Ear Vacuuming

[Andrewhf]

Hi Stephen,

I developed intrusive tinnitus this time last year, tests showed very good hearing and no discernible hearing loss and no other audiological pathology that would explain the tinnitus. I also have a degree of TTTS.
After a pretty tumultuous first few months I made great progress to habituation to the tinnitus - up to the point about a month ago whereby I was aware of my tinnitus only 10% - 20% of the day and even had a couple of occasions where in a quiet environment no matter how much I listened for it I could not hear a thing. About 3 weeks ago I went to an audiologist to have casts made for custom made musicians ear plugs. The audiologist proceeded to micro-vacuum my ears to remove a little bit of wax. I was very nervous about that but let her do it as I thought that the vacuuming would only be of short duration and unlikely to cause any issues related to the Tinnitus and TTTS. It seems now that the Tinnitus is higher volume and more intrusive, I am aware of it 80% of the day now and it is not "settling" back to the previous level (or perceived level?).
I read an article by Jack Vernon that no one with tinnitus should ever have their ears vacuumed. I have had a discussion with the audiologist and they say that there is little chance that the vacuuming could cause any permanent damage and/or permanent tinnitus exacerbation. The way things are going I am worried that the habituation achieved previously has been significantly undone and that the tinnitus has been permanently pushed up a level. Can I have your thoughts on the vacuuming and Jack Vernon's comments and any comments on re-habituating?

 

[Dr. Nagler]

Can I have your thoughts on the vacuuming and Jack Vernon's comments and any comments on re-habituating?

Although some disagree, I have no particular problem with the micro-vacuum approach in experienced hands. I do, however, have a problem with the idea of removing "a little bit" of wax in the first place. The ears are supposed to produce wax. It's the mechanism by which the ear moves dust and debris from deeper in near the tympanic membrane out towards the external auditory meatus. So as I see it, removing a "little bit" of wax is meddlesome. The only reason to remove wax is if it is causing a conductive hearing loss (which requires a lot of wax) or if it is preventing visualization of the tympanic membrane when such visualization is deemed necessary to rule out perforation, inflammation, etc.

In terms of re-habituating, the only experience I have had is with my own TRT patients. Re-habituation using TRT is a usually a piece of cake. You resume the protocol, and typically within a few days to a few weeks you are there. It's like re-learning to ride a bike. I suspect that things are a good bit more variable in general, but I do not feel comfortable making a definitive statement in that regard.

Dr. Stephen Nagler