Tinnitus: Causes, Concerns, and Treatment Options

Q: Tinnitus: Causes, Concerns, and Treatment Options

Hello： There are many factors that can cause tinnitus. <br>If hearing tests and neurological functions show no significant abnormalities, it is often more related to stress symptoms such as anxiety and insomnia. <br>It is advisable to start by improving sleep and reducing anxiety

Tinnitus issues

Hello, doctor.
I would like to correct my previous message.
On a certain day in February, I suddenly experienced severe pain in my left ear.
The next day, I sought medical attention and was diagnosed with temporomandibular joint inflammation.
After taking medication, the pain decreased, but since that day, I have had constant tinnitus in my left ear 24/7.
The sound resembles a mix of an "e" sound, a beep, and a hissing noise, which I find difficult to distinguish.
Occasionally, I also feel pain and pressure in my inner ear.
Sometimes, when I swallow, I hear a popping sound in my left ear.
I visited a clinic twice during this period, and both times I was told it might be due to chronic tonsillitis.
Since the tinnitus was not very loud at that time, I did not pursue further examination.
Around April 25, I woke up in the morning coughing up green phlegm, so I went to an ENT clinic.
On the second night after taking the medication, I suddenly experienced high-frequency tinnitus several times, and afterward, the tinnitus became louder.
I returned to the clinic and informed the doctor, who suggested it might be caused by nasal allergies.
He advised me to treat the green phlegm first and also to try treating the tinnitus.
He examined my eardrum with an otoscope and found no issues, but when measuring my ear pressure, it was abnormal.
The doctor prescribed medication for five days, but there was no improvement in the tinnitus.
I had my tonsils removed bilaterally on April 1, and just yesterday, on May 3, I returned for a follow-up appointment.
I mentioned my tinnitus issue to the doctor, who conducted a hearing test (in a soundproof room).
The report indicated that my hearing was mostly normal.
When I asked the doctor about the cause of the tinnitus, he suggested it might be related to the surgery.
However, the issue is that I had already experienced tinnitus before the surgery, and it only worsened a month post-operatively.
Is there really a connection to the surgery?
Additionally, since the surgery, I still feel a dull pain in the area where my left tonsil was, and I find it difficult to swallow certain foods, which may be due to the healing process.
I also still have some yellow phlegm when I cough.
I wonder if this could be affecting the tinnitus in my left ear.
Now, even during the day with the TV on, I can hear the tinnitus, which is constant and loud at night, making it hard to sleep.
I feel very depressed and am in a lot of pain.
I truly want to escape this situation, but I can't bear to leave my 2.5-year-old child behind.
I am also worried that I might have a serious illness.
The doctor has prescribed vitamins B and C, as well as a medication called Anxiolytic, to see if it helps improve or eliminate the tinnitus.
I am concerned that I might have a serious condition in my brain, such as a brain tumor, nasopharyngeal carcinoma, vascular obstruction, or a eustachian tube tumor.
What should I do now? Can I request the doctor to arrange for an MRI? How much would it cost out of pocket? If the MRI shows no issues, can I rule out serious conditions like nasopharyngeal carcinoma, brain tumors, vascular obstruction, or eustachian tube tumors?
Since the surgery was performed in Yunlin (and I currently live in New Taipei City), it is quite far, and I have to wait until the end of the month for a follow-up appointment, which is very difficult for me.
I really want to find a doctor to help me with further examinations to rule out serious illnesses.
Additionally, my father was diagnosed with breast cancer earlier this year.
Am I at an increased risk of developing cancer? The tinnitus is really affecting my emotions every day.
I hope the doctor can provide answers and suggestions.
Will my tinnitus get better? Thank you.

Miss Yang, 40~49 year old female. Ask Date: 2021/05/05

Dr. Zheng Jueyi reply Otolaryngology

Hello: There are many factors that can cause tinnitus.
If hearing tests and neurological functions show no significant abnormalities, it is often more related to stress symptoms such as anxiety and insomnia.
It is advisable to start by improving sleep and reducing anxiety, or using white noise or music to mask the tinnitus sound.
If the symptoms persist without improvement, it is recommended to continue follow-up visits for the clinical physician to determine if further examinations are necessary.
Wishing you peace and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2021/05/05

More Info

Tinnitus, commonly referred to as ringing in the ears, can be a distressing condition that significantly impacts one’s quality of life. Understanding its causes, concerns, and treatment options is crucial for managing this condition effectively.

Causes of Tinnitus
Tinnitus can arise from various underlying issues. In your case, the initial pain in your left ear and the subsequent diagnosis of temporomandibular joint (TMJ) inflammation may have contributed to the onset of tinnitus. TMJ disorders can lead to ear pain and tinnitus due to the close anatomical relationship between the jaw joint and the ear. Other potential causes of tinnitus include:
1. Hearing Loss: Age-related hearing loss or exposure to loud noises can damage the hair cells in the inner ear, leading to tinnitus.

2. Ear Infections or Blockages: Conditions such as chronic tonsillitis, as you mentioned, can lead to inflammation and pressure changes in the ear, potentially causing tinnitus.

3. Eustachian Tube Dysfunction: This can occur when the tube that connects the middle ear to the back of the nose becomes blocked or does not function properly, leading to pressure changes and tinnitus.

4. Medications: Certain medications, particularly ototoxic drugs, can cause or worsen tinnitus.

5. Other Medical Conditions: Conditions such as high blood pressure, diabetes, and even tumors can contribute to tinnitus.

Concerns Regarding Tinnitus
Your concerns about serious underlying conditions such as brain tumors, nasopharyngeal cancer, or vascular blockages are understandable, especially given your family history of cancer. While tinnitus can be associated with serious conditions, it is often benign. However, persistent or worsening tinnitus warrants further investigation to rule out any serious underlying issues.

Treatment Options
1. Medical Evaluation: Since you have already undergone hearing tests and examinations, it is essential to follow up with an ENT specialist. If you feel that your concerns are not being addressed, you can certainly request further imaging studies, such as an MRI or CT scan, to rule out serious conditions. The cost of these tests can vary widely depending on your location and whether you have insurance coverage, but they are generally in the range of several hundred to a few thousand dollars.

2. Management of Underlying Conditions: Addressing any underlying conditions, such as your chronic tonsillitis or Eustachian tube dysfunction, may help alleviate tinnitus. Continuing to follow up with your healthcare provider regarding your throat pain and any residual symptoms post-surgery is crucial.

3. Sound Therapy and Counseling: Many individuals find relief through sound therapy, which involves using background noise or white noise to mask the tinnitus. Cognitive-behavioral therapy (CBT) can also be beneficial in managing the emotional distress associated with tinnitus.

4. Medications: While there is no specific medication to cure tinnitus, some medications may help alleviate the symptoms. The vitamins B and C your doctor prescribed may support overall ear health, but their effectiveness can vary.

5. Lifestyle Modifications: Reducing stress, avoiding loud noises, and managing any anxiety or depression can also help improve your symptoms. Engaging in relaxation techniques or mindfulness practices may provide some relief.

Conclusion
It is essential to communicate openly with your healthcare provider about your symptoms and concerns. If you feel that your current treatment plan is not effective, do not hesitate to seek a second opinion or request further evaluations. Tinnitus can be a complex condition, but with the right approach, many individuals find ways to manage their symptoms effectively. Remember that while your concerns about serious conditions are valid, many cases of tinnitus are manageable and do not indicate a severe underlying issue.

Similar Q&A

Understanding Tinnitus: Causes, Concerns, and Treatment Options

Hello Doctor, On a certain day in February, I suddenly experienced severe pain in my left ear. The next day, I visited a doctor who diagnosed me with temporomandibular joint inflammation. After taking medication, the pain subsided, but since that day, I have had continuous tinn...

Dr. Zheng Jueyi reply Otolaryngology
Hello: There are many factors that can cause tinnitus. If hearing tests and neurological functions show no significant abnormalities, it is often associated with stress symptoms such as anxiety and insomnia. It is advisable to start by improving sleep and reducing anxiety, or usi...

Understanding Tinnitus: Causes, Symptoms, and Treatment Options

Hello Dr. Yeh, I have a question that has been bothering me for a long time, and I would like to ask for your advice. My ears often have a "buzzing" sound, usually in the left ear, but sometimes in both ears. I have hepatitis B and I sleep on my side, and I wonder if ...

Dr. Ye Dawei reply Otolaryngology
Xiao Xun, your tinnitus issue is not significantly related to hepatitis B or sleeping on your side. Here is the information for your reference: ----------------------------------------------------------- 【"Local Surrounding the Central" – Correct Concepts for Treating ...

Understanding Tinnitus: Causes, Concerns, and When to Seek Help

Hello Doctor: I have been experiencing tinnitus in my ears for about six years now, and I have undergone hearing tests, all of which indicated no issues. However, the ringing persists, especially louder during the quiet of the night. Should I seek medical attention again? Additio...

Dr. Wu Yuxin reply Otolaryngology
Tinnitus may be more likely associated with the degeneration of the auditory nerve. Generally, oral medications can be used for treatment, but the effects are often very slow. Some individuals may not experience any improvement even after several months of medication. In such cas...

Understanding Tinnitus: Causes, Effects, and Treatment Options

Hello doctor, I have a problem with tinnitus in both ears. It's not very loud, but I can hear it when I wear earplugs or sometimes when I'm sleeping. I'm not sure if the tinnitus has caused any other effects on my body. What will happen if I don't treat it? If...

Dr. Zheng Jueyi reply Otolaryngology
Hello: Most cases of tinnitus are benign. It is recommended to maintain a regular routine and ensure good sleep, and not to pay excessive attention to it. If you still have concerns, you may seek medical examination and treatment. Wishing you peace and health. Sincerely, Dr. Chen...