Can Someone With Physiological Knowledge Explain How ETD Can Cause Tinnitus?

[Anti]

Hello,

As the title asks, I would love it if someone who understood physiology could explain how ETD (specifically blocked) causes tinnitus. I understand the basics, that something (allergies, infection, inflammation, etc.) causes the eustachian tube to become blocked which traps air in the middle ear. The air is absorbed by the epithelia which results in negative pressure in the middle ear (eardrum is pulled inward).

How does this cause the ringing in the ear, though? I thought that sound vibrations caused the bones of the middle ear to push into the fluid of the inner ear, resulting in a physical motion of that fluid that is picked up by the cells of the inner ear. How does negative pressure, which should be fairly static, produce enough movement to cause constant stimulation of those cells and result in the incessant ringing of tinnitus? If it's just a space with lower pressure - why does it cause any vibration?

I don't understand why ETD-related negative pressure results in anything more than difficulty hearing.

Thanks in advance!

 

[Karl28]

I'd like to know because I have ETD.
My T might all of a sudden get louder in my left ear for no reason and I just know its the ETD on that side thats just gotten a bit worse and sure enough ill swallow and the crunching / crackling on that side will be worse.

 

[Thongjy]

I'd like to know because I have ETD.
My T might all of a sudden get louder in my left ear for no reason and I just know its the ETD on that side thats just gotten a bit worse and sure enough ill swallow and the crunching / crackling on that side will be worse.

Yours is not noise induced?

 

[Dr. Nagler]

I don't understand why ETD-related negative pressure results in anything more than difficulty hearing.

That's basically the whole story. ETD causes a conductive hearing loss. The result is that when you hear externally-generated sounds less, you will hear internally-generated sounds more. It has nothing do do with vibration or increased stimulation of hair cells.

 

[Xorthian]

That's basically the whole story. ETD causes a conductive hearing loss. The result is that when you hear externally-generated sounds less, you will hear internally-generated sounds more. It has nothing do do with vibration or increased stimulation of hair cells.

I have some interesting story here. This is just wild speculation though and I write this as sort of "my experience" and not "medical facts" type of thingy. It might calm someone down in future if he find similiar issue

So I probably have some minor fluid in my ear as I was doing valsalva gently and it probably pushed some fluid back.

I had trouble to equalize pressure in my right ear (it wouldnt pop at all even when yawning or eating and I got nervous because last time it ended up in ear infection) so i kept doing it. Left ear opens very easily and probably accumulated some fluid. I started to hear some weird cricket/clicking irregular noise over almost everything. It was very upsetting because from my limited experience usual tinnitus (non reactive etc) can get masked partially or entirely with sounds. At one point I felt rushing sensation of water against my left ear drum when popping ears. Eustachian tube opened, pushed air but air pushed fluid against ear drum - since im not a doctor thats only reasonable explanation I have for it. Once I figured this out I calmed down a lot

This cricket might be anything internal. It might be even sound of my spontanteous accoustic emission from cochlea.

For now I'm just trying to swallow yawn and chew a lot. After couple of hours doing that my tube started to crack and sounds are less and less audible. I actually need to cover my ears to hear that clicking very clearly. Sound also changed. But pattern (sound,sound,stop,stop,stop,sound) didnt. It is so far very interesting experience but it caused me much distress at first. ET still cant really open as easily as it could couple of days ago but hopefully I wont get inflammation and middle ear infection once again.

I do not know how conductive hearing loss would work in my case as I can hear as good as couple of days ago.

 

[Dr. Nagler]

Seems you're trying to "figure out" your tinnitus. Good luck with that one!

I'm just give you some general principles.

 

[Anti]

That's basically the whole story. ETD causes a conductive hearing loss. The result is that when you hear externally-generated sounds less, you will hear internally-generated sounds more. It has nothing do do with vibration or increased stimulation of hair cells.

Well, I suppose I'm screwed then. While I have slight trouble hearing at the frequency of my tinnitus (360Hz) I hear everything else fine. So I guess that means I somehow have noise induced or infection-related tinnitus and I'm stuck with this for life.

I guess the fact that I can't pop my ears and have high negative pressure in the affected ear is just a weird coincidence.

Colour me depressed.

 

[Dr. Nagler]

Well, I suppose I'm screwed then. While I have slight trouble hearing at the frequency of my tinnitus (360Hz) I hear everything else fine. So I guess that means I somehow have noise induced or infection-related tinnitus and I'm stuck with this for life.

So why does that mean you're screwed? I mean, I've had tinnitus for more than twenty years now, and I'm not screwed. Why are you? It's a serious question!

 

[Anti]

So why does that mean you're screwed? I mean, I've had tinnitus for more than twenty years now, and I'm not screwed. Why are you? It's a serious question!

Hello,

Before I get into anything, I just want to say thanks for taking time to answer all the questions and address the concerns people have on this site. Having an actual doctor who also understands what we're going through is important to this community. While I am a very new member here, I can see from my readings that your effort on this site has helped many. Thanks for that.

As for my situation, I feel like I am screwed because I don't know how to cope with this. I don't know how it happened, not that it even matters at this point but perhaps it would be psychologically beneficial to have something to "blame." I spend inordinate amounts of time trying to figure out what caused this. I can't let it go. I feel like somehow I'm "ruined" and that my life is going to suck permanently. I can't escape this. I hear it over noise machines. I hear it over the oscillating fan set up in my room. I can't sleep. I'm exhausted. I've stopped socializing. I avoid noise because I'm afraid of making it worse. I don't know what to do. I feel like I'm losing my mind. Doctors here said "You may have had an ear infection, come back in a month if your ear is still bugging you." I've missed any window of "shock treatment" prednisone because of a general lack of concern on the part of my physicians. I'm furious. I'm frustrated.

I have always worn hearing protection – to the point where I've been made fun of for it at events – and yet here I am, stuck with this 360Hz cacophony in my head: the soundtrack to "How to Hate Your Life."

Like many people on this site, I value peace and quiet. I was never one to go out to clubs or be surrounded by loud music. I enjoyed sitting at home and reading. I like going out for walks in the woods. I live in a rural area - there is no loud noise, just nature. I feel like the solace I found in those environments has been shattered.

In the 8 weeks I've been dealing with this I haven't listened to any music, I've hardly socialized, I can't read, I can't write, I can't paint. I feel like a husk. I'm afraid to be around any noise that may make the tinnitus worse. Since I don't even know why it started, I'm not sure if noise will enhance it as others on this board have claimed. I literally move around my house turning on fans in each room in order to minimize the noise in my head. It has completely controlled my life. People say "you learn to deal with it." I'm not sure I can. 8 weeks isn't a long time but I'm not sure I have the mental fortitude to overcome this; I have other issues that I'm sure compound the effects of tinnitus.

I have had a few days with no sound at all and it always comes back with a vengeance. I don't understand why. Why would tinnitus just disappear for a while? Why does it disappear after a nap? Any time I think it's getting better it comes back like a cruel joke. I can't get clear answers on what is happening or why. It controls my life. I don't even know which sounds are real and which are in my head. I've caught myself more than a few times with my head pressed up against appliances to try to figure out of they're making the noise I hear or if it's my ear. It's an absurdity.

I am not the same person I was before this started. I don't want to live like this. If there's no solution to the problem (as everyone seems to suggest) and it's not transient (caused by an infection that may improve as I was hoping in my post) then I'm screwed.

 

[truesilence]

Hello,

Before I get into anything, I just want to say thanks for taking time to answer all the questions and address the concerns people have on this site. Having an actual doctor who also understands what we're going through is important to this community. While I am a very new member here, I can see from my readings that your effort on this site has helped many. Thanks for that.

As for my situation, I feel like I am screwed because I don't know how to cope with this. I don't know how it happened, not that it even matters at this point but perhaps it would be psychologically beneficial to have something to "blame." I spend inordinate amounts of time trying to figure out what caused this. I can't let it go. I feel like somehow I'm "ruined" and that my life is going to suck permanently. I can't escape this. I hear it over noise machines. I hear it over the oscillating fan set up in my room. I can't sleep. I'm exhausted. I've stopped socializing. I avoid noise because I'm afraid of making it worse. I don't know what to do. I feel like I'm losing my mind. Doctors here said "You may have had an ear infection, come back in a month if your ear is still bugging you." I've missed any window of "shock treatment" prednisone because of a general lack of concern on the part of my physicians. I'm furious. I'm frustrated.

I have always worn hearing protection – to the point where I've been made fun of for it at events – and yet here I am, stuck with this 360Hz cacophony in my head: the soundtrack to "How to Hate Your Life."

Like many people on this site, I value peace and quiet. I was never one to go out to clubs or be surrounded by loud music. I enjoyed sitting at home and reading. I like going out for walks in the woods. I live in a rural area - there is no loud noise, just nature. I feel like the solace I found in those environments has been shattered.

In the 8 weeks I've been dealing with this I haven't listened to any music, I've hardly socialized, I can't read, I can't write, I can't paint. I feel like a husk. I'm afraid to be around any noise that may make the tinnitus worse. Since I don't even know why it started, I'm not sure if noise will enhance it as others on this board have claimed. I literally move around my house turning on fans in each room in order to minimize the noise in my head. It has completely controlled my life. People say "you learn to deal with it." I'm not sure I can. 8 weeks isn't a long time but I'm not sure I have the mental fortitude to overcome this; I have other issues that I'm sure compound the effects of tinnitus.

I have had a few days with no sound at all and it always comes back with a vengeance. I don't understand why. Why would tinnitus just disappear for a while? Why does it disappear after a nap? Any time I think it's getting better it comes back like a cruel joke. I can't get clear answers on what is happening or why. It controls my life. I don't even know which sounds are real and which are in my head. I've caught myself more than a few times with my head pressed up against appliances to try to figure out of they're making the noise I hear or if it's my ear. It's an absurdity.

I am not the same person I was before this started. I don't want to live like this. If there's no solution to the problem (as everyone seems to suggest) and it's not transient (caused by an infection that may improve as I was hoping in my post) then I'm screwed.

If you have ETD it is treatable. May take a bit of time and management to see improvement, but don't ever think you are screwed!! It took me over a year and 3 ENT to get a proper diagnosis after the 1st ENT said I had hearing loss because he wasn't listening to all of my symptoms. Are you using any nasal steroids? Maybe you could try some gentle steaming to unblock your tubes? Don't take no for answer. Go back to your doctor and get a second, damn it even a third opinion.

 

[Evian]

The thing is though presumably even if you do manage to unblock the ETD you will still hear the T. I've noticed mine is louder when the aural fullness goes( which I assumes is what the ETD is)

I think the brain gets fed up with hearing nothing due to the ETD so you start hearing the T instead.

I think that is what the Dr up thread is saying as well but in a more medical way than me.

I saw two ENt's when my ETD blocked and neither said it would lead to Tinnitus then when I saw the second one again and told him what happened he said you will have to live with it.

I am in that phase of feeling totally let down by Med professional even though I know there are good ones out there somewhere I feel it's too late for me. I needed good advice on how to unblock my ETD as it was a few months before the T kicked in.

I totally empathise with Anti and all the comments in his/her post, I could have written it myself.

Also like many other I am dealing with this on top of other health issues.

 

[Evian]

Hello,

Before I get into anything, I just want to say thanks for taking time to answer all the questions and address the concerns people have on this site. Having an actual doctor who also understands what we're going through is important to this community. While I am a very new member here, I can see from my readings that your effort on this site has helped many. Thanks for that.

As for my situation, I feel like I am screwed because I don't know how to cope with this. I don't know how it happened, not that it even matters at this point but perhaps it would be psychologically beneficial to have something to "blame." I spend inordinate amounts of time trying to figure out what caused this. I can't let it go. I feel like somehow I'm "ruined" and that my life is going to suck permanently. I can't escape this. I hear it over noise machines. I hear it over the oscillating fan set up in my room. I can't sleep. I'm exhausted. I've stopped socializing. I avoid noise because I'm afraid of making it worse. I don't know what to do. I feel like I'm losing my mind. Doctors here said "You may have had an ear infection, come back in a month if your ear is still bugging you." I've missed any window of "shock treatment" prednisone because of a general lack of concern on the part of my physicians. I'm furious. I'm frustrated.

I have always worn hearing protection – to the point where I've been made fun of for it at events – and yet here I am, stuck with this 360Hz cacophony in my head: the soundtrack to "How to Hate Your Life."

Like many people on this site, I value peace and quiet. I was never one to go out to clubs or be surrounded by loud music. I enjoyed sitting at home and reading. I like going out for walks in the woods. I live in a rural area - there is no loud noise, just nature. I feel like the solace I found in those environments has been shattered.

In the 8 weeks I've been dealing with this I haven't listened to any music, I've hardly socialized, I can't read, I can't write, I can't paint. I feel like a husk. I'm afraid to be around any noise that may make the tinnitus worse. Since I don't even know why it started, I'm not sure if noise will enhance it as others on this board have claimed. I literally move around my house turning on fans in each room in order to minimize the noise in my head. It has completely controlled my life. People say "you learn to deal with it." I'm not sure I can. 8 weeks isn't a long time but I'm not sure I have the mental fortitude to overcome this; I have other issues that I'm sure compound the effects of tinnitus.

I have had a few days with no sound at all and it always comes back with a vengeance. I don't understand why. Why would tinnitus just disappear for a while? Why does it disappear after a nap? Any time I think it's getting better it comes back like a cruel joke. I can't get clear answers on what is happening or why. It controls my life. I don't even know which sounds are real and which are in my head. I've caught myself more than a few times with my head pressed up against appliances to try to figure out of they're making the noise I hear or if it's my ear. It's an absurdity.

I am not the same person I was before this started. I don't want to live like this. If there's no solution to the problem (as everyone seems to suggest) and it's not transient (caused by an infection that may improve as I was hoping in my post) then I'm screwed.

I agree it's totally horrible but I think it's quite promising that you gave some quiet days as well, plus you are only 8 weeks in, so don't give up hope yet.

I am also lived a quiet life, reading walking in woods. I tend to do the it's not fair stuff a lot and then remember that life isn't fair.

I would also like to thank Dr Nagler for his input in this site, for some strange reason IT is good to know that not only does he come from a position of medical knowledge but he has real life knowledge of tinnitus as well, and as most of us know it is only really others with thus condition who truly understand.

All I need to do now is work out how to get more than two or three hours sleep at night now

 

[Anti]

If you have ETD it is treatable. May take a bit of time and management to see improvement, but don't ever think you are screwed!! It took me over a year and 3 ENT to get a proper diagnosis after the 1st ENT said I had hearing loss because he wasn't listening to all of my symptoms. Are you using any nasal steroids? Maybe you could try some gentle steaming to unblock your tubes? Don't take no for answer. Go back to your doctor and get a second, damn it even a third opinion.

Hello,

I'm not sure it was/is an ETD. I have/had some symptoms similar to that but I'm missing other symptoms. When they look in my ear it doesn't look infected and there's no fluid, I can also hear quite well. On the other hand, I cannot "pop" the affected ear (by plugging my nose and trying to blow) no matter how hard I try (not that I go too crazy - don't want to do more harm) and I have random ear pain, as well as a feeling of something being "off" with the affected ear. I feel like I have congestion and I've been taking a nasal spray and antibiotics but they haven't seemed to help.

I have no idea what's going on. That's part of the frustration, as I'm sure many can relate to. Glad you managed to get some help but I'm sorry it took you so long. That must have been tough to deal with.

 

[Anti]

I agree it's totally horrible but I think it's quite promising that you gave some quiet days as well, plus you are only 8 weeks in, so don't give up hope yet.

I am also lived a quiet life, reading walking in woods. I tend to do the it's not fair stuff a lot and then remember that life isn't fair.

I would also like to thank Dr Nagler for his input in this site, for some strange reason IT is good to know that not only does he come from a position of medical knowledge but he has real life knowledge of tinnitus as well, and as most of us know it is only really others with thus condition who truly understand.

All I need to do now is work out how to get more than two or three hours sleep at night now

Unfortunately 8 weeks seems like it's beyond the point where any early help could be of any benefit. The doctors I've seen are a) booked weeks in advance and b) don't seem to care much about tinnitus. Sorry you're in the same situation as the rest of us.

 

[Anti]

The thing is though presumably even if you do manage to unblock the ETD you will still hear the T. I've noticed mine is louder when the aural fullness goes( which I assumes is what the ETD is)

I think the brain gets fed up with hearing nothing due to the ETD so you start hearing the T instead.

I think that is what the Dr up thread is saying as well but in a more medical way than me.

I saw two ENt's when my ETD blocked and neither said it would lead to Tinnitus then when I saw the second one again and told him what happened he said you will have to live with it.

I am in that phase of feeling totally let down by Med professional even though I know there are good ones out there somewhere I feel it's too late for me. I needed good advice on how to unblock my ETD as it was a few months before the T kicked in.

I totally empathise with Anti and all the comments in his/her post, I could have written it myself.

Also like many other I am dealing with this on top of other health issues.

Yes, it's extremely frustrating feeling like your quality of life has been utterly destroyed because of the complacency (or lack of understanding) of the only physicians you have an opportunity to see. Sorry that happened to you.

 

[truesilence]

The thing is though presumably even if you do manage to unblock the ETD you will still hear the T. I've noticed mine is louder when the aural fullness goes( which I assumes is what the ETD is)

I think the brain gets fed up with hearing nothing due to the ETD so you start hearing the T instead.

I think that is what the Dr up thread is saying as well but in a more medical way than me.

I saw two ENt's when my ETD blocked and neither said it would lead to Tinnitus then when I saw the second one again and told him what happened he said you will have to live with it.

I am in that phase of feeling totally let down by Med professional even though I know there are good ones out there somewhere I feel it's too late for me. I needed good advice on how to unblock my ETD as it was a few months before the T kicked in.

I totally empathise with Anti and all the comments in his/her post, I could have written it myself.

Also like many other I am dealing with this on top of other health issues.

I'm in your corner Evain

Hello,

I'm not sure it was/is an ETD. I have/had some symptoms similar to that but I'm missing other symptoms. When they look in my ear it doesn't look infected and there's no fluid, I can also hear quite well. On the other hand, I cannot "pop" the affected ear (by plugging my nose and trying to blow) no matter how hard I try (not that I go too crazy - don't want to do more harm) and I have random ear pain, as well as a feeling of something being "off" with the affected ear. I feel like I have congestion and I've been taking a nasal spray and antibiotics but they haven't seemed to help.

I have no idea what's going on. That's part of the frustration, as I'm sure many can relate to. Glad you managed to get some help but I'm sorry it took you so long. That must have been tough to deal with.

Please don't give up. If you can't pop one your ears it could mean that your Eustation tube is sticky or imflamed. It does take a while for the nasal spray to work and it must be done correctly. Your symptoms are very similar to mine, so I can appreciate your frustration!!
My right ear has negative pressure and when I blow my nose I can feel the gunk hitting my ear drum. I have no idea what's happening with my left either as everything seems to be ok. When I first got T I had a couple of weeks of sheer hell at night when my head would produce a dreadful buildup of his hissing, my ears felt they where being pulled inwards coupled with a burning sensation. The ENT has said that this is ETD. I still get a slight burning sensation in my ears when I eat or drink as well .

 

[Evian]

I'm in your corner Evain


Please don't give up. If you can't pop one your ears it could mean that your Eustation tube is sticky or imflamed. It does take a while for the nasal spray to work and it must be done correctly. Your symptoms are very similar to mine, so I can appreciate your frustration!!
My right ear has negative pressure and when I blow my nose I can feel the gunk hitting my ear drum. I have no idea what's happening with my left either as everything seems to be ok. When I first got T I had a couple of weeks of sheer hell at night when my head would produce a dreadful buildup of his hissing, my ears felt they where being pulled inwards coupled with a burning sensation. The ENT has said that this is ETD. I still get a slight burning sensation in my ears when I eat or drink as well .

I had what I assume is EDT dysfunction for 8 weeks from beginning of Oct 2014 then it seemed to clear a bit but nit much, I hated it but was getting used to it, saw two ENT who kept saying your ears are OK, but stuck me on a wait list for a sinus op as I had problems blowing my nose for years.

The next thing I know blocked right ear and raging T in my left ear, and then right ear decides to join in.

The ENTs offered no remedies for the blocked ears so whilst it was annoying I was living with it big knowing it would lead to the trauma of T :-(

 

[Mad maggot]

I think perhaps there's more to it than just noise being blocked out. I don't have any noise being blocked out - I have super hearing but I have T. I just discovered my skull is rather badly deformed and the deformities around my jaw and ears could be part of the cause of my T because nerves and muscles etc are irritated. Perhaps ETD could also be disturbing things in the same way?

 

[Evian]

I think perhaps there's more to it than just noise being blocked out. I don't have any noise being blocked out - I have super hearing but I have T. I just discovered my skull is rather badly deformed and the deformities around my jaw and ears could be part of the cause of my T because nerves and muscles etc are irritated. Perhaps ETD could also be disturbing things in the same way?

It's complicated isn't it. I wonder how many people have good hearing but still have T?

Like most I am hopeful for not necessarily a cure but a drug to control it, but when there seem to be so many variables that makes me think they will need more than one medication

 

[Deandush]

@Anti hey I'm just wondering if your tinnitus ever cleared up