Tinnitus: Causes, Treatments, and When to Seek Help

Q: Tinnitus: Causes, Treatments, and When to Seek 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>This is likely related to nasal congestion. <b

Tinnitus issues?

Hello Doctor: Three months ago, I occasionally experienced a low rumbling sound in my right ear, which would resolve after a while.
Later, I began to hear a high-pitched sound in my left ear, resembling an ambulance siren, which has been constant for 24 hours.
I usually cannot hear it in louder environments like when watching TV, but it becomes noticeable when I am sleeping or in quieter settings.
I visited a clinic for pure tone audiometry and tympanometry, both of which were normal, so the doctor did not prescribe any medication.
Two weeks later, I went to a larger hospital for pure tone audiometry, tympanometry, and speech audiometry.
The doctor informed me that the hearing tests were normal, but the low frequencies in my left ear were worse than in my right ear.
However, since there was no objective hearing loss, no medications were prescribed for that.
Additionally, I often have nasal congestion while sleeping, so the doctor prescribed medication to improve peripheral circulation and for nasal allergies.
During my second follow-up, due to lack of improvement, a different medication to promote peripheral circulation was prescribed.
The same situation occurred during my third follow-up, where I was again prescribed medications for peripheral circulation, antihistamines for nasal allergies, and anti-anxiety medication.
I would like to ask if my nasal congestion could be causing the tinnitus? Should I consider seeing a different specialist? Are there any methods to improve the tinnitus? Thank you, Doctor.

Nina, 20~29 year old female. Ask Date: 2024/03/05

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.
This is likely related to nasal congestion.
2) Sudden sensorineural hearing loss (commonly referred to as sudden deafness).
3) Otitis media: a) Acute otitis media: Often occurs alongside upper respiratory infections (such as 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 contaminated 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 booth, where sounds are presented for you to respond to, 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 deafness or sudden hearing loss.
Wishing you safety and good health.

Reply Date: 2024/03/05

More Info

Tinnitus, commonly referred to as "ringing in the ears," is a condition characterized by the perception of sound when no external sound is present. This can manifest as ringing, buzzing, hissing, or roaring sounds, and it can vary in intensity and frequency. Understanding tinnitus involves recognizing its potential causes, available treatments, and when to seek professional help.

Causes of Tinnitus
Tinnitus can arise from a variety of factors, including:
1. Hearing Loss: Age-related hearing loss (presbycusis) is one of the most common causes of tinnitus. Damage to the inner ear can lead to abnormal neural activity, resulting in the perception of sound.

2. Exposure to Loud Noises: Prolonged exposure to loud sounds can damage the hair cells in the cochlea, leading to tinnitus. This is often seen in musicians, construction workers, and those who frequently attend loud events.

3. Ear Infections or Blockages: Conditions such as ear infections, fluid in the ear, or earwax buildup can affect hearing and lead to tinnitus. Your mention of nasal congestion may suggest that Eustachian tube dysfunction could be contributing to your symptoms, as this can affect pressure and fluid in the ear.

4. Medications: Certain medications, known as ototoxic drugs, can cause or worsen tinnitus. These include some antibiotics, diuretics, and chemotherapy drugs.

5. Underlying Health Conditions: Conditions such as Meniere's disease, acoustic neuroma, or temporomandibular joint (TMJ) disorders can also lead to tinnitus.

Treatments for Tinnitus
While there is currently no definitive cure for tinnitus, several treatment options can help manage the symptoms:
1. Sound Therapy: This involves using background noise or white noise machines to mask the tinnitus sounds. This can be particularly helpful at night or in quiet environments.

2. Cognitive Behavioral Therapy (CBT): CBT can help individuals manage the emotional response to tinnitus, reducing anxiety and improving quality of life.

3. Medications: While there are no specific medications for tinnitus, some patients find relief with certain antidepressants or anti-anxiety medications, which can help alleviate the distress associated with tinnitus.

4. Hearing Aids: For those with hearing loss, hearing aids can amplify external sounds, making tinnitus less noticeable.

5. Lifestyle Changes: Reducing caffeine and alcohol intake, managing stress, and avoiding loud environments can help minimize tinnitus symptoms.

When to Seek Help
You should consider seeking further medical advice if:
- Your tinnitus is persistent and affects your daily life.

- You experience sudden changes in hearing or the onset of tinnitus following an injury or infection.

- You have accompanying symptoms such as dizziness, balance issues, or significant ear pain.

In your case, since you have undergone several hearing tests that returned normal results, it may be beneficial to explore the relationship between your nasal congestion and tinnitus. Consulting an ear, nose, and throat (ENT) specialist could provide insights into whether your nasal issues are contributing to your ear symptoms. They may evaluate for conditions like Eustachian tube dysfunction or sinus-related issues that could be impacting your auditory system.

Conclusion
Tinnitus can be a challenging condition to manage, especially when its causes are multifactorial. While your current treatment regimen focuses on improving blood circulation and addressing nasal allergies, it may be worthwhile to explore additional avenues, including ENT consultation, to ensure a comprehensive approach to your symptoms. Remember, effective management often involves a combination of strategies tailored to your specific situation.

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