Fluid Causing Tinnitus

[citigirl13]

Hi Doctor,

I have had T (tinnitus) for about two and a half months now. I noticed it after a cold. The first two times I went to the doctor they said my ears "did not look right" and "mucus-y". The third time a doctor said he could see fluid, but by that point I could hear it going round my head. I have four questions for you:

1) Can anything else apart from a cold cause fluid in the ear, such as TMJ or hearing loss (sorry if those are stupid questions, but it might finally stop me worrying)?

2) Can fluid be absorbed into the body and go away with the help of a nasal spray only (I should mention that I believe my T has gotten lower recently and that my symptoms, such a pressure, headaches, earache and pain in sinuses have lessened a lot)?

3) When is the time to start thinking about medical intervention?

4) Is the T likely to go away?

Thanks in advance for your answers!

 

[Dr. Nagler]

Hi @citigirl13 -

You ask a number of very good questions. I will try to answer each briefly.

1) Can anything else apart from a cold cause fluid in the ear, such as TMJ or hearing loss (sorry if those are stupid questions, but it might finally stop me worrying)?

When people talk about "fluid in the ear," they are referring to the middle ear, which is the part of the ear between the eardrum and the cochlea. The middle ear contains the malleus, incus, and stapes bones - the three smallest bones in the body. The middle ear would be a closed space save for the fact that it drains via the Eustachian tube into the nasopharynx (in the back of the throat). Since the middle ear itself secretes small amounts of fluid, anything that blocks the Eustachian tube can cause build-up of that fluid. The most common thing blocking the Eustachian tube is "congestion" from an upper respiratory infection like a cold. TMJ problems or hearing loss cannot block the Eustachian tube, but fluid build-up in the middle ear from a blocked Eustachian tube can result in some degree of conductive hearing loss until it can once again drain through the Eustachian tube. Temporary tinnitus (or temporarily increased tinnitus) can accompany that hearing loss. It gets a bit more complicated than that, but you have the gist of it anyway.

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2) Can fluid be absorbed into the body and go away with the help of a nasal spray only (I should mention that I believe my T has gotten lower recently and that my symptoms, such a pressure, headaches, earache and pain in sinuses have lessened a lot)?

The body's ability to absorb the fluid is limited. It either needs to drain through the Eustachian tube or through the eardrum. (Infected middle ear fluid under pressure is one of the potential causes of a ruptured eardrum.) Nasal sprays are sometimes used to try to decrease Eustachian tube swelling and allow proper draining.

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3) When is the time to start thinking about medical intervention?

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I'm not sure what you mean by medical intervention. If you have fluid buildup in the middle ear under pressure and nasal sprays and antibiotics (if indicated) don't help, then your ENT might want to consider a tube myringotomy (putting a small temporary tube through the eardrum). The most important thing is to be evaluated by an knowledgeable otolaryngologist (ENT).

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4) Is the T likely to go away?

Well, that sort of depends on the cause for your tinnitus and how intrusive it is. Can't help you there without knowing a whole lot more about your case. Indeed, your tinnitus might be totally unrelated to any fluid buildup! Or maybe you first noticed it when you had a cold, but now your brain has "locked onto it." Too many possibilities there to answer your question responsibly. My suggestion would be for you to see a clinician near you who has a lot of knowledge and experience about such things. Perhaps contact the British Tinnitus Association and see who they might recommend.

Hope this helps more than confuses.

All the best -

Dr. Stephen Nagler