Unexplained Eardrum Tremors: Causes and Insights

Unexplained tympanic membrane oscillation

Not long ago, I experienced a situation where I might have had a cold and blew my nose incorrectly by inhaling too forcefully.
I felt a retraction in my right eardrum, which caused a sensation of fullness and impaired hearing.
Although the feeling of retraction and fullness disappeared the next day, now my right ear exhibits the following symptoms whenever certain conditions occur:
1.
Sounds like dishes clinking or utensils being struck (even at low volumes can trigger this).
2.
When I speak slightly louder (it feels like there is a slight echo and air is escaping from my right ear).
3.
The popping sound in my right ear is noticeably louder than in my left ear when I swallow.
4.
The symptoms worsen in cold weather, but they become milder or disappear when it warms up.
5.
The sensation of pulsation feels like it originates from within and moves outward.
6.
If I encounter very loud noises, such as fireworks, even with earplugs, I still experience this sensation; however, I do not have this issue with regular music or when listening through headphones.
I underwent an otoscopic examination of my eardrum and a nasopharyngoscopy, both of which were normal (the examination coincided with a warmer day when I had minimal symptoms).
My hearing test results were also excellent, and I have no prior history of nasal or ear diseases.
I am unsure what other possibilities could explain these strange symptoms.

Niming, 20~29 year old female. Ask Date: 2012/01/28

Dr. Xu Jiazhen reply Otolaryngology

This issue can be explained in terms of changes in hearing and no changes in hearing.
If there are changes in hearing, it is more likely related to eustachian tube obstruction combined with middle ear effusion.
Generally, this can be identified using instruments in an otolaryngology clinic.
However, in some cases, the fluid may not be significant enough to affect hearing, or there may be a slight impact that is not obvious.
This is quite common and usually resolves quickly after medication.
In rare instances, excessive nose blowing can create pressure that leads to damage of the inner ear labyrinth.
Although this is uncommon, it should be approached with caution.
Patients with this condition often experience accompanying dizziness, which was not mentioned in your inquiry, so please discuss this further with your physician.

Reply Date: 2012/01/28

More Info

Understanding unexplained eardrum tremors can be quite perplexing, especially when accompanied by other auditory sensations such as popping or crackling sounds. Based on your description, it seems that you are experiencing a phenomenon that could be related to several underlying causes, including Eustachian tube dysfunction, middle ear muscle spasms, or even a form of auditory sensitivity.

The Eustachian tube connects the middle ear to the back of the nose and throat, helping to equalize pressure in the ear. When you mentioned that you had a sensation of your eardrum being "inward" or "stuffy" after forcefully blowing your nose, it is possible that you temporarily altered the pressure in your middle ear. This can lead to a feeling of fullness or pressure, which may resolve quickly but can leave the Eustachian tube functioning abnormally for a while. When the Eustachian tube does not open properly, it can cause a sensation of pressure or even lead to the eardrum vibrating in response to sounds or changes in pressure, which could explain the "popping" or "crackling" sounds you hear.

Additionally, the muscles in the middle ear, namely the tensor tympani and stapedius, can sometimes go into spasms. This can happen due to stress, loud sounds, or even changes in temperature. The fact that you notice the symptoms worsening in cold weather and improving when it warms up could suggest that temperature changes are affecting the muscle function or the Eustachian tube's ability to equalize pressure.

Your symptoms of experiencing a pronounced sound when swallowing or speaking loudly could also indicate a heightened sensitivity of the auditory system, which can occur after any form of trauma or stress to the ear. This sensitivity can make normal sounds seem amplified or cause unusual auditory sensations.

Given that your ear examinations and hearing tests have returned normal results, it is reassuring that there are no obvious structural issues. However, if the symptoms persist or worsen, it may be beneficial to consult with an otolaryngologist (ENT specialist) who can conduct further assessments, such as tympanometry, to evaluate the function of your eardrum and Eustachian tube more thoroughly.

In the meantime, here are some recommendations that may help alleviate your symptoms:
1. Avoid Forceful Nose Blowing: Instead of blowing your nose forcefully, try to gently pinch your nostrils and breathe out softly to equalize pressure without causing trauma to the ear.

2. Stay Hydrated: Keeping well-hydrated can help maintain mucosal health, which is important for Eustachian tube function.

3. Warm Compress: Applying a warm compress to the affected ear may help relax the muscles and alleviate discomfort.

4. Avoid Loud Noises: Protect your ears from loud sounds, as they can exacerbate sensitivity and discomfort.

5. Nasal Decongestants: If you feel congested, over-the-counter nasal decongestants may help open the Eustachian tube, but consult with a healthcare provider before using them.

6. Follow-Up: If symptoms persist, follow up with your ENT specialist for further evaluation and management options.

In conclusion, while your symptoms are unusual, they may be related to Eustachian tube dysfunction or muscle spasms in the middle ear. Monitoring your symptoms and seeking further evaluation if they persist will be key to finding a resolution.

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