are not alone in this experience, and many effective strategies can help manage tinnitus.

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