Pulsatile Tinnitus Due to Myringotomy?

[Matthew231]

Hello there everyone, I am a 17-year-old male tinnitus sufferer that has had a history with this. I am new to this thread and hoping this will provide some answers.

I started getting tinnitus when it was first discovered that I had accumulated fluid in the Middle Ear behind the ear drum that my Eustachian Tube apparently couldn't siphon away. My ENT that I visited suggested I get a Myringotomy. I did and this went by without incident. Within a few months I realized I also developed fluid in the other ear and again had a Myringotomy with no incident. This was when I was in the 6th or 7th grade I believe so around 3-4 years ago give or take.

My issues arose when the fluid came back in both ears in my 8th grade year. I waited and eventually in 9th Grade and I decided to get a Myringotomy in both ears. This time everything was fine until about 6-7 months later when I was up for about 5 hours attempting to fall asleep because of regular tinnitus. I have since grown accustomed to the regular tinnitus and have no issues with it ever since as I've found a method to tune it out.

However around the same time, I noticed that there was a distinct but not unbearably loud whooshing sound in my right ear before I went to sleep every night. I honestly have no idea how I fell asleep all those nights. I quickly realized it was pulsatile tinnitus. My ear tubes fell out a short while afterwards and the strange thing was the tinnitus stopped after they had fallen out (presumably).

Then about 3-4 months after they had fallen out (this was last November), I again accumulated fluid behind my left ear. I did an ear tube anyways because I could not stand the apparent feeling of deafness that the fluid induced as well as a wind like sound whenever I ran or jumped. I switched ENTs this time because my original ENT did not diagnose a problem and we decided to visit another to get a second opinion.

Well, about a month in, I began experiencing the same whooshing sound. It was mostly when I went to bed but I could also hear it when I was reading on occasion and as I was wearing ear plugs to prevent water from accumulating in the ear, when I stepped out of the shower occasionally it would also be very significant a noise. The interesting thing is I never once heard this noise during the day or at school, even when the classroom was dead silent during a test (I took a State test during this time frame and found no issue with the whooshing whatsoever. At about April of this year, the whooshing stopped and I assume the tubes fell out.

Well it is now July and I have again accumulated fluid behind my left ear. The windlike sound is still annoying me and preventing me from running and exercising a lot. The issue is, I am afraid to get another ear tube because I do not want to have to go through another 6-8 months of pulsatile tinnitus.

Does anyone have any reasoning as to why Myringotomy Tubes would cause pulsatile tinnitus? I have searched everywhere and cannot find a single piece of information with a plausible clause. I do have a possible theory though, because I complained to my current ENT twice of the whooshing and his only answer was that there was debris from earwax and possibly that was the problem. I think he's off on the debris part but I do think he's onto something as he cleared earwax both times I complained and both times I experienced relief after the earwax was cleared.

Does anyone have any suggestions or possible causes?

 

[Juan]

Hello there everyone, I am a 17-year-old male tinnitus sufferer that has had a history with this. I am new to this thread and hoping this will provide some answers.

I started getting tinnitus when it was first discovered that I had accumulated fluid in the Middle Ear behind the ear drum that my Eustachian Tube apparently couldn't siphon away. My ENT that I visited suggested I get a Myringotomy. I did and this went by without incident. Within a few months I realized I also developed fluid in the other ear and again had a Myringotomy with no incident. This was when I was in the 6th or 7th grade I believe so around 3-4 years ago give or take.

My issues arose when the fluid came back in both ears in my 8th grade year. I waited and eventually in 9th Grade and I decided to get a Myringotomy in both ears. This time everything was fine until about 6-7 months later when I was up for about 5 hours attempting to fall asleep because of regular tinnitus. I have since grown accustomed to the regular tinnitus and have no issues with it ever since as I've found a method to tune it out.

However around the same time, I noticed that there was a distinct but not unbearably loud whooshing sound in my right ear before I went to sleep every night. I honestly have no idea how I fell asleep all those nights. I quickly realized it was pulsatile tinnitus. My ear tubes fell out a short while afterwards and the strange thing was the tinnitus stopped after they had fallen out (presumably).

Then about 3-4 months after they had fallen out (this was last November), I again accumulated fluid behind my left ear. I did an ear tube anyways because I could not stand the apparent feeling of deafness that the fluid induced as well as a wind like sound whenever I ran or jumped. I switched ENTs this time because my original ENT did not diagnose a problem and we decided to visit another to get a second opinion.

Well, about a month in, I began experiencing the same whooshing sound. It was mostly when I went to bed but I could also hear it when I was reading on occasion and as I was wearing ear plugs to prevent water from accumulating in the ear, when I stepped out of the shower occasionally it would also be very significant a noise. The interesting thing is I never once heard this noise during the day or at school, even when the classroom was dead silent during a test (I took a State test during this time frame and found no issue with the whooshing whatsoever. At about April of this year, the whooshing stopped and I assume the tubes fell out.

Well it is now July and I have again accumulated fluid behind my left ear. The windlike sound is still annoying me and preventing me from running and exercising a lot. The issue is, I am afraid to get another ear tube because I do not want to have to go through another 6-8 months of pulsatile tinnitus.

Does anyone have any reasoning as to why Myringotomy Tubes would cause pulsatile tinnitus? I have searched everywhere and cannot find a single piece of information with a plausible clause. I do have a possible theory though, because I complained to my current ENT twice of the whooshing and his only answer was that there was debris from earwax and possibly that was the problem. I think he's off on the debris part but I do think he's onto something as he cleared earwax both times I complained and both times I experienced relief after the earwax was cleared.

Does anyone have any suggestions or possible causes?

Did the ear tubes always fall off by themselves or they were removed?

 

[Matthew231]

@Juan As far as I know, the ear tubes fell out by themselves the first time around (so the first time for both ears even though they were implanted at different times). But the second time, I forgot which one, there was one that somehow impacted a nerve or something (or maybe it was a blood vessel, I forgot which, and that could explain a lot) and had to be removed manually by my ENT (the first one).

 

[Juan]

@Juan As far as I know, the ear tubes fell out by themselves the first time around (so the first time for both ears even though they were implanted at different times). But the second time, I forgot which one, there was one that somehow impacted a nerve or something (or maybe it was a blood vessel, I forgot which, and that could explain a lot) and had to be removed manually by my ENT (the first one).

My guess is the force or method used to implant or remove the tubes may have caused the tinnitus. Take into account that the eardrum is connected to muscles, the middle ear bones etc, so an impact there is driven inside through muscles and the tiny bones.

 

[Matthew231]

My guess is the force or method used to implant or remove the tubes may have caused the tinnitus. Take into account that the eardrum is connected to muscles, the middle ear bones etc, so an impact there is driven inside through muscles and the tiny bones.

That is plausible but if that was the case I'd have many question marks.

For example, the tinnitus was only pulsatile and was very intermittent. Most of the time I could only hear it in a position where I was lying down. It seemed to bother me most in sleep. It also seems as though you're describing a more permanent damage to the ear, but in both cases, the tinnitus stopped as soon as the tubes were ejected from the eardrum (whenever that happened to be).

 

[Juan]

That is plausible but if that was the case I'd have many question marks.

For example, the tinnitus was only pulsatile and was very intermittent. Most of the time I could only hear it in a position where I was lying down. It seemed to bother me most in sleep. It also seems as though you're describing a more permanent damage to the ear, but in both cases, the tinnitus stopped as soon as the tubes were ejected from the eardrum (whenever that happened to be).

So you only heard the tinnitus when the tubes were on, when the eardrum was perforated? Do you think that could be related to either a change of pressure in the ear due to the tubes and / or to the fluid being drained through them?

 

[Matthew231]

So you only heard the tinnitus when the tubes were on, when the eardrum was perforated? Do you think that could be related to either a change of pressure in the ear due to the tubes and / or to the fluid being drained through them?

Yes I only heard the whooshing (which has to be Pulsatile Tinnitus) during the time frame in which the ear tubes were in. The pressure change is a plausible cause. I'm not too sure about the fluid draining cause though, as all the fluid was drained before the installment of the ear tubes.

 

[Juan]

Yes I only heard the whooshing (which has to be Pulsatile Tinnitus) during the time frame in which the ear tubes were in. The pressure change is a plausible cause. I'm not too sure about the fluid draining cause though, as all the fluid was drained before the installment of the ear tubes.

Then the tubes were not performing their role, which is to drain fluid. Maybe you Heard the whooshing while the tubes were in because of the different pressure in every ear, depending on the amount of fluid inside, it's just a guess.

How many times did you get tubes inserted? Did they have to use anesthesia for that? What's the procedure like?

 

[Matthew231]

Then the tubes were not performing their role, which is to drain fluid. Maybe you Heard the whooshing while the tubes were in because of the different pressure in every ear, depending on the amount of fluid inside, it's just a guess.

How many times did you get tubes inserted? Did they have to use anesthesia for that? What's the procedure like?

Sorry for this late response but so when they apply the anesthesia, it's a numbing cream that's put into the ear canal. After they apply the cream, they let it sit and after about 2 hours or so, the procedure is ready to begin. First an incision is made with a scalpel, then the tube is inserted. I've had 4 tubes I believe so far in the left ear. I just recently got another one for the fluid.

 

[Juan]

Sorry for this late response but so when they apply the anesthesia, it's a numbing cream that's put into the ear canal. After they apply the cream, they let it sit and after about 2 hours or so, the procedure is ready to begin. First an incision is made with a scalpel, then the tube is inserted. I've had 4 tubes I believe so far in the left ear. I just recently got another one for the fluid.

And after it heals, after the tube is removed, does it leave your eardrum scarred?

 

[Matthew231]

And after it heals, after the tube is removed, does it leave your eardrum scarred?

According to my ENT, there is no scarring, so far at least.