Persistent Tinnitus and Eardrum Thinning: Key Insights

Long-term tinnitus in the ear, accompanied by a feeling of fullness, with thinning of the tympanic membrane?

1.
I have been experiencing tinnitus for about 2-3 years, where I can hear a buzzing sound in my ears at any time and place.
The sound varies in pitch and sharpness depending on external noise levels.
I have previously undergone magnetic resonance imaging (MRI) and pure tone audiometry, both of which were normal.
The doctor could not determine the cause.
Are there any other methods to investigate tinnitus?
2.
Recently, during an ear cleaning procedure, I discovered that there are one large and two small holes in my right eardrum, which appear to be very thin.
Will this have any impact on my hearing?
3.
Over the past year, I occasionally experience a feeling of fullness in my ears.
When I play music, my left ear often perceives a three-dimensional sound, while sometimes my right ear sounds sharper.
I wonder if this is related to the second point? (I do not have a habit of using headphones.)

Linda, 30~39 year old female. Ask Date: 2023/08/07

Dr. Zheng Jueyi reply Otolaryngology

Hello, 1.
There are many factors that can cause tinnitus.
If both magnetic resonance imaging (MRI) and pure tone audiometry are normal, brain tumors, vascular abnormalities, or structural issues can be ruled out, and no further detailed examinations are necessary at this time.
2.
If there are no significant hearing abnormalities, it does not necessarily correlate with the tinnitus.
3.
It is commonly associated with dysfunction of the Eustachian tube; if discomfort persists, it is advisable to seek medical evaluation for confirmation.

Reply Date: 2023/08/07

More Info

Persistent tinnitus, or ringing in the ears, can be a frustrating and distressing condition for many individuals. Your experience of having tinnitus for 2-3 years, accompanied by fluctuations in pitch and intensity, is not uncommon. Tinnitus can manifest in various ways, and its causes can be multifactorial, often making it difficult to pinpoint a specific origin.
1. Understanding Tinnitus: Tinnitus is often associated with hearing loss, exposure to loud noises, ear infections, or even stress and anxiety. Since your MRI and pure tone audiometry tests returned normal results, it suggests that there may not be an obvious structural issue in the auditory system. However, it is essential to consider that tinnitus can also arise from conditions such as temporomandibular joint (TMJ) disorders, eustachian tube dysfunction, or even neurological conditions. If you haven't already, you might want to consult an otolaryngologist (ENT specialist) who can perform a thorough examination and possibly recommend additional tests, such as tympanometry or acoustic reflex testing, to evaluate the function of your middle ear and eardrum.

2. Eardrum Thinning and Perforation: The discovery of a large and two small holes in your right eardrum, especially if it appears thin, is concerning. The eardrum (tympanic membrane) serves as a barrier protecting the middle ear from infections and helps in sound transmission. A perforated or thinned eardrum can lead to various complications, including increased susceptibility to ear infections, conductive hearing loss, and potential changes in how you perceive sound. If the perforation is significant, it may require medical intervention, such as tympanoplasty, to repair the eardrum and restore its function.

3. Ear Congestion and Sound Perception: The sensation of ear fullness or congestion, along with the perception of stereo sound in your left ear, could be related to the condition of your eardrum and the overall health of your auditory system. The eustachian tube, which connects the middle ear to the back of the throat, helps equalize pressure in the ear. If this tube is not functioning properly, it can lead to feelings of fullness and affect sound perception. Additionally, the differences in sound quality between your ears may be exacerbated by the condition of your right eardrum.

In summary, persistent tinnitus can be a complex condition influenced by various factors, including ear health, auditory processing, and even psychological aspects. The thinning and perforation of your eardrum could significantly impact your auditory experience and may require further evaluation and treatment. It is advisable to follow up with an ENT specialist who can provide a comprehensive assessment and discuss potential treatment options tailored to your specific situation. They may also explore therapies such as sound therapy, cognitive behavioral therapy, or tinnitus retraining therapy to help manage your symptoms effectively.

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