Fleeting Tinnitus Multiple Times a Day — What Are the Implications?

[Deseree]

Hello Dr. Nagler,

First of all, I just want to thank you for being here on this forum to answer questions, it is very appreciated and very helpful!

My apologies for the lengthy post, but I want to make sure I am describing everything accurately. I've had a very hard time finding much information regarding this issue. I've had very mild tinnitus ever since I can remember (I'm 31 now). It never really bothered me as a child because I thought it was normal, especially since both of my parents and sister said they could hear ringing in the silence as well. Not sure if this is relevant, but figured I'd mention it.

Anyway, starting about a month ago, I started getting fleeting tinnitus every day. You know, those random, quick bouts of loud ringing and muffled hearing that go away rather quickly. I've always had random episodes of this, maybe once a month or so since I was a child, but this has been different because now it's happening every day, sometimes multiple times.

The first occurrence last month was rather scary: I felt a rumbling in my head, a tiny bit of dizziness/disorientation, followed by ringing that lasted about 5 minutes. When it went away, sounds were very distorted for about another thirty minutes or so and then things returned to normal. But ever since that day, I've been getting these 30 seconds or less episodes of ringing, sometimes in the left ear, sometimes the right. Luckily, the strange sound distortion and dizziness haven't really accompanied any of the occurrences after that first one, but they are still very scary. Most of the time the tone is high, but sometimes it's low. It all seems rather random, with no discernible cause or pattern.

I have 3 questions regarding this:

1) I'm really worried that this could mean my mild tinnitus is getting worse. Do you think this increase in fleeting tinnitus is a "warning sign" that something sinister is developing?

2) Can fleeting tinnitus get "stuck" like that? For example, could it just happen and never stop, becoming the new tinnitus?

3) Do you know of anything that can cause fleeting tinnitus? I just can't think of any reason why I would suddenly be getting this every day for a month now. I don't have allergies, haven't had any recent illnesses (other than a week long bout of acid reflux preceding this) and I've always been very protective of my ears. I'm pretty shaken up and worried about this.

Thank you so much for your time!

 

[Dr. Nagler]

Hello @Deseree.

"Fleeting tinnitus" is a rather common phenomenon that - to the best of my knowledge - has absolutely no diagnostic, therapeutic, or prognostic consequences. Dr. Jack Vernon (1922-2010) once observed that in folks who have both tinnitus and fleeting tinnitus that the fleeting tinnitus tends to mask or suppress the tinnitus during the periods of time that it is apparent, be that once a week, once a day, or several times a day. Basically, other than being a nuisance, fleeting tinnitus is one big nothing-burger. Now I am not minimizing your distress at all. But what I wish to convey to you is that your concern is based in emotional thinking rather than in rational thinking. (That's not meant to be any sort of criticism. We all think emotionally from time to time; it is what separates humans from machines.)

So, the answers to your three questions above are: No, No, and No.

With regard to your comment "I'm pretty shaken up and worried about this," I have a story you might find to be interesting. Several years ago I was invited to speak at a tinnitus conference where there were a couple of hundred audiologists and ENTs in the audience. Once of the other speakers asked for a show of hands as to how many of those attending had tinnitus. As you might expect, roughly 20% of the audience raised their hands. The speaker then went on to describe fleeting tinnitus similar to the way you described it in your post above: "random, quick bouts of loud ringing and muffled hearing that go away rather quickly." He did not call it fleeting tinnitus; he merely described it. Then he asked for a show of hands as to how many in the audience experienced it. And almost everybody raised their hands! Now these were folks who obviously were attuned to their auditory systems - they were audiologists and ENTs after all. So maybe fewer hands would have been raised in an audience of plumbers or accountants. But what I want to convey to you regarding your fleeting tinnitus is that you can rest assured that you can rest assured!

Hope this helps.

Stephen M. Nagler, M.D.