Persistent Tinnitus: Causes and When to Seek Help

Q: Persistent Tinnitus: Causes and When to Seek Help

Hello： Tinnitus can be attributed to issues originating from the ear or related to the brain. <br>Common causes include external auditory canal inflammation, foreign body obstruction, and earwax buildup, which can all lead to tinnitus. <br>Even dental extractions and temporomandi

Suspected persistent tinnitus?

Hello Doctor: Recently, I have been frequently cleaning my ears, and I suspect that I may have caused some inflammation in the ear canal.
I suddenly started experiencing a persistent sharp, electric-like sound in one ear, but my hearing in both ears seems unaffected.
I visited an otolaryngologist who used an endoscope to examine my ears.
Some earwax was pushed deeper with a cotton swab, and after suctioning some out, there was still a piece of earwax too close to the eardrum, which I was advised to soften with ear drops to allow it to come out on its own.
However, I continue to experience a unilateral sharp tinnitus sound 24 hours a day (except while sleeping), but it does not affect my hearing; I can hear sounds clearly in that ear.
This has been ongoing for about a week, and I have no other discomfort, just this strange sharp electric sound (similar to high-frequency noise from a transformer).

I read online about the symptom of pulsatile tinnitus, and previously, I had some facial numbness possibly due to tightness in my shoulder and neck muscles.
I consulted a doctor at that time and took some muscle relaxants, but it resolved on its own later.
Recently, I feel that my shoulder and neck muscles are tense again, causing soreness throughout the day, along with a vague pressure that gives a sensation of constriction in the left side of my abdomen (I had a colonoscopy last year that confirmed irritable bowel syndrome with no other issues).
I wonder if this could be related to the tension in my shoulder and neck muscles.

Could this be stress-induced pulsatile tinnitus? Or is there any specific abnormal condition that would warrant a detailed examination at the hospital? Thank you, Doctor.

Niu, 30~39 year old female. Ask Date: 2018/01/02

Dr. Jiang Junyi reply Neurology

Hello: Tinnitus can be attributed to issues originating from the ear or related to the brain.
Common causes include external auditory canal inflammation, foreign body obstruction, and earwax buildup, which can all lead to tinnitus.
Even dental extractions and temporomandibular joint inflammation can cause tinnitus; however, tinnitus caused by these factors usually resolves once the underlying issue is addressed.

Middle ear infections and abnormalities of the ossicles can also lead to tinnitus.
Fluid accumulation in the middle ear and dysfunction of the Eustachian tube often result in low-frequency tinnitus.
In contrast, tinnitus caused by disturbances in the cochlea or auditory nerve of the inner ear is typically high-frequency.
Prolonged exposure to noisy environments, certain medications, and inflammation of the inner ear can affect the auditory nerve or brain nerves.
If unilateral high-frequency tinnitus is accompanied by hearing loss or dizziness, it may be necessary to consider issues such as acoustic neuroma.
It is advisable to discuss examination and treatment options with an otolaryngologist and a neurologist.
Wishing you good health and peace.
Dr.
Tao, concerned about you.

Reply Date: 2018/01/02

More Info

Tinnitus, often described as a ringing, buzzing, or hissing sound in the ears, can be a perplexing and distressing condition. Your experience of persistent tinnitus following ear cleaning and potential ear canal inflammation raises several important considerations regarding its causes and when to seek further medical help.

Understanding Tinnitus
Tinnitus can arise from various factors, including exposure to loud noises, earwax buildup, ear infections, age-related hearing loss, and even stress. In your case, the recent ear cleaning may have inadvertently caused irritation or inflammation in the ear canal, leading to the perception of sound even in the absence of external stimuli. The fact that you have a sharp, electrical sound in one ear, while your hearing remains intact, suggests that the tinnitus may be related to the changes in your ear environment rather than a systemic issue.

Possible Causes
1. Earwax Buildup: As you mentioned, earwax can sometimes be pushed deeper into the ear canal, leading to blockage and irritation. This can create pressure changes that might trigger tinnitus.

2. Inflammation or Infection: If there is inflammation in the ear canal (otitis externa), it can lead to abnormal auditory perceptions. Even if the inflammation is mild, it can still affect how sound is processed.

3. Muscle Tension: You noted experiencing tension in your neck and shoulders, which can contribute to tinnitus. The muscles in the neck and jaw can affect the auditory system, and tension in these areas can lead to increased perception of tinnitus.

4. Stress and Anxiety: Psychological factors such as stress can exacerbate tinnitus. The perception of sound can become more pronounced when one is anxious or under pressure.

When to Seek Help
While tinnitus is often benign and may resolve on its own, there are specific circumstances under which you should seek further medical evaluation:
1. Duration: If your tinnitus persists for more than a week without improvement, it is advisable to consult an ear, nose, and throat (ENT) specialist. Persistent tinnitus can sometimes indicate underlying conditions that need to be addressed.

2. Associated Symptoms: If you experience additional symptoms such as dizziness, hearing loss, or a feeling of fullness in the ear, these could indicate a more serious issue that requires medical attention.

3. Impact on Daily Life: If the tinnitus is affecting your quality of life, sleep, or concentration, it is important to discuss this with a healthcare provider. There are various management strategies available that can help alleviate the distress caused by tinnitus.

4. Changes in Symptoms: If the nature of the tinnitus changes (e.g., becoming louder, changing in pitch, or accompanied by pain), this warrants further investigation.

Conclusion
In summary, while your current experience of tinnitus may be related to recent ear cleaning and potential inflammation, it is essential to monitor the situation closely. If the tinnitus persists beyond a week or is accompanied by other concerning symptoms, seeking a thorough evaluation from an ENT specialist is recommended. They can perform a comprehensive assessment, including hearing tests and possibly imaging studies, to rule out any serious underlying conditions. Additionally, addressing any muscle tension through relaxation techniques or physical therapy may also help alleviate your symptoms. Remember, you are not alone in this experience, and there are resources and treatments available to help manage tinnitus effectively.

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