Cannot Tell If It Is Pulsatile Tinnitus or Hyperacusis or Both

[Stocktrader86]

CliffsNotes version:
Tinnitus began 2 months ago post a cold, left ear only, did prednisone and Z-Pack when it began.
I have good days and bad.

Incidentally my good days are at the office: office environment keeps the AC very cold, I sit straight up maybe a 20 degree angle arched backwards for back.

Symptoms: Ear fullness or pressure, comes and goes... heartbeat like sensation in ear... comes and goes, sometimes more noticeable due to stress or when laying down with head slightly up watching tv.... also sensitivity to sounds... loud sounds, and or toilet flushing/loud faucet are guaranteed triggers (movie theater very noticeable if its loud)...

I noticed the hyperacusis... its a staticky like sound... kinda resembles a whooshing now that I observe it better... and the whooshing may match the tempo of the pulsatile beating sensation... so leaves me curious...

Been to 3 ents, normal range hearing test, left ear slightly worse... MRI scheduled this week...

That is where I am at. Thoughts?

 

[Karen]

Hi, @Stocktrader86,

I have a couple of thoughts about your condition. First of all, it is possible that, since your pulsating is intermittent, it could be tensor tympani syndrome. http://www.hyperacusis.net/other-factors/tensor-tympani-syndrome/

Tensor tympani may be associated with hyperacusis, in that the ear reacts to loud sound in order to "protect" itself, and the pulsating begins. I've had this strange pulsating in my good ear on occasion; it will start up for no particular reason, and sometimes lasts about 24 hours, then goes away. I have pulsatile tinnitus in my other ear, and this feeling is much different than that. My tensor tympani often starts when I am lying down with my head slightly tilted upward while reading in bed -- and that sounds a lot like the way yours starts.

Another thought: I've heard that Z-Pack can cause regular tinnitus to start, and it could be aggravating your condition. Perhaps after you stop taking it, the intermittent pulsating will improve.

I wish you success with your MRI, and will be interested to hear the outcome.

Best wishes,
Karen

 

[Contrast]

I'm going to assume the possibility that you may have both pusatile and actual tinnitus due to hyperacusis and TTTS (tensor typani syndrome) being tied in with actual tinnitus. Get checked for pusatile T, A trained audiologist can objectively find that out.

Pusatile and actual tinnitus share nothing in common, one of them is a vascular condition the other one is an auditory brain condition.

 

[Stocktrader86]

thank you for your replies, I will share my results as I get them.

I have thought about that Tensor Tympani Syndrome as well.

At any rate, I have done a good amount of watching over my body lately and still have questions.

Have either of you found successful treatment for TT Syndrome or Pulsatile T? Or Hyperacusis related to them?

 

[Karen]

Hi, @Stocktrader86,

I don't have hyperacusis, so I am not the best person to comment on it. However, I do have both PT and tensor tympani syndrome. To answer your question, I have had a lot of tests for the PT, but nothing was found to be the cause. In my case, the PT started after taking a blood pressure drug, so I feel it is related to that. What I have been doing to control it is to keep my blood pressure as low as possible. That doesn't cure PT, but it helps it to be in a more manageable range. I try to watch my diet, exercise regularly, and take a supplement for blood pressure (the one I take is called "Carditone").

As for the tensor tympani syndrome, I haven't had that for very long, but what seems to work best is to keep things calm and quiet around my bad ear. Also, I take magnesium every night, which helps keep things calm, too. When I do get the vibration in my ear, I try not to panic, and wait about 24 hours. It usually goes away within that time frame.

Here's hoping your doctor will be able to assist you, and provide you with some answers!

Best wishes,
Karen

 

[Stocktrader86]

for your Tensor tympani do you ever hear certain loud sounds as a chshhhhh sounds or staticky like sound? depending on the tilt of your head or the loudness of it?

 

[Stocktrader86]

ps thank you for your kind words, I appreciate it.


I am going to a tinnitus specialist audiologist and having an MRI separately with my ENT


I have another ENT I am working with that has some potential treatment options like ear steroid injections etc... no clue what works or doesnt... Hard to move forward with treatment for my either hyperacusis or TT syndrome / tinnitus without knowing the cause... IDK

anyways thank you

 

[Karen]

Hi, @Stocktrader86,

The tensor tympani sound I hear is usually staticky, and it is faster than my heartbeat. It does sometimes seem to be worse when I turn my head. Is that what yours is like?

I'd like to hear more about the steroid injections. It would be wonderful if those would work, at least for the TT!

Good luck with your tests, and please keep us posted on how you're doing.

 

[Stocktrader86]

So to update you all...

My MRI was clear ... and they did not see any abnormalities.

It is now agreed upon that i "likely" have cochlear hydrops... I have been put on Triamterene HCTZ 37.5 25 mg and prednisone (again second time)


So

1) I am not sure how serious cochlear hydrops is potentially... and if surgery or steroid ear injections will ever be needed. Is cochlear hydrops a life sentence of being on meds or treating the issue? This is still unclear from my web search.

2) I have seen and heard the steps of treatment are oral steroid and diuretic... then followed by something called betahistine, then followed by possible steroid injections into the ear.... some of the other procedures I read about include endolymphatic sac decomression and shunts, etc.... as well as more serious old school surgeries cutting the nerve/ killing the hearing in that ear.


3) Can cochlear hydrops improve from diuretic? This is not conclusive but seems to be indicative of improvement.

and Can cochlear hydrops be improved and go away for good?

btw i have been reading a lot on NCBI about studies relative to this topic in addition by going through my ENT... for now I am on day 4 of the meds... and attempting to reduce my salt in my diet.