Am I Having Eustachian Tube Issues or Is My Tinnitus Worsening Caused by Augmentin?

[Clare Johnson]

Hello Dr. Nagler, I hope you are well.

I had a very helpful ENT visit in New York City recently. She found severe inflammation and infection in my nasal passages, and around my Eustachian tubes, which led her to believe this is the cause of my tinnitus (I have no hearing loss or damage, checked by an audiologist).

She prescribed Augmentin and Prednisone, of which I felt WONDERFUL for 2 or so days (before I started tapering down).

It was a few days into this regimen that I felt a pressure shift in my right ear, which had less tinnitus than the left. Ever since then my right has felt slightly more clogged or "full", and has been noticeably louder.

I don't know if this is just due to pressure changes since I am having Eustachian tube issues- or if it could be Augmentin-induced. Although I doubt Augmentin would cause the weird fullness feeling too.

In your experience, is Augmentin ototoxic? Also, do you think this increase could just be a spike because of the weirdness of the medication/ my tubes acting up?

Thank you very much for your time.

 

[Dr. Nagler]

Hello Dr. Nagler, I hope you are well.

I am. Thank you for asking.

I had a very helpful ENT visit in New York City recently. She found severe inflammation and infection in my nasal passages, and around my Eustachian tubes, which led her to believe this is the cause of my tinnitus (I have no hearing loss or damage, checked by an audiologist).

Well, everybody has hearing loss. Even people with normal audiograms have hearing loss. We lose 0.5% of our hair cells for every year of our adult lives through natural attrition (presbycusis). I am not saying that your hearing loss is the cause of your tinnitus; there is no way to tell. But I respectfully disagree with the premise.

She prescribed Augmentin and Prednisone, of which I felt WONDERFUL for 2 or so days (before I started tapering down).
It was a few days into this regimen that I felt a pressure shift in my right ear, which had less tinnitus than the left. Ever since then my right has felt slightly more clogged or "full", and has been noticeably louder.

I suspect that the fullness in your right ear resulted in a mild (temporary) conductive hearing loss superimposed on whatever sensorineural hearing loss you have related to your presbycusis.

I don't know if this is just due to pressure changes since I am having Eustachian tube issues- or if it could be Augmentin-induced. Although I doubt Augmentin would cause the weird fullness feeling too.

It is certainly possible that the fullness is due to a Eustachian tube problem. You might want to return to your ENT if the fullness persists.

In your experience, is Augmentin ototoxic?

Augmentin does not cause auditory damage. Moreover, I have never seen it on any of the lists of drugs that are associated with tinnitus in any way.

Also, do you think this increase could just be a spike because of the weirdness of the medication/ my tubes acting up?

Well, I highly doubt that it is the Augmentin or the prednisone. One tinnitus authority used to say that the brain puts the tinnitus in the weaker ear. The fullness in your right ear makes it the weaker one. Now whether or not the fullness is definitely due to a Eustachian tube problem, that I cannot say, which is why (as noted above) I think you should return to your ENT if it persists.

Thank you very much for your time.

Not a problem. Glad to help.

Stephen M. Nagler, M.D.