Persistent Tinnitus and Throat Discomfort After Tonsil Surgery: What to Do?

Q: Persistent Tinnitus and Throat Discomfort After Tonsil Surgery: What to Do?

Hello： There are many factors that can cause tinnitus. <br>If hearing and ear pressure tests are normal, it is likely that the middle ear and inner ear functions are also normal. <br>If unilateral tinnitus persists, it is advisable to consult an otolaryngologist or a neurologist

Tinnitus and throat issues?

Hello Doctor, I have been experiencing tinnitus for three months, which is unilateral and accompanied by some ear pain and a feeling of fullness in the ear.
Three months ago, I underwent a bilateral tonsillectomy, and about 25 days post-surgery, I suddenly developed a loud unilateral tinnitus that has not stopped since.
I previously consulted with the surgeon about this, and they prescribed medication that was supposed to help with Eustachian tube issues, but after taking it for almost a month, the tinnitus has not improved and seems to have worsened.
Could this be related to the surgery?
Additionally, it has been three months since the surgery, and I still feel a sensation of a foreign body in my throat.
I feel like I cannot completely swallow, and even swallowing saliva gives me a sensation of something stuck.
Is this normal? I visited an ENT specialist at the end of April, and they performed an endoscopy, which showed slight swelling in my throat.
The sensation of a foreign body is very uncomfortable, and I am worried it might be related to thyroid issues or esophageal problems.
What tests should I undergo to rule out serious conditions causing this sensation? I had an endoscopy in late February, and there were no issues with my esophagus at that time.

If there are thyroid problems, can I easily detect them by palpation? I have been feeling my throat, and it feels oddly hard.
The tinnitus has not stopped, and I have already had normal hearing and ear pressure tests.
What other tests can help identify the cause of the tinnitus, and what treatments are available to help? Thank you!

Miss Lin, 40~49 year old female. Ask Date: 2021/06/18

Dr. Zheng Jueyi reply Otolaryngology

Hello: There are many factors that can cause tinnitus.
If hearing and ear pressure tests are normal, it is likely that the middle ear and inner ear functions are also normal.
If unilateral tinnitus persists, it is advisable to consult an otolaryngologist or a neurologist to assess whether there are issues related to nerve function or central nervous system problems.
If there is discomfort from a sensation of a foreign body in the throat and concerns about potential issues with the thyroid or esophagus, it would be prudent to visit the internal medicine endocrinology or gastroenterology department for evaluation.
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: 2021/06/18

More Info

Persistent tinnitus and throat discomfort following a tonsillectomy can be concerning and uncomfortable. Let's break down your symptoms and explore potential causes and solutions.

Tinnitus After Tonsil Surgery
Tinnitus, or ringing in the ears, can occur for various reasons, and it’s not uncommon for patients to experience it after surgical procedures, including tonsillectomy. The surgery itself may not directly cause tinnitus, but several factors could contribute to its onset:
1. Eustachian Tube Dysfunction: The tonsils are located near the Eustachian tubes, which help equalize pressure in the ears. Surgery may lead to inflammation or dysfunction of these tubes, causing pressure changes that can result in tinnitus.

2. Nerve Irritation: Surgical procedures can sometimes irritate nearby nerves, including those involved in hearing. This irritation might lead to auditory symptoms like tinnitus.

3. Infection or Inflammation: Post-operative infections or inflammation can also affect the ear and lead to tinnitus. If there was any complication during or after the surgery, it could be a contributing factor.

4. Stress and Anxiety: Undergoing surgery can be stressful, and anxiety can exacerbate tinnitus. The psychological impact of surgery and recovery can sometimes heighten awareness of tinnitus.

Throat Discomfort
The sensation of a foreign body in the throat, especially after tonsil surgery, can be attributed to several factors:
1. Healing Process: After tonsillectomy, the throat undergoes significant healing. Swelling and scarring can create sensations that feel like something is stuck in the throat.

2. Residual Inflammation: If there is lingering inflammation in the throat, it can cause discomfort and the sensation of something being lodged.

3. Muscle Tension: Anxiety and discomfort can lead to muscle tension in the throat, which may contribute to the feeling of something being stuck.

4. Gastroesophageal Reflux Disease (GERD): Sometimes, reflux can cause throat discomfort and a sensation of a lump in the throat. If you have a history of acid reflux, this could be a contributing factor.

Recommendations
1. Follow-Up with an ENT Specialist: Since you have already seen an ENT specialist, it may be beneficial to schedule a follow-up appointment. Discuss your persistent tinnitus and throat discomfort in detail. They may perform additional examinations, such as a tympanometry test to assess Eustachian tube function or imaging studies if necessary.

2. Consider Audiological Evaluation: If you haven't already, an audiologist can perform a comprehensive hearing evaluation to rule out any underlying auditory issues that might be contributing to your tinnitus.

3. Explore Treatment Options: If Eustachian tube dysfunction is diagnosed, treatments may include nasal decongestants, nasal corticosteroids, or even Eustachian tube balloon dilation in some cases. For tinnitus, sound therapy, cognitive behavioral therapy (CBT), or tinnitus retraining therapy (TRT) may be beneficial.

4. Monitor Thyroid Health: If you are concerned about thyroid issues, a simple blood test measuring thyroid hormone levels (TSH, T3, T4) can help rule out any thyroid dysfunction. Self-examination for thyroid issues can be tricky; if you feel any unusual lumps or have symptoms like changes in weight, energy levels, or temperature sensitivity, consult your physician.

5. Manage Anxiety and Stress: If anxiety is a concern, consider speaking with a mental health professional. Techniques such as mindfulness, relaxation exercises, or therapy can help manage stress and potentially alleviate tinnitus.

6. Diet and Lifestyle Adjustments: If you suspect GERD, dietary changes (avoiding spicy, fatty, or acidic foods) and lifestyle modifications (elevating the head during sleep, avoiding late meals) may help alleviate throat discomfort.

Conclusion
Persistent tinnitus and throat discomfort after tonsil surgery can be distressing, but understanding potential causes and seeking appropriate follow-up care can lead to effective management. Keep an open line of communication with your healthcare providers, and don’t hesitate to seek further evaluations if your symptoms persist or worsen. Your health and comfort are paramount, and addressing these issues comprehensively will help you on your path to recovery.

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