Tinnitus: Causes, Symptoms, and When to Seek Help

Q: Tinnitus: Causes, Symptoms, and When to Seek Help

Hello, the issues you mentioned could be due to： 1) Eustachian tube dysfunction： This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over. <br>2) Sudden sensorineural hearing loss. <br>3) O

Tinnitus issues

Hello, I have a history of allergic rhinitis (dust), mild asthma, chronic migraines, and low blood pressure.
Since childhood, I have experienced tinnitus (a feeling of fullness in the ears with a whooshing sound) when exercising or slightly out of breath (such as going up and down stairs), especially when exhaling through my nose, which makes the ear fullness more pronounced.
This condition lasts for a while, and then I start to feel pain at the base of my ears.
This sensation is different from the usual ear pressure experienced during flights, as it cannot be alleviated by swallowing or yawning; instead, I need to inhale forcefully through my nose to relieve it.
Additionally, if I exercise for an extended period (regardless of winter or summer), my throat begins to feel uncomfortable, tight, and constricted, and I experience slight difficulty in breathing, which makes me want to cough, although I'm unsure if this is related to my asthma.
I rarely exercise; could this situation be related to my level of physical activity? Should I reduce or increase my exercise? Do I need to undergo any examinations at the hospital? Thank you!

Boo, 20~29 year old female. Ask Date: 2018/02/12

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the issues you mentioned could be due to: 1) Eustachian tube dysfunction: This is the most common cause and can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over.
2) Sudden sensorineural hearing loss.
3) Otitis media: a) Acute otitis media: This often occurs alongside upper respiratory infections (such as colds) and sinusitis, and in severe cases, there may be ear discharge.
b) Chronic otitis media with acute exacerbation: This usually occurs when there is a pre-existing perforation in the eardrum, which can become inflamed due to unclean water or improper ear cleaning.
All of the above conditions can be appropriately managed with medication after consulting a healthcare provider.
If you have already undergone pure tone audiometry (which requires headphones in a soundproof booth, where sounds are presented and you respond by pressing a button, rather than just using a tuning fork), and it has been confirmed that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not had a pure tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
The golden treatment window for sudden sensorineural hearing loss is two weeks, and early treatment yields better outcomes.
Regarding the parts mentioned about exercise and throat locking, the information provided is too vague for an accurate response, so it is best to consult an otolaryngologist.
Wishing you safety and good health.
Sincerely, Dr.
Chi Chao-Yun, Head of the Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/02/12

More Info

Tinnitus, commonly referred to as ringing in the ears, can be a perplexing and distressing condition. Understanding its causes, symptoms, and when to seek medical help is crucial for managing this issue effectively.

Causes of Tinnitus
Tinnitus can arise from a variety of factors. In your case, having a history of allergic rhinitis, mild asthma, chronic migraines, and low blood pressure may contribute to your symptoms. Common causes of tinnitus include:
1. Hearing Loss: Age-related hearing loss or exposure to loud noises can lead to tinnitus.

2. Ear Infections or Blockages: Allergies, sinus infections, or earwax buildup can create pressure in the ear, resulting in tinnitus.

3. Medications: Certain medications, especially high doses of aspirin or other ototoxic drugs, can cause or worsen tinnitus.

4. Health Conditions: Conditions such as Meniere's disease, acoustic neuroma, or temporomandibular joint (TMJ) disorders can lead to tinnitus.

5. Stress and Anxiety: Emotional stress can exacerbate the perception of tinnitus.

Symptoms of Tinnitus
The symptoms of tinnitus can vary widely among individuals. Commonly reported symptoms include:
- Ringing, buzzing, hissing, or roaring sounds in the ears.

- A feeling of fullness or pressure in the ear.

- Pain or discomfort in the ear region, particularly if there is an underlying condition such as an ear infection or sinus pressure.

- Difficulty concentrating or sleeping due to the persistent noise.

In your description, the sensation of ear fullness and the need to forcefully inhale through your nose to relieve pressure suggest that there may be an underlying issue related to your nasal passages or Eustachian tubes, which connect the middle ear to the back of the throat.

When to Seek Help
Given your symptoms, it is advisable to consult a healthcare professional, particularly an ENT (ear, nose, and throat) specialist. You should seek medical attention if you experience:
- Persistent tinnitus that affects your daily life.

- Ear pain or discomfort that does not resolve.

- Changes in hearing or balance.

- Symptoms that worsen with physical activity or exertion.

Relationship Between Exercise and Tinnitus
Your concern about the relationship between exercise and your tinnitus is valid. While regular physical activity is generally beneficial for overall health, it can sometimes exacerbate tinnitus, especially if you have underlying respiratory issues like asthma. The tightness in your throat and difficulty breathing during exercise could indicate that your asthma is not well-controlled, which may contribute to your tinnitus symptoms.

Recommendations
1. Consult a Specialist: Given your complex medical history, it would be wise to see an ENT specialist who can evaluate your tinnitus and related symptoms. They may conduct hearing tests, imaging studies, or other assessments to determine the underlying cause.

2. Manage Allergies and Asthma: Since you have allergic rhinitis and asthma, ensuring that these conditions are well-managed can help alleviate some of your symptoms. This may include using antihistamines or nasal corticosteroids for allergies and bronchodilators or inhaled corticosteroids for asthma.

3. Monitor Physical Activity: While exercise is important, consider starting with low-impact activities that do not exacerbate your breathing difficulties. Gradually increase your activity level as tolerated, and pay attention to how your body responds.

4. Stress Management: Since stress can worsen tinnitus, incorporating relaxation techniques such as deep breathing, meditation, or yoga may be beneficial.

5. Keep a Symptom Diary: Documenting when your tinnitus occurs, its intensity, and any associated activities or triggers can provide valuable information for your healthcare provider.

In conclusion, tinnitus can be multifactorial, and understanding its relationship with your existing health conditions is essential. Seeking professional guidance will help you navigate this issue effectively and improve your quality of life.

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