There is a popping sound in the ear?
Hello Dr.
Cheng, four and a half months ago, I experienced right-sided facial nerve paralysis due to an unknown viral infection.
After receiving treatment and rehabilitation at a hospital in the northern region for about a month and a half, I have mostly recovered.
However, I have developed a sensation of muscle tension on the right side of my face, accompanied by a popping sound in my right ear, similar to a drumming sound from the eardrum.
Each time I blink, there is a popping sound in my ear.
Whenever the environment is noisy or multiple people are speaking at the same time, the popping sound in my ear continues without interruption.
If the popping sound persists for too long, I also experience ear fullness and mild dizziness.
Pressing on the front, back, and below my ear produces the same sound.
The hospital conducted tests and stated that my hearing is normal and that the auditory nerve is intact, but they could not determine the cause.
I consulted another hospital, and the results were the same, confirming that both the nerves and hearing are normal.
This symptom appeared after my facial expression had mostly recovered and is on the same side as the facial paralysis.
Dr.
Cheng, could facial nerve paralysis lead to such sequelae? Previous doctors have said it is unrelated to the facial nerve paralysis, yet they cannot find the cause.
I kindly request your response and suggestions! Thank you very much!
Mr. Zhang, 40~49 year old female. Ask Date: 2014/05/01
Dr. Zheng Jueyi reply Otolaryngology
Dear Mr.
Chang,
Hello.
One of the branches of the facial nerve controls the small muscles connected to the stapes (one of the three auditory ossicles).
Its function is to reduce the vibrational energy transmitted to the inner ear in response to loud sounds.
It is possible that after recovery from facial nerve paralysis, this branch may exhibit functional abnormalities, causing the small muscle to contract simultaneously when the facial nerve is activated, resulting in sound production.
You may want to discuss this further with an otolaryngologist or a neurologist.
Wishing you peace and good health.
Sincerely,
Dr.
Cheng Jue-Yi
Director, Department of Otolaryngology
Taoyuan Hospital, Ministry of Health and Welfare
Reply Date: 2014/05/01
More Info
Hello! Thank you for sharing your experience regarding the symptoms you are experiencing after recovering from facial nerve paralysis. It sounds like you have been through a challenging time, and I appreciate your detailed description of your symptoms.
From what you've described, it seems that you are experiencing a phenomenon known as "auditory reflex" or "middle ear muscle reflex," which can sometimes occur after facial nerve recovery. The facial nerve (cranial nerve VII) innervates the muscles of facial expression and also has connections to the stapedius muscle in the middle ear. This muscle helps to dampen loud sounds and can be affected by changes in nerve function.
The "popping" or "thumping" sounds you hear in your ear when you make facial movements, such as blinking or tensing your facial muscles, could be related to the re-establishment of nerve function in the facial nerve. As the nerve heals, it may cause abnormal contractions of the stapedius muscle, leading to the sounds you are experiencing. This phenomenon is sometimes referred to as "stapedius muscle hyperactivity" and can be more pronounced in noisy environments, as you noted.
Additionally, the sensation of ear fullness and mild dizziness could be linked to changes in the pressure within the middle ear or even the vestibular system, which is responsible for balance. It’s important to note that while these symptoms can be distressing, they are often temporary and may improve as the nerve continues to heal and adapt.
Regarding your question about whether facial nerve paralysis can lead to such symptoms, the answer is yes. While many doctors may not directly link these symptoms to facial nerve issues, the intricate relationship between the facial nerve and the auditory system means that changes in one can affect the other.
Here are some suggestions for managing your symptoms:
1. Consultation with a Specialist: Since you have already seen multiple doctors, it may be beneficial to consult with an otolaryngologist (ENT specialist) who has experience with facial nerve disorders. They may provide additional insights or suggest specific tests to rule out other causes.
2. Physical Therapy: Engaging in physical therapy focused on facial exercises may help improve muscle coordination and potentially reduce the abnormal sounds you are experiencing. A therapist experienced in facial rehabilitation can provide tailored exercises.
3. Sound Therapy: If the sounds are bothersome, sound therapy or white noise machines may help mask the sounds and provide relief, especially in noisy environments.
4. Monitoring and Patience: Since you are in the recovery phase, it’s essential to be patient. Nerve healing can take time, and many patients find that their symptoms gradually improve over several months.
5. Avoiding Loud Environments: As you mentioned that the sounds worsen in noisy settings, try to minimize exposure to loud environments, which may help reduce the intensity of the sounds.
6. Follow-Up: Continue to follow up with your healthcare providers. If your symptoms persist or worsen, further evaluation may be necessary to explore other underlying conditions.
In conclusion, while your symptoms may be related to the recovery process of the facial nerve, they are not uncommon. With time and appropriate management, many individuals find that their symptoms improve significantly. Please continue to seek medical advice and support as you navigate this recovery journey. Wishing you all the best in your healing process!
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