Tinnitus: Causes and When to Seek Help

Q: Tinnitus: Causes and When to Seek Help

Hello, the issues you mentioned could be due to： 1) Eustachian tube dysfunction： This can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over. <br>2) Sensorineural hearing loss： This may not affect all frequencies; it coul

Tinnitus issues?

Hello Dr.
Chi, I have been experiencing noticeable tinnitus in my left ear for the past few days, characterized by a persistent EEE sound or noise.
It is particularly pronounced during the quiet nighttime environment, ringing continuously and being louder at night than during the day.
My right ear has a less noticeable, more subtle noise.
Dr.
Chi, based on what I just described, should I be concerned about my tinnitus, or is it considered relatively normal? My left ear also feels somewhat stuffy and pressured.

Chen, 20~29 year old female. Ask Date: 2023/10/13

Dr. Ji Zhaoyun reply Otolaryngology

Hello, the issues you mentioned could be due to: 1) Eustachian tube dysfunction: This can occur not only during flying, climbing, or diving, but also when forcefully blowing your nose or bending over.
2) Sensorineural hearing loss: This may not affect all frequencies; it could involve only specific frequency ranges.
3) Sudden sensorineural hearing loss (commonly referred to as sudden deafness).
4) Otitis media: a) Acute otitis media: Often occurs alongside upper respiratory infections (like colds) or 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, which can become inflamed due to unclean water or improper ear cleaning.
All of the above conditions can be appropriately treated with medication after consulting a healthcare provider.
If you have already undergone a pure-tone audiometry test (which requires headphones in a soundproof room, where you respond to sounds by pressing a button, rather than just using a tuning fork), and it confirms that you do not have sudden deafness, then medication may suffice.
However, if you have not had a pure-tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss.
The golden treatment window for sudden sensorineural hearing loss is within two weeks, and early treatment yields better outcomes.
Wishing you safety and good health.

Reply Date: 2023/10/13

More Info

Tinnitus, commonly referred to as "ear ringing," is a condition characterized by the perception of sound when no external sound is present. It can manifest as ringing, buzzing, hissing, or other noises, and can vary in intensity and frequency. Your description of experiencing a persistent "EEE" sound or noise in your left ear, especially noticeable in quiet environments at night, is a common presentation of tinnitus.

Causes of Tinnitus
Tinnitus can arise from various underlying causes, including:
1. Hearing Loss: Age-related hearing loss (presbycusis) is one of the most common causes of tinnitus. As we age, the sensory cells in the inner ear can become damaged, leading to both hearing loss and tinnitus.

2. Exposure to Loud Noises: Prolonged exposure to loud sounds, such as music concerts or machinery, can damage the hair cells in the cochlea, leading to tinnitus.

3. Ear Infections or Blockages: Conditions such as earwax buildup, middle ear infections, or Eustachian tube dysfunction can create pressure changes in the ear, resulting in tinnitus.

4. Ototoxic Medications: Certain medications, including some antibiotics, diuretics, and chemotherapy drugs, can have side effects that include tinnitus.

5. Medical Conditions: Conditions such as Meniere's disease, acoustic neuroma, or vascular disorders can also lead to tinnitus.

6. Stress and Anxiety: Psychological factors can exacerbate the perception of tinnitus, making it more noticeable, especially in quiet environments.

When to Seek Help
While tinnitus is often benign and may resolve on its own, there are specific circumstances where seeking medical advice is essential:
1. Sudden Onset: If tinnitus appears suddenly, especially if accompanied by hearing loss or dizziness, it is crucial to seek medical attention promptly.

2. Persistent Symptoms: If the tinnitus persists for several weeks or worsens over time, it is advisable to consult a healthcare professional.

3. Associated Symptoms: If you experience other symptoms such as pain, discharge from the ear, or significant changes in hearing, these could indicate an underlying condition that requires evaluation.

4. Impact on Daily Life: If tinnitus interferes with your ability to concentrate, sleep, or enjoy daily activities, it is worth discussing with a healthcare provider.

Management and Treatment
Management of tinnitus often involves addressing the underlying cause, if identifiable. Here are some approaches that may help:
1. Hearing Aids: If hearing loss is a contributing factor, hearing aids can amplify external sounds, making tinnitus less noticeable.

2. Sound Therapy: Background noise or white noise machines can help mask the tinnitus sounds, especially at night.

3. Cognitive Behavioral Therapy (CBT): This therapeutic approach can help manage the emotional response to tinnitus, reducing distress and improving coping strategies.

4. Lifestyle Modifications: Reducing caffeine and alcohol intake, managing stress through relaxation techniques, and avoiding loud environments can help alleviate symptoms.

5. Medical Treatment: In some cases, medications may be prescribed to help manage tinnitus, particularly if it is associated with anxiety or depression.

In conclusion, while your experience of tinnitus may not seem alarming, it is essential to monitor your symptoms. If you notice any changes or if the condition persists, seeking the advice of an ear, nose, and throat (ENT) specialist or an audiologist would be prudent. They can provide a thorough evaluation and recommend appropriate management strategies tailored to your specific situation.

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