Sinusitis and Tinnitus: the Connection and Symptoms

Sinusitis and tinnitus

Hello, doctor! I have been suffering from sinusitis for over five years.
Recently, I have been experiencing tinnitus, and after undergoing an MRI, it was found that there is a significant amount of fluid in my sinuses.
I would like to ask if this condition could be affecting my tinnitus, as I have been experiencing worsening tinnitus in both ears over the past year, with a loud ringing sound.
Additionally, I have noticed swelling in the lymph nodes on the left side of my neck, and the MRI showed inflammatory lymphadenopathy that has been present for a year.
Could the excess fluid in my nasal cavity be contributing to these issues? Thank you!

Roy, 40~49 year old female. Ask Date: 2020/08/04

Dr. Ji Zhaoyun reply Otolaryngology

Hello! The issues you mentioned could be due to several reasons:
1) Poor Eustachian tube function, which is quite common and can occur not only during flights but also while hiking or diving.
Forcefully blowing your nose or bending over can also contribute to this issue.

2) Sudden sensorineural hearing loss.

3) Otitis media:
a) Acute otitis media often occurs alongside upper respiratory infections (like the common cold) and sinusitis.
In severe cases, there may be discharge from the ear.

b) Chronic otitis media with acute exacerbation usually involves a pre-existing perforation in the eardrum, which can become inflamed due to contaminated water or improper ear cleaning.
All of the above conditions can be appropriately managed with medication prescribed by a healthcare provider.
If you have already undergone a pure tone audiometry test (which requires headphones in a soundproof room, where you press a button in response to sounds, rather than just using a tuning fork), and it confirms that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not had this test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
Common symptoms of sinusitis include nasal congestion, yellow-green nasal discharge, fever, facial pain, foul smell, changes in smell, ear fullness, and tinnitus, but not all symptoms may be present.
Diagnostic methods include endoscopy and imaging studies.
If acute sinusitis persists despite antibiotic treatment for more than two weeks, it is recommended to see an otolaryngologist for bacterial culture.
If a more virulent strain of bacteria is identified, a stronger antibiotic may be necessary.
You may consider purchasing a nasal irrigation device (containing isotonic saline) and perform rinses 1-2 times daily to enhance the treatment of sinusitis.
Additionally, avoid staying up late, refrain from smoking, and if you have diabetes, control your blood sugar levels.
If sinusitis does not improve after 2-3 months of treatment, it is highly likely to be chronic sinusitis, which requires further evaluation and possibly surgical intervention.
It is advisable to consult an otolaryngologist for assessment.
Enlarged cervical lymph nodes can have various causes, and sinusitis could be one of them, but there are other potential reasons as well.
If symptoms persist, it is best to consult an otolaryngologist.
Wishing you good health!

Reply Date: 2020/08/04

More Info

Sinusitis, or inflammation of the sinuses, can indeed have a significant impact on various aspects of health, including the auditory system, which may explain your experience with tinnitus. Tinnitus is characterized by the perception of noise or ringing in the ears when no external sound is present. It can be caused by a variety of factors, including ear infections, exposure to loud noises, and even sinus issues.

In your case, the presence of fluid in the sinuses, as indicated by your MRI results, can lead to increased pressure and inflammation in the surrounding areas, including the ears. The sinuses are connected to the ears via the Eustachian tubes, which help to equalize pressure in the middle ear. When the sinuses are inflamed or filled with fluid, it can obstruct the Eustachian tubes, leading to a sensation of fullness in the ears and potentially contributing to tinnitus.

Moreover, the inflammation in your lymph nodes, as noted in your MRI, suggests that there may be an ongoing infection or inflammatory process in your body. This can further exacerbate your symptoms, as systemic inflammation can affect various bodily functions, including those related to hearing. The swelling of lymph nodes, particularly in the neck, can indicate that your body is responding to an infection, which may also be linked to your sinusitis.

It is important to consider that chronic sinusitis can lead to complications, including the development of nasal polyps or chronic otitis media (middle ear infection), both of which can contribute to hearing issues and tinnitus. The prolonged presence of fluid in the sinuses can create an environment conducive to bacterial growth, leading to further complications.

In terms of management, addressing the underlying sinusitis is crucial. This may involve the use of nasal corticosteroids to reduce inflammation, saline nasal irrigation to help clear mucus, and possibly antibiotics if a bacterial infection is suspected. Additionally, if you are experiencing significant discomfort or if your tinnitus persists, it may be beneficial to consult with an otolaryngologist (ENT specialist) who can provide a comprehensive evaluation and tailored treatment plan.

In summary, your sinusitis and the associated fluid buildup can indeed contribute to your tinnitus and other symptoms. It is essential to address the sinus issues to potentially alleviate the auditory symptoms you are experiencing. Regular follow-ups with your healthcare provider will be important to monitor your condition and adjust treatment as necessary. If your symptoms worsen or new symptoms arise, do not hesitate to seek further medical attention.

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