Tinnitus and Ear Noises: When to Seek Medical Help

Q: Tinnitus and Ear Noises: When to Seek Medical 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, pulsatile tinnitus, and a sensation of bubbling sounds in the ear?

Hello, doctor.
I have been troubled for a long time by tinnitus and possibly pulsatile tinnitus.
Sometimes, my right ear suddenly feels blocked, and I experience tinnitus, which sometimes goes away.
The symptoms are always on the right side, and at times, I also hear a roaring sound in my right ear.
Now, whenever I swallow, I hear a popping sound.
I have gastroesophageal reflux disease (GERD) and I'm not sure if it is related.
Every time I lie down before sleeping, I hear sounds at the back of my head, which has been bothering me for a long time.
I have also seen a specialist for temporomandibular joint (TMJ) issues and had an MRI, which indicated cartilage displacement.
I am unsure if this could also be affecting my condition.
Could you please advise me on which specialty I should consult?

Mike, 20~29 year old female. Ask Date: 2021/06/06

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: 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, often due to contaminated water or improper ear cleaning, leading to inflammation.
4) Other conditions such as temporomandibular joint disorders or gastroesophageal reflux may also be possible.
All of the above conditions can be appropriately treated with medication after consulting a healthcare provider.
If you have already undergone pure tone audiometry (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 a pure tone audiometry test, it is recommended to visit a hospital for evaluation to rule out sudden hearing loss.
The golden treatment period for sudden sensorineural hearing loss is within two weeks, and early treatment yields better outcomes.
Wishing you safety and good health.

Reply Date: 2021/06/06

More Info

Tinnitus, often described as ringing, buzzing, or hissing in the ears, can be a frustrating and distressing condition. It is important to understand that tinnitus can arise from various underlying issues, and its management often requires a comprehensive approach. Given your symptoms, including the sensation of fullness in your right ear, the presence of noise when swallowing, and your history of gastroesophageal reflux disease (GERD), it is crucial to explore these connections further.

Firstly, the relationship between tinnitus and ear fullness can indicate a problem with the Eustachian tube, which connects the middle ear to the back of the throat. Dysfunction in this tube can lead to pressure imbalances, resulting in sensations of fullness and contributing to tinnitus. Additionally, GERD can exacerbate ear symptoms, as acid reflux may irritate the throat and Eustachian tube, leading to inflammation and discomfort.

Your mention of experiencing sounds in your ear when swallowing suggests that there may be some involvement of the Eustachian tube or even the muscles around the ear. This phenomenon, known as "patulous Eustachian tube," occurs when the Eustachian tube remains open, allowing sounds from the throat to be transmitted to the ear. This can be particularly noticeable during activities like swallowing or yawning.

Furthermore, the fact that you have seen a specialist for temporomandibular joint (TMJ) issues is also relevant. TMJ disorders can contribute to ear symptoms, including tinnitus, due to the close anatomical relationship between the jaw joint and the ear structures. Displacement of the soft tissues in the TMJ can lead to referred sensations in the ear, including noise and fullness.

Given the complexity of your symptoms, it is advisable to consult with an otolaryngologist (ENT specialist) who can perform a thorough evaluation. This may include a detailed history, physical examination, and possibly additional tests such as audiometry to assess your hearing and tympanometry to evaluate Eustachian tube function. If necessary, imaging studies like a CT scan or MRI may be warranted to rule out structural abnormalities.

In terms of treatment, addressing the underlying causes is key. If Eustachian tube dysfunction is confirmed, treatments may include nasal decongestants, antihistamines, or even nasal corticosteroids to reduce inflammation. For TMJ-related issues, dental splints or physical therapy may be recommended to alleviate symptoms. Additionally, managing GERD through dietary changes and medications can also help reduce associated ear symptoms.

For tinnitus specifically, while there is no one-size-fits-all cure, various strategies can help manage the condition. Sound therapy, cognitive behavioral therapy (CBT), and relaxation techniques can be beneficial in reducing the perception of tinnitus and improving quality of life.
In conclusion, it is essential to seek medical help when experiencing persistent tinnitus and associated ear symptoms. A multidisciplinary approach involving ENT specialists, dentists for TMJ issues, and possibly gastroenterologists for GERD can provide a comprehensive evaluation and tailored treatment plan. By addressing the underlying causes and utilizing appropriate management strategies, you can work towards alleviating your symptoms and improving your overall well-being.

Similar Q&A

Understanding Tinnitus: When to Seek Further Medical Evaluation

Hello doctor, I have been troubled by tinnitus for two years since I can remember. I am not sure why I have a high-pitched ringing sound 24 hours a day, which is especially noticeable in very quiet places, and I can't distinguish which ear it is coming from since both ears h...

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 flights, mountain climbing, or diving, but also when forcefully blowing your nose or bending over. 2) Sudden sensorineural hearing loss. 3)...

Understanding Tinnitus: When to Seek Help After Earphone Use

Hello, doctor. Last Friday, while I was wearing headphones and giving a presentation, a friend suddenly came to talk to me, and I forgot that I still had one earphone in. It's now the third day, and I still hear a "ringing" sound in my ear. I visited an otolaryngol...

Dr. Zheng Jueyi reply Otolaryngology
Hello: If you experience changes in hearing or persistent tinnitus, it is recommended to visit a hospital for a hearing examination to confirm the diagnosis. Wishing you safety and health. Sincerely, Dr. Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital...

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: When to Consult a Neurologist for Relief

Hello Doctor: Over the past year, I have been hearing a high-pitched ringing or hissing sound in my left ear, especially in quiet environments, which often affects my sleep. I have visited an otolaryngologist three times, and the doctors have stated that there are no significant ...

Dr. Jiang Junyi reply Neurology
Hello: Based on your description, if you are experiencing frequent tinnitus, it may be necessary to consider potential issues with the cochlea in the inner ear and the auditory nerve. This is commonly seen in individuals who work in noisy environments for extended periods, use me...