Two-year lurker here. I'm a 20-year-old college student from Texas who first developed tinnitus in November 2016 when I was 18. I was sitting at my computer after a long car ride and had a brief moment of vertigo that lasted for about 10 seconds coupled with extremely loud tinnitus. The vertigo never came back but the tinnitus stayed, though thankfully at a reduced volume from initial onset.
Since that point, I have been to an ENT and an ear specialist clinic. My audiogram and extended frequency audiogram is normal, I have no history of excessive noise exposure nor was I exposed to any excess noise before my onset, no history of ear infections, didn't correspond with any illness I can remember, no ototoxic drug use, etc. My ENT flippantly suggested in January 2017 that it was probably a "blood clot" but my neurotologist noted 1 1/2 years later that an ischemia to the blood supply of the ears would have much more severe immediate symptoms than what I experienced. Basically, I'm somewhat at a loss and wondering if y'all can point me in the right direction.
My tinnitus is polytonal (a low hum, mid-frequency tone, and whistling, fluctuating hiss). The hiss is the only thing I can hear in my daily life unless I'm in a totally silent room, then the lower tones and hums seem to overwhelm it. The onset with dizziness suggested to me initially a vestibular etiology, but I really see no possibility for that -- Dr. Assar Bjorne explored the relation between cervicogenic and jaw problems with tinnitus and vertigo and found correlations and possible causations, so it seems to me that other causes may exist for the vertigo origin. I had dental surgery (to remove ameloblastoma) a few months before the tinnitus began, and also had wisdom teeth removed, which promoted malocclusion problems. Previously I had extensive orthodontic treatment and braces in my teens. I also have forward head posture and mild scoliosis, and occasional upper back and shoulder pain. I can modulate the hissing tinnitus noise noticeably by opening my mouth widely, manipulating my jaw, and it gets perceptably worse when I bend over if the tinnitus is loud to begin with. I had a transient worsening with a neck maneuver that compress my upper cervical vertebrae: loud bilateral tinnitus ensued and went back to normal in around 2 minutes. From what I can tell, this is more likely somatosensory over vascular etiology. A 48-hour increase was noted a few hours after a severe tension headache (I get these infrequently, it's not a common thing I deal with). Finally, I get muscle spasms in my ears sometimes and what I believe is called tensor tympani syndrome.
It's a lot to deal with, and if you've made it this far, I appreciate it. I just need some advice to move forward with this. I'm a severely anxious person as is so this has not been an easy two years, primarily due to my tinnitus. I was on Klonopin for several years due to my anxiety problems, but stopped over a few months about a year before my onset, so I can't see a correlation there. It is obvious to me that there exists a correlation between my dental work and jaw problems as well as neck/postural problems and my tinnitus, especially when it comes to modulation. It's sometimes very striking -- I can completely abolish the hissing part of my tinnitus when it's loud if I open my mouth widely, and immediately after stopping it returns with a higher level. This rebound effect subsides after about 30 seconds.
I will be getting an MRI done (belated, I know) soon to test for evident brain abnormalities such as vestibular schwannoma and vascular compression. I have read some encouraging reports on TMJ treatment (Wright & Bifano, Gelb, etc.) on tinnitus as well as physical therapy-based treatment on upper neck (Bjorne, Sanchez, etc.). I found this case report which is similar to mine aside from the age difference.
I just want to know, if I can, what's causing my problem. I realize the more realistic goal is improvement or therapy over total resolution, but I'll take what I can get. I want to go for causal treatment first, and if that fails, symptomatic treatment such as benzodiazepines, Neuromonics, vagus nerve therapy (I'm a student at UT Dallas so that helps), something like the UMich timed signal device, etc. In terms of causal treatment: orthotic, cervical collar, physical therapy on neck, postural work? What should I do? I've narrowed down the scientifically accepted causes of tinnitus from this flowchart to those few things.
Thanks for reading.
Since that point, I have been to an ENT and an ear specialist clinic. My audiogram and extended frequency audiogram is normal, I have no history of excessive noise exposure nor was I exposed to any excess noise before my onset, no history of ear infections, didn't correspond with any illness I can remember, no ototoxic drug use, etc. My ENT flippantly suggested in January 2017 that it was probably a "blood clot" but my neurotologist noted 1 1/2 years later that an ischemia to the blood supply of the ears would have much more severe immediate symptoms than what I experienced. Basically, I'm somewhat at a loss and wondering if y'all can point me in the right direction.
My tinnitus is polytonal (a low hum, mid-frequency tone, and whistling, fluctuating hiss). The hiss is the only thing I can hear in my daily life unless I'm in a totally silent room, then the lower tones and hums seem to overwhelm it. The onset with dizziness suggested to me initially a vestibular etiology, but I really see no possibility for that -- Dr. Assar Bjorne explored the relation between cervicogenic and jaw problems with tinnitus and vertigo and found correlations and possible causations, so it seems to me that other causes may exist for the vertigo origin. I had dental surgery (to remove ameloblastoma) a few months before the tinnitus began, and also had wisdom teeth removed, which promoted malocclusion problems. Previously I had extensive orthodontic treatment and braces in my teens. I also have forward head posture and mild scoliosis, and occasional upper back and shoulder pain. I can modulate the hissing tinnitus noise noticeably by opening my mouth widely, manipulating my jaw, and it gets perceptably worse when I bend over if the tinnitus is loud to begin with. I had a transient worsening with a neck maneuver that compress my upper cervical vertebrae: loud bilateral tinnitus ensued and went back to normal in around 2 minutes. From what I can tell, this is more likely somatosensory over vascular etiology. A 48-hour increase was noted a few hours after a severe tension headache (I get these infrequently, it's not a common thing I deal with). Finally, I get muscle spasms in my ears sometimes and what I believe is called tensor tympani syndrome.
It's a lot to deal with, and if you've made it this far, I appreciate it. I just need some advice to move forward with this. I'm a severely anxious person as is so this has not been an easy two years, primarily due to my tinnitus. I was on Klonopin for several years due to my anxiety problems, but stopped over a few months about a year before my onset, so I can't see a correlation there. It is obvious to me that there exists a correlation between my dental work and jaw problems as well as neck/postural problems and my tinnitus, especially when it comes to modulation. It's sometimes very striking -- I can completely abolish the hissing part of my tinnitus when it's loud if I open my mouth widely, and immediately after stopping it returns with a higher level. This rebound effect subsides after about 30 seconds.
I will be getting an MRI done (belated, I know) soon to test for evident brain abnormalities such as vestibular schwannoma and vascular compression. I have read some encouraging reports on TMJ treatment (Wright & Bifano, Gelb, etc.) on tinnitus as well as physical therapy-based treatment on upper neck (Bjorne, Sanchez, etc.). I found this case report which is similar to mine aside from the age difference.
I just want to know, if I can, what's causing my problem. I realize the more realistic goal is improvement or therapy over total resolution, but I'll take what I can get. I want to go for causal treatment first, and if that fails, symptomatic treatment such as benzodiazepines, Neuromonics, vagus nerve therapy (I'm a student at UT Dallas so that helps), something like the UMich timed signal device, etc. In terms of causal treatment: orthotic, cervical collar, physical therapy on neck, postural work? What should I do? I've narrowed down the scientifically accepted causes of tinnitus from this flowchart to those few things.
Thanks for reading.
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