High-Frequency Tinnitus: Causes, Effects, and Next Steps

Q: High-Frequency Tinnitus: Causes, Effects, and Next Steps

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 (commonly

High-frequency tinnitus

Hello Dr.
Chi, I appreciate the various tinnitus issues and the advice from the physicians on this webpage.
I do not have hypertension, diabetes, or high cholesterol, and my lifestyle and diet are normal.
I smoke a little and walk 5,000 steps daily.
In my younger years (before age 45), I frequently played badminton and soccer, and I feel that my physical condition is good.
Two years ago, I experienced pain while swallowing, so I went to a nearby clinic for an examination, but my throat was normal with no redness or swelling.
However, after about 3-4 days, my throat returned to normal, and I subsequently developed tinnitus in both ears.
Initially, the sound was quite loud, but it decreased after a week, so it did not affect my daily life.
Since it is difficult to get an appointment at the ENT department of the nearby hospital, I did not undergo any further examination.
Last year, I visited Asia University Hospital for an evaluation and underwent various hearing tests.
The doctor informed me that it was age-related hearing loss with reduced hearing bandwidth, which I had to accept.
During this time, I traveled abroad, and high-altitude flights did not affect my tinnitus (it has always been present but unchanged).
A month ago, my tinnitus suddenly intensified, affecting my sleep; I can only fall asleep when I am extremely tired, and I wake up easily.
However, there have been no changes in my other physiological conditions.
I wonder if you have any suggestions, Dr.
Chi? Should I accept the tinnitus, or should I seek further evaluation from a neurologist or an ENT specialist? Thank you!

Mr. Deng, 70~79 year old female. Ask Date: 2023/11/16

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 (commonly referred to as sudden deafness) or sensorineural hearing loss.
3) Otitis media: a) Acute otitis media: Often occurs alongside upper respiratory infections (like colds) or sinusitis, and in severe cases, there may be discharge from the ear.
b) Chronic otitis media with acute exacerbation: This often 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 has been confirmed that you do not have sudden sensorineural hearing loss, then medication may suffice.
However, if you have not undergone a pure tone audiometry test, it is advisable to visit a hospital for evaluation to rule out sudden hearing loss, as early treatment is more effective.
Additionally, there is a correlation between sleep apnea and tinnitus/sensorineural hearing loss, which has been supported by numerous research studies.
It is recommended to consult an otolaryngologist if symptoms persist.
Wishing you safety and good health.

Reply Date: 2023/11/16

More Info

High-frequency tinnitus can be a challenging condition to manage, especially when it affects your quality of life, such as sleep disturbances. Based on your description, it seems that you have experienced a gradual onset of tinnitus following a throat issue, which resolved itself but was followed by the onset of ear ringing. This pattern is not uncommon, as various factors can contribute to tinnitus, including age-related hearing loss, exposure to loud noises, and even stress or anxiety.

Understanding Tinnitus
Tinnitus is often described as a ringing, buzzing, or hissing sound in the ears that is not caused by an external sound source. It can be subjective, meaning that only the person experiencing it can hear the sound. The causes of tinnitus can vary widely, but some common factors include:
1. Hearing Loss: Age-related hearing loss (presbycusis) is a significant contributor to tinnitus. As we age, the sensory cells in the inner ear can become damaged, leading to a decrease in hearing ability and the perception of tinnitus.

2. Noise Exposure: Prolonged exposure to loud noises can damage the hair cells in the cochlea, leading to tinnitus. This can occur from occupational noise, concerts, or even loud music through headphones.

3. Ear Infections or Blockages: Conditions such as earwax buildup, middle ear infections, or Eustachian tube dysfunction can also lead to tinnitus.

4. Medical Conditions: Certain medical conditions, including hypertension, diabetes, and thyroid issues, can contribute to tinnitus.
5. Medications: Some medications, particularly ototoxic drugs (those that can damage the ear), can cause or worsen tinnitus.

Effects of Tinnitus
The effects of tinnitus can vary from person to person. While some may find it merely a nuisance, others may experience significant distress, leading to anxiety, depression, and sleep disturbances. In your case, the recent increase in the intensity of your tinnitus has begun to affect your sleep, which is a common complaint among those with this condition.

Next Steps
Given your situation, here are some recommendations:
1. Consultation with Specialists: Since your tinnitus has worsened and is affecting your sleep, it would be beneficial to consult an Ear, Nose, and Throat (ENT) specialist or a neurologist. They can perform a thorough examination and possibly recommend further tests, such as audiometric testing or imaging studies, to rule out any underlying conditions.

2. Hearing Evaluation: A comprehensive hearing test can help determine if there is any significant hearing loss contributing to your tinnitus. If hearing loss is confirmed, hearing aids may help alleviate the perception of tinnitus by amplifying external sounds.

3. Cognitive Behavioral Therapy (CBT): If tinnitus is causing anxiety or sleep disturbances, CBT can be an effective way to manage the emotional response to tinnitus. This therapy helps change the way you think about and react to the sound.

4. Sound Therapy: Using background noise or white noise machines can help mask the tinnitus, making it less noticeable, especially at night.

5. Lifestyle Modifications: Continue with your healthy lifestyle, including regular exercise and a balanced diet. Reducing caffeine and nicotine intake may also help, as these can exacerbate tinnitus in some individuals.

6. Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

In conclusion, while tinnitus can be a persistent and frustrating condition, there are various avenues for management and relief. Seeking professional advice and exploring treatment options can significantly improve your quality of life.

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