Second Acoustic Trauma: Seeking Advice on Ear Fullness/Pressure

[matt89]

Hi everyone,

In 2016, I experienced an acoustic trauma, and I am immensely grateful for the support Tinnitus Talk provided. It helped me adapt to living with tinnitus in both ears, a high-frequency hearing loss in my right ear, and to continue my life with these little devils in my ears every day.

Unfortunately, I am quite certain that I suffered another acoustic trauma four weeks ago. My wife and I attended a wedding party where the music was extremely loud. Because it was a close friend's wedding, I assumed the music would be at a moderate volume and did not bring my earplugs. I asked the couple to lower the volume, but they did not. Several guests, including my wife and me, eventually left because we couldn't even talk due to the high volume. Although we left after being exposed to the loud music for only 30 minutes (sometimes closer to the speakers, sometimes farther away), it seems that was enough to put me back into a similar situation as in 2016.

On the way home from the wedding, I noticed that I couldn't hear well and had a strange feeling. Two days later, I experienced ear fullness and pressure in both ears, with my hearing resembling the sensation of being under a cheese cover or a motorcycle helmet. I could hear everything, but it seemed distant and different from before. When someone is right in front of me, I can understand them, but I have to listen carefully to those farther away. Fortunately, my wife is fine.

I immediately visited the ENT and explained the situation. He examined my ears and found fluid behind both eardrums. A tympanometry test showed high negative pressure in both ears, leading to a diagnosis of Eustachian Tube Dysfunction with fluid behind both eardrums. He attributed it to an infection or allergic reaction, not the loud party, and prescribed Mometasone nasal spray. Skeptical but hopeful, I used the nasal spray daily, yet nothing changed. I still had ear fullness and felt like I was living under a helmet.

Five days later, I returned to the ENT. A hearing test showed normal results except for the high-frequency hearing loss in my right ear from the 2016 trauma. After two weeks with no improvement, another ENT visit confirmed the fluid was gone, and a second tympanometry was normal. However, I still experienced intense ear fullness and pressure. The ENT then prescribed Prednisolone (100 mg per day for five days), which did not help. He had not been prescribed it earlier because no new hearing loss had been detected.

Unfortunately, four weeks later, I am still struggling with the following issues:

• Severe ear fullness and pressure in both ears that won't go away.
• Although the ENT said there is no more fluid behind the eardrums, my hearing, especially for distant sounds, is still muffled, and unlike before, it is as if I am under a motorcycle helmet.

I am unsure of what is happening and have the following questions:

Can an acoustic trauma cause Eustachian Tube Dysfunction, resulting in fluid behind the eardrums? If so, shouldn't the ear fullness and pressure also disappear once the fluid is gone? I can perform the Valsalva maneuver, suggesting that air circulation works and the fluid should be gone. So, where is the pressure/fullness coming from? Could it originate from the cochlea or inner ear? If so, how long does it take for the fullness to subside? Is it also a kind of fluid that needs to drain from the cochlea down the Eustachian tubes but takes more time, or could it be something else?

Thank you in advance for any help!
Matt

 

[withintention]

I was diagnosed with "otitis media with effusion" (which just means fluid behind the ear drums) after my acoustic trauma. The doctor absolutely misdiagnosed it first as an ear infection and then a sinus infection. I later saw an ENT who told me that acoustic trauma can definitely cause fluid build-up behind the ear drums.

I am 10 months from my trauma and still feel the occasional feeling of fullness and dull pain in my inner ear. However, it's less and less each month. I wish my tinnitus had decreased similarly, but unfortunately, it has not.

I don't think that helps you understand why your hearing is still muffled, but I at least wanted to share that fluid build-up behind the ear drums can be a result of acoustic trauma.

 

[matt89]

I was diagnosed with "otitis media with effusion" (which just means fluid behind the ear drums) after my acoustic trauma. The doctor absolutely misdiagnosed it first as an ear infection and then a sinus infection. I later saw an ENT who told me that acoustic trauma can definitely cause fluid build-up behind the ear drums.

I am 10 months from my trauma and still feel the occasional feeling of fullness and dull pain in my inner ear. However, it's less and less each month. I wish my tinnitus had decreased similarly, but unfortunately, it has not.

I don't think that helps you understand why your hearing is still muffled, but I at least wanted to share that fluid build-up behind the ear drums can be a result of acoustic trauma.

Thanks for sharing your story! I completely understand what you're going through. It's reassuring to know that the ear fullness is gradually diminishing over time. This symptom is currently the most bothersome for me. I constantly feel the need to perform Valsalva maneuvers to relieve the pressure or fullness. While the Valsalva maneuver is usually effective, it doesn't seem to work for me (no pressure or fullness is relieved).

From what I've read in several threads, the feeling of fullness (when there's no fluid visible behind the eardrum) is likely due to inner ear or cochlea inflammation, which takes more time to heal. Interestingly, this inflammation can occur after an acoustic trauma even without any detectable hearing loss, as my hearing tests are normal. It seems like the cochlea is wounded on the outside due to the sound pressure from the trauma, but the inside remains fine. This persistent pressure or fullness sensation in my ear is driving me crazy.

Additionally, I sometimes experience a tickling feeling inside my ears during the day. Do you ever feel that too?

I am considering undergoing some hyperbaric oxygen therapy (HBOT) sessions to support the healing of the inflammation. Even if it doesn't help, at least I will have tried everything possible to aid the healing process. I read your initial thread; how did the HBOT work out for you?

 

[withintention]

Yes, I still get tickling and the occasional ache inside my ear canal. I wonder if it is the cochlea slowly healing over time? It feels like it could be.

I did a pretty extensive HBOT, and like anything else, it's so hard to say if it helped. I don't know if I'd be worse today without it. I think the tinnitus has probably gotten better over the last ten months. Was it due to HBOT? Is it just me getting used to it? Impossible to say.

 

[Utdmad89]

Yes, I still get tickling and the occasional ache inside my ear canal. I wonder if it is the cochlea slowly healing over time? It feels like it could be.

No, it's not your cochlea healing.

 

[matt89]

No, it's not your cochlea healing.

And what does the tickling sensation stand for?

Another question: Does it make sense to protect the ears with earplugs during the day after an acoustic trauma to gain more silence? I know you shouldn't overprotect your ears after an acoustic trauma. Still, I read in some posts that members had remarkable improvements by permanently using earplugs after their acoustic trauma for a while.

Does it make sense to use earplugs to give your ears a break from sounds, similar to how you would use a plaster to protect a wound?

 

[Utdmad89]

And what does the tickling sensation stand for?

Another question: Does it make sense to protect the ears with earplugs during the day after an acoustic trauma to gain more silence? I know you shouldn't overprotect your ears after an acoustic trauma. Still, I read in some posts that members had remarkable improvements by permanently using earplugs after their acoustic trauma for a while.

Does it make sense to use earplugs to give your ears a break from sounds, similar to how you would use a plaster to protect a wound?

It could be early signs of pain hyperacusis or irritation from earplugs; if you are getting any pain, then there is no such thing as over-protection. If it's just hyperacusis, I would carefully start to reintroduce sound when you feel ready.

Good luck.

 

[tomytl]

Hi everyone,

In 2016, I experienced an acoustic trauma, and I am immensely grateful for the support Tinnitus Talk provided. It helped me adapt to living with tinnitus in both ears, a high-frequency hearing loss in my right ear, and to continue my life with these little devils in my ears every day.

Unfortunately, I am quite certain that I suffered another acoustic trauma four weeks ago. My wife and I attended a wedding party where the music was extremely loud. Because it was a close friend's wedding, I assumed the music would be at a moderate volume and did not bring my earplugs. I asked the couple to lower the volume, but they did not. Several guests, including my wife and me, eventually left because we couldn't even talk due to the high volume. Although we left after being exposed to the loud music for only 30 minutes (sometimes closer to the speakers, sometimes farther away), it seems that was enough to put me back into a similar situation as in 2016.

On the way home from the wedding, I noticed that I couldn't hear well and had a strange feeling. Two days later, I experienced ear fullness and pressure in both ears, with my hearing resembling the sensation of being under a cheese cover or a motorcycle helmet. I could hear everything, but it seemed distant and different from before. When someone is right in front of me, I can understand them, but I have to listen carefully to those farther away. Fortunately, my wife is fine.

I immediately visited the ENT and explained the situation. He examined my ears and found fluid behind both eardrums. A tympanometry test showed high negative pressure in both ears, leading to a diagnosis of Eustachian Tube Dysfunction with fluid behind both eardrums. He attributed it to an infection or allergic reaction, not the loud party, and prescribed Mometasone nasal spray. Skeptical but hopeful, I used the nasal spray daily, yet nothing changed. I still had ear fullness and felt like I was living under a helmet.

Five days later, I returned to the ENT. A hearing test showed normal results except for the high-frequency hearing loss in my right ear from the 2016 trauma. After two weeks with no improvement, another ENT visit confirmed the fluid was gone, and a second tympanometry was normal. However, I still experienced intense ear fullness and pressure. The ENT then prescribed Prednisolone (100 mg per day for five days), which did not help. He had not been prescribed it earlier because no new hearing loss had been detected.

Unfortunately, four weeks later, I am still struggling with the following issues:

• Severe ear fullness and pressure in both ears that won't go away.
• Although the ENT said there is no more fluid behind the eardrums, my hearing, especially for distant sounds, is still muffled, and unlike before, it is as if I am under a motorcycle helmet.

I am unsure of what is happening and have the following questions:

Can an acoustic trauma cause Eustachian Tube Dysfunction, resulting in fluid behind the eardrums? If so, shouldn't the ear fullness and pressure also disappear once the fluid is gone? I can perform the Valsalva maneuver, suggesting that air circulation works and the fluid should be gone. So, where is the pressure/fullness coming from? Could it originate from the cochlea or inner ear? If so, how long does it take for the fullness to subside? Is it also a kind of fluid that needs to drain from the cochlea down the Eustachian tubes but takes more time, or could it be something else?

Thank you in advance for any help!
Matt

As long as there is no additional, measurable hearing loss, that's something positive. Twenty years ago, I had my darkest day with sudden hearing loss, resulting in hearing loss, hyperacusis, tinnitus, and pressure in the ear. Since then, I have always protected my ears very well, and for about 15 years, I have almost always been walking around with cotton balls in my ears... this might not be very good... but that's how it is.

Despite this, I have occasionally encountered situations too loud for my ears, such as in a crowded restaurant, at a festival, and recently at a concert, even with custom-made earplugs with maximum damping. I believe that after hyperacusis, the entire hearing processing system is disrupted, and loud events cause the hearing to freak out, while people with normal hearing have a much more typical tolerance.

If it stems from a hearing impairment or hyperacusis, pressure in the ear usually takes quite a long time to normalize. I do not know what is responsible for this, either. It is incredibly frustrating to find yourself in this situation again. However, I have managed to get out of it so far, and I hope to do so this time, and I hope everyone does. Time is often the most significant factor.

 

[ECP]

I apologize that the loud music at the wedding party affected your ears.

The symptoms you developed afterward are uncommon for the general population but, unfortunately, quite familiar to those of us who frequent this message board. Once your ears have experienced trauma, they might become more vulnerable to further damage compared to the average person's ears.

I'm surprised no one has linked to this academic paper yet. It's a beneficial and validating resource that may explain why you have such an unusual cluster of symptoms several weeks after the noise event. Apologies if you're already familiar with this often-cited paper, but if you haven't seen it, I hope you'll find it informative:

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

Several weeks or even months after noise trauma, many of us, including myself, have continued to experience ear fullness like you. However, when a doctor examines the ear with an otoscope, no fluid is present, even though it feels like there is. It's also worth noting that while many people with Eustachian tube dysfunction (ETD) are diagnosed in childhood, many adults on this message board were diagnosed with ETD only after experiencing acoustic trauma in adulthood, with no prior history of childhood ear infections. It seems that acoustic trauma can indeed induce adult-onset ETD or cause symptoms nearly identical to it. This academic paper is cherished by many on this message board because it scientifically validates our perplexing experiences as patients.

None of us here can agree on the optimal amount of hearing protection to use after acoustic trauma. Trust your own judgment, and don't second-guess the pain signals from your ears or brain. Gradually expose yourself to sound and back off if it feels painful.

 

[Michael Leigh]

Can an acoustic trauma cause Eustachian Tube Dysfunction, resulting in fluid behind the eardrums? If so, shouldn't the ear fullness and pressure also disappear once the fluid is gone? I can perform the Valsalva maneuver, suggesting that air circulation works and the fluid should be gone. So, where is the pressure/fullness coming from? Could it originate from the cochlea or inner ear? If so, how long does it take for the fullness to subside? Is it also a kind of fluid that needs to drain from the cochlea down the Eustachian tubes but takes more time, or could it be something else?

I think you have done the right thing by visiting your ENT and having tests carried out on your auditory system after you were exposed to the loud music at the wedding. I agree with you that you have suffered a second noise trauma. It can result in experiencing ear fullness and, unfortunately, many other symptoms in addition to those you mention. I advise caution when performing the Valsalva maneuver and suggest you leave your ears alone and give them time to heal.

When a person habituates to noise-induced tinnitus and then suffers a second noise trauma, it can affect the ears and auditory system in many ways. I have explained this in my thread: Can I Habituate to Variable Tinnitus? I advise you to read it, as I believe you will find it helpful. Variable tinnitus is my definition of a more severe form of noise-induced tinnitus. It usually occurs after a person has suffered a second noise trauma once they have habituated noise-induced tinnitus.

Please give yourself time and hopefully you will start to feel better.

All the best,
Michael

Can I Habituate to Variable Tinnitus? | Tinnitus Talk Support Forum

 

[matt89]

I apologize that the loud music at the wedding party affected your ears.

The symptoms you developed afterward are uncommon for the general population but, unfortunately, quite familiar to those of us who frequent this message board. Once your ears have experienced trauma, they might become more vulnerable to further damage compared to the average person's ears.

I'm surprised no one has linked to this academic paper yet. It's a beneficial and validating resource that may explain why you have such an unusual cluster of symptoms several weeks after the noise event. Apologies if you're already familiar with this often-cited paper, but if you haven't seen it, I hope you'll find it informative:

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

Several weeks or even months after noise trauma, many of us, including myself, have continued to experience ear fullness like you. However, when a doctor examines the ear with an otoscope, no fluid is present, even though it feels like there is. It's also worth noting that while many people with Eustachian tube dysfunction (ETD) are diagnosed in childhood, many adults on this message board were diagnosed with ETD only after experiencing acoustic trauma in adulthood, with no prior history of childhood ear infections. It seems that acoustic trauma can indeed induce adult-onset ETD or cause symptoms nearly identical to it. This academic paper is cherished by many on this message board because it scientifically validates our perplexing experiences as patients.

None of us here can agree on the optimal amount of hearing protection to use after acoustic trauma. Trust your own judgment, and don't second-guess the pain signals from your ears or brain. Gradually expose yourself to sound and back off if it feels painful.

Yes, the symptoms are uncommon for the general population. I asked all of my friends who also attended the wedding party. They found it extremely loud, too, but have no issues at all. It's just me with pre-damaged ears (the black sheep in the crowd). I have to admit I was stupid. I thought I was safe because the wedding couple were good friends of mine, and I thought the sound at the party would be moderate. But I can't change it now and have to deal with it.

Now, six weeks later, I am still having the following issues:

• Both ears feel clogged and not clear. During the day, I also get the strange sensation of a tightened earlobe. It's a very strange feeling, and I don't know where it's coming from.
  
  
• Strong hyperacusis. I hear sounds like car brakes, cutlery, porcelain, crackling bags, and keys rattling ten times louder than everything else, even with earplugs. This is also typical for acoustic trauma. I had hyperacusis in 2016 (my first acoustic trauma), which faded over half a year to a manageable level.
  
  
• My hearing tests are normal, including the speech-in-noise hearing test (hidden hearing loss detection). However, my hearing perception is only good when sounds are coming from a close distance. Everything from farther away seems quieter and not processed accurately. Maybe the inner ear muscles (tensor tympani) are responsible for this, and there's still some swelling, inflammation, or whatever caused by the acoustic trauma that needs more time for recovery.

What I also wonder about is that I can do the Valsalva maneuver just fine. Can I still have Eustachian Tube Dysfunction, which is also responsible for a different hearing perception? How is Eustachian Tube Dysfunction diagnosed when you have no fluid behind your eardrums and can do the Valsalva maneuver without any issues?

From what I have read, the clogged feeling can take up to three months or even longer after an acoustic trauma to fade. In the meantime, earplugs have to be your best friends. You have to use them whenever the sound level exceeds a comfortable level (for example, streets with traffic, crowded cafes, and restaurants). Only at home or in the office with closed doors are you safe, and hearing protection is not needed.

Because of the severity of the clogged feeling, I did five two-hour Hyperbaric Oxygen Therapy sessions a week ago. I know the effects are controversial, but at least I gave it a try. More oxygen coming towards the cochlea can only be advantageous for healing. I didn't notice any positive effects after the Hyperbaric Oxygen Therapy sessions right away.

I also went to another ENT who prescribed me Betahistine (24 mg tablets). He recommended taking three tablets per day and said it does miracles regarding the release of ear pressure after an acoustic trauma. I have been taking it without noticing any major difference, but I did some research, and Betahistine seems to be one of the only medications that increase blood flow inside the inner ear without significant side effects. There are also some scientific publications discussing the use of Betahistine besides/in combination with Prednisolone and Hyperbaric Oxygen Therapy.

 

[Michael Leigh]

Can I still have Eustachian Tube Dysfunction,

You might have Eustachian Tube Dysfunction and an ear infection, as your doctor has said. This is the ENT's area of expertise. However, I believe most of your symptoms result from exposure to loud noise caused by being exposed to loud sound levels at the wedding.

In addition to this, if you have been regularly listening to audio through any type of headphones, even at low volume, since you habituated, or if you have been listening to loud sound levels at clubs and concerts wearing earplugs, or if you have been listening to loud music on your home stereo system, then I suspect it was only a matter of time before your tinnitus increased and developed into variable tinnitus, as mentioned in my thread.

I strongly advise that you don't try HBOT and suggest that you stop doing the Valsalva maneuver. Variable tinnitus is not something to mess around with, as I believe you could make your symptoms worse!

I'm sorry to sound so sobering, but I have corresponded and counseled many people who have habituated to noise-induced tinnitus and then, at some time, suffered a second noise trauma. It happened to me and is the reason I was able to write about it.

Take things slowly. I advise you to seek the help of an audiologist who specializes in tinnitus and hyperacusis management.

I wish you well,
Michael

 

[matt89]

You might have Eustachian Tube Dysfunction and an ear infection, as your doctor has said. This is the ENT's area of expertise. However, I believe most of your symptoms result from exposure to loud noise caused by being exposed to loud sound levels at the wedding.

In addition to this, if you have been regularly listening to audio through any type of headphones, even at low volume, since you habituated, or if you have been listening to loud sound levels at clubs and concerts wearing earplugs, or if you have been listening to loud music on your home stereo system, then I suspect it was only a matter of time before your tinnitus increased and developed into variable tinnitus, as mentioned in my thread.

I strongly advise that you don't try HBOT and suggest that you stop doing the Valsalva maneuver. Variable tinnitus is not something to mess around with, as I believe you could make your symptoms worse!

I'm sorry to sound so sobering, but I have corresponded and counseled many people who have habituated to noise-induced tinnitus and then, at some time, suffered a second noise trauma. It happened to me and is the reason I was able to write about it.

Take things slowly. I advise you to seek the help of an audiologist who specializes in tinnitus and hyperacusis management.

I wish you well,
Michael

Thanks @Michael Leigh. Fortunately, my tinnitus hasn't changed after my second acoustic trauma six weeks ago. The ear fullness makes it harder to ignore the tinnitus, although I was habituated to it years ago.

May I ask why you don't recommend HBOT?

Also, do you have any advice for someone like me who is still dealing with heavy ear fullness six weeks after an acoustic trauma?

Right now, when I take my earplugs out at home, it takes around 15 minutes before the fullness rises to its full extent, along with some dragging pain.

Ears need time to rest and heal. This may be the most challenging part: being patient and waiting. I'm not seeing any light at the end of the tunnel right now. Is six weeks after an acoustic trauma too early for any improvements in terms of ear pressure/fullness?

Any advice on dealing with all of this is much appreciated. Thanks.

 

[Michael Leigh]

May I ask why you don't recommend HBOT?

I have corresponded with people who have tried HBOT to help with their tinnitus. Unfortunately, most have said their tinnitus has become louder and more intrusive. We are all different, so it might not affect you similarly, but I wouldn't try it. The choice is yours.

Also, do you have any advice for someone like me who is still dealing with heavy ear fullness six weeks after an acoustic trauma?

If your ear fullness is similar to what I experienced 28 years ago when I first got tinnitus, then it is caused by noise trauma. The whole of my head felt numb, and I felt fullness in my ears. It felt like my head was underwater, and it was so frightening I never told members of my family, although I mentioned having tinnitus and hyperacusis.

I met a herbalist who knew a lot about noise-induced tinnitus. She said the numbness and ear fullness were caused by noise trauma, which also caused tinnitus and hyperacusis. She recommended that I take Magnesium tablets to help heal the auditory pathways' nerves and Ginkgo biloba. Although I didn't have a hearing test then, I knew my hearing was somewhat impaired. The ear fullness went completely away after six months. When I was seen at ENT around the same time, the doctor said my hearing was above average. He asked if I had been taking anything, so I told him about the Magnesium and Ginkgo biloba. He said he advises all his tinnitus patients to take Magnesium and Ginkgo biloba. I just followed the instructions on the bottle.

Is six weeks after an acoustic trauma too early for any improvements in terms of ear pressure/fullness?

You need to give yourself time for your auditory system to heal. You may or may not need a hearing aid(s). Your audiologist and ENT should advise you on this.

If I am correct and you have suffered a second noise trauma, this can affect the auditory system in many ways. Print and read my thread: Can I Habituate to Variable Tinnitus. I suggest you read my threads: The Habituation Process and How to Habituate to Tinnitus.

I suggest you start using low-level sound enrichment at night, using a sound machine by your bedside. Introduce it slowly and keep the volume low. It is probably a good idea to see an audiologist specializing in tinnitus and hyperacusis management.

Michael

 

[matt89]

I have corresponded with people who have tried HBOT to help with their tinnitus. Unfortunately, most have said their tinnitus has become louder and more intrusive. We are all different, so it might not affect you similarly, but I wouldn't try it. The choice is yours.

If your ear fullness is similar to what I experienced 28 years ago when I first got tinnitus, then it is caused by noise trauma. The whole of my head felt numb, and I felt fullness in my ears. It felt like my head was underwater, and it was so frightening I never told members of my family, although I mentioned having tinnitus and hyperacusis.

I met a herbalist who knew a lot about noise-induced tinnitus. She said the numbness and ear fullness were caused by noise trauma, which also caused tinnitus and hyperacusis. She recommended that I take Magnesium tablets to help heal the auditory pathways' nerves and Ginkgo biloba. Although I didn't have a hearing test then, I knew my hearing was somewhat impaired. The ear fullness went completely away after six months. When I was seen at ENT around the same time, the doctor said my hearing was above average. He asked if I had been taking anything, so I told him about the Magnesium and Ginkgo biloba. He said he advises all his tinnitus patients to take Magnesium and Ginkgo biloba. I just followed the instructions on the bottle.

You need to give yourself time for your auditory system to heal. You may or may not need a hearing aid(s). Your audiologist and ENT should advise you on this.

If I am correct and you have suffered a second noise trauma, this can affect the auditory system in many ways. Print and read my thread: Can I Habituate to Variable Tinnitus. I suggest you read my threads: The Habituation Process and How to Habituate to Tinnitus.

I suggest you start using low-level sound enrichment at night, using a sound machine by your bedside. Introduce it slowly and keep the volume low. It is probably a good idea to see an audiologist specializing in tinnitus and hyperacusis management.

Michael

Thanks @Michael Leigh.

Time (I'm speaking of months, not days) seems to be the most crucial factor for ears to heal. This is what causes the most struggle, and it's why people like me feel trapped in a rabbit hole, unable to see any light at the end of the tunnel. For example, if you've experienced acoustic trauma and 6 or 8 weeks pass with little to no improvement, it's hard to convince yourself that things will be better in a year. However, stories like yours—where symptoms of fullness and hearing as if underwater faded over six months—offer hope and strength to others.

My feelings of fullness and muffled hearing have persisted until now. I'll update here on my progress in 30 days and in the following months, hoping that my story, along with others shared on this forum, can help those searching for guidance and answers.

Even though your acoustic trauma occurred years ago, may I ask how many milligrams of Ginkgo Biloba and Magnesium you took per day? If you don't remember, that's okay.

 

[Michael Leigh]

Even though your acoustic trauma occurred years ago, may I ask how many milligrams of Ginkgo Biloba and Magnesium you took per day? If you don't remember, that's okay.

I still continue to take Ginkgo Biloba and Magnesium. When I had my first acoustic trauma in 1996, then again in 2008, I followed the daily requirements indicated on the bottles. I can't remember the amount of milligrams of Ginkgo Biloba or Magnesium I took back then.

The brand of Magnesium I now take is made by Holland & Barrett. Daily dose: one 375 mg tablet 3x a day. Ginkgo Biloba is high-strength, also made by Holland & Barrett. Daily dose: 2 tablets. Each tablet contains 240 mg of Ginkgo Biloba extract. It reads on the bottle that it is equivalent to 12,000 mg of Ginkgo Biloba leaf.

As I previously mentioned, my ENT advises all his tinnitus patients to take Ginkgo Biloba and Magnesium supplements.

All the best,
Michael

 

[Furetto]

The brand of Magnesium I now take is made by Holland & Barrett. Daily dose: one 375 mg tablet 3x a day. Ginkgo Biloba is high-strength, also made by Holland & Barrett. Daily dose: 2 tablets. Each tablet contains 240 mg of Ginkgo Biloba extract. It reads on the bottle that it is equivalent to 12,000 mg of Ginkgo Biloba leaf.

Why do you take a generic brand of Ginkgo Biloba and not an EGB761 extract? It is the only type of extract that consistently returned positive results in studies.

And what type of Magnesium are you taking and why? I am taking L-Threonate because it's the only type that goes past the blood-brain barrier, so I guess it should be more effective for nerves and neuroplasticity.

 

[Michael Leigh]

Why do you take a generic brand of Ginkgo Biloba and not an EGB761 extract? It is the only type of extract that consistently returned positive results in studies.

Studies can be beneficial in some instances. I choose not to follow them and give my reasons in my thread: Keeping Things Simple with Tinnitus.

I have had noise-induced tinnitus for 28 years. I have tried various brands of Ginkgo Biloba and found most types to be helpful. Holland & Barrett is well known in the UK. Their supplements are good quality.

what type of Magnesium are you taking and why? I am taking L-Threonate because it's the only type that goes past the blood-brain barrier, so I guess it should be more effective for nerves and neuroplasticity.

The Magnesium tablets I take are made by Holland & Barrett. Magnesium can help to repair the nerves in the auditory pathways and throughout the body. I was told this by my Herbalist many years ago.

As I previously mentioned, my ENT advises his tinnitus patients to take Ginkgo Biloba and Magnesium. He did not specify any particular brand.

Michael

 

[matt89]

Why do you take a generic brand of Ginkgo Biloba and not an EGB761 extract? It is the only type of extract that consistently returned positive results in studies.

And what type of Magnesium are you taking and why? I am taking L-Threonate because it's the only type that goes past the blood-brain barrier, so I guess it should be more effective for nerves and neuroplasticity.

I agree with the benefits of higher bio-available forms of vitamins and supplements; however, the "normal" Magnesium (oxide) is sufficient enough to support recovery in case of acoustic trauma. The inner ear is protected by the blood-labyrinth barrier (and not the blood-brain barrier), and any form of Magnesium can easily cross this one:

One-month treatment with magnesium after an impulse noise trauma was effective in the preservation of hair cell and cochlear function. It suggests that magnesium acts on the later metabolic processes after noise exposure. Magnesium, a small molecule that can easily cross the blood labyrinth barrier, presents fully its neuroprotective and vasodilatory effects in cochlea. The efficacy of magnesium, administered either to prevent or to treat NIHL has been demonstrated in several studies in animals and humans.

(Source)

 

[matt89]

I'm trying to understand the background of experiencing muffled hearing, ear fullness, and hyperacusis after an acoustic trauma, despite having no detectable hearing loss. Additionally, I occasionally feel a tickling sensation in my ears, which comes and goes during the day. It's difficult to pinpoint what's causing it, but when it happens, it feels as if an ant is moving on my eardrum, and then it fades away.

My grandmother used to say that when a wound on the body is tickling, it's a sign that it's healing. Could this also apply to the tickling sensation in my ears?

The ENTs I've consulted haven't offered any useful advice. They say that the combination of fullness and muffled hearing is not understandable, and according to my audiogram, my hearing is normal. They conclude that this means my cochlea is fine and that the symptoms I describe cannot have a physical cause.

After doing some research, I learned about hidden hearing loss (for which there aren't typically any tests available at the ENT). To investigate, I did a speech-in-noise test with a friend of mine who has no ear issues. We used headphones, and our results were the same. I also went with him to a crowded café to test my hearing perception in a noisy environment. I had earplugs with me but didn't use them for the test. Even with the background noise, I understood him well, so I've excluded hidden hearing loss based on what I've read.

Now I'm left wondering what could be causing the muffled hearing, ear fullness, and hyperacusis in my case. The ENTs have no answers. After reading dozens of threads here and on other forums, I've come across a few potential causes:

1. Inflammation of the cochlea without damaged hair cells: Excessive sound can create too much pressure in the ear, and when it reaches the cochlea, it might "punch" it, causing inflammation even if no hair cells are damaged. This inflammation might take time to heal. From what I've read, the cochlea itself doesn't have pain receptors, so when it's inflamed, it may respond with other sensations. Hyperacusis could be one of these sensations. Perhaps cochlear inflammation, with hyperacusis as a consequence, is causing the fullness and muffled hearing as an expression of pain?
   
   
2. Inflammation of the inner ear muscles (especially the tensor tympani) combined with Eustachian Tube Dysfunction (ETD): I still don't fully understand ETD. Even if you can perform the Valsalva maneuver (equalizing pressure) without issue, it seems you can still have ETD. How is it detected then? Could a tympanometry (which measures ear pressure) exclude ETD? In my case, the tympanometry came back normal. However, I've noticed that when I move my lower jaw forward and backward, I feel something popping in my right ear. It feels as if something is glued together, but I can't remove the "glue."

I'm also curious if an MRI can detect inflammation in the inner ear muscles, the Eustachian tube, or the cochlea.

Thanks in advance for any help or advice!

 

[Michael Leigh]

I'm trying to understand the background of experiencing muffled hearing, ear fullness, and hyperacusis after an acoustic trauma, despite having no detectable hearing loss. Additionally, I occasionally feel a tickling sensation in my ears, which comes and goes during the day. It's difficult to pinpoint what's causing it, but when it happens, it feels as if an ant is moving on my eardrum, and then it fades away.

As I previously mentioned to you, @matt89, when I first got tinnitus and hyperacusis many years ago, I also experienced ear fullness and, to some extent, muffled hearing that you speak of. My Herbalist said it was caused by noise trauma and advised that I start taking Magnesium and Ginkgo Biloba. It was a tough time for me. The whole of my head felt completely numb; I could hear, but it felt like my head was underwater.

I was so frightened I never told friends or any family members about this. All they knew was that I was suffering from severe tinnitus and hyperacusis. The ear fullness and muffled hearing cleared up after six months when I was about to be seen by an ENT for the first time.

The fact that your ENT doctor can find no underlying medical problem causing the ear fullness and muffled hearing is a good sign. I suggest that you give your ears and auditory system time to heal. Continue taking the Magnesium and Ginkgo Biloba, and try not to worry too much.

All the best,
Michael

 

[matt89]

As I previously mentioned to you, @matt89, when I first got tinnitus and hyperacusis many years ago, I also experienced ear fullness and, to some extent, muffled hearing that you speak of. My Herbalist said it was caused by noise trauma and advised that I start taking Magnesium and Ginkgo Biloba. It was a tough time for me. The whole of my head felt completely numb; I could hear, but it felt like my head was underwater.

I was so frightened I never told friends or any family members about this. All they knew was that I was suffering from severe tinnitus and hyperacusis. The ear fullness and muffled hearing cleared up after six months when I was about to be seen by an ENT for the first time.

The fact that your ENT doctor can find no underlying medical problem causing the ear fullness and muffled hearing is a good sign. I suggest that you give your ears and auditory system time to heal. Continue taking the Magnesium and Ginkgo Biloba, and try not to worry too much.

All the best,
Michael

Thank you, @Michael Leigh.

May I ask why you decided to see an ENT for the first time after your symptoms had cleared up rather than at the onset when you also sought help from an herbalist? By the way, your hyperacusis thread is very informative. I also believe that exposing your ears to normal sounds without earplugs is important for better hyperacusis recovery.

Many people recommend 3 to 4 weeks of pure silence at home following an acoustic trauma for optimal recovery. While I think a few days of silence are essential, relying on it too much can become a trap. The damaged ears can start to learn that silence is the new normal, which may hinder recovery. It's actually the damaged ears that need training from the beginning. Exposing them to everyday sounds, such as normal road noise, with earplugs as a backup, is a better approach.

Back in 2016, I experienced my first acoustic trauma when someone near me in the gym caused an extremely loud iron-on-iron clash while wearing headphones. This resulted in hyperacusis, tinnitus in both ears, and high-frequency hearing loss in my right ear. I struggled to sleep for almost four months because the loud tinnitus was perceived by my brain as an enemy when I tried to sleep. Those were tough times, and I genuinely thought the good days were behind me.

I remember that metal sounds were much louder than before, and music sounded different, though I don't recall any feelings of fullness or muffled hearing. I used earplugs when expecting loud noises, but otherwise, I exposed my ears to all normal daily sounds from the start. My hyperacusis faded within six months, but it took a full year to habituate to the tinnitus.

Once the hyperacusis had faded, I slowly began to live my life again—though cautiously, always acting like a "noise spy" with hearing protection as a backup. Over the years, I grew more confident and began carrying hearing protection only when I knew I would be in very loud environments, like train stations, airports, or construction sites. As time passed, I started to forget about the dangers of loud noises, especially unforeseen ones and neglected that my ears were still pre-damaged.

This led me to attend a good friend's wedding party eight weeks ago without earplugs. To my surprise, the music was as loud as a Boeing 747 taking off next to me. I realized it was too loud, but it was too late by then. Just a few minutes in that environment, even at a distance from the speakers, was enough to send me back down a deep rabbit hole.

Right now, I'm trying to dig my way out of that hole, but it's not easy. At this point, I'm not seeing the light at the end of the tunnel, but I know the only option is to keep going. I'll stick to it, just as I did eight years ago.

 

[Michael Leigh]

May I ask why you decided to see an ENT for the first time after your symptoms had cleared up rather than at the onset when you also sought help from an herbalist? By the way, your hyperacusis thread is very informative. I also believe that exposing your ears to normal sounds without earplugs is important for better hyperacusis recovery.

Thank you for your kind comments on my thread, Hyperacusis, As I See It, @matt89. I encourage you to explore my other threads, as most of them are written to help people cope with noise-induced tinnitus and hyperacusis. In particular, please pay attention to the thread Can I Habituate to Variable Tinnitus? I believe this might apply to you, especially since you've experienced a second noise trauma.

In the UK, it is standard practice that anyone who visits their GP for tinnitus and is then referred to an NHS ENT clinic may face a waiting time of up to six months for their first appointment. There's a good reason for this, which I explain in my thread Tinnitus, a Personal View. However, if a person experiences hearing loss, balance issues, dizziness, or severe ear pain alongside their tinnitus, they are often fast-tracked to ENT.

When I consulted an herbalist, my GP had already referred me to an NHS ENT clinic. I was trying to help myself in the meantime. My GP emphasized that the best long-term care and aftercare for tinnitus are provided through the NHS and that no private practice in the UK could offer comparable support. Over the years, I have found this to be true.

Although the ear fullness and muffled hearing had resolved by the time I saw the ENT specialist, I still suffered from severe tinnitus and hyperacusis.

It's important to note that quiet rooms and environments are not ideal for people with tinnitus and hyperacusis. It's helpful to have low-level sound enrichment playing in the background. Some people with severe hyperacusis believe that staying in quiet surroundings will promote healing, but unfortunately, this often worsens the condition. Hyperacusis needs to be treated, and in some cases, this may require the assistance of an audiologist specializing in tinnitus and hyperacusis management.

Right now, I'm trying to dig my way out of that hole, but it's not easy. At this point, I'm not seeing the light at the end of the tunnel, but I know the only option is to keep going. I'll stick to it, just as I did eight years ago.

It would be best to give your ears and auditory system time to heal. Please print the threads I have mentioned and refer to them often; this will help reinforce positive thinking.

I wish you well,
Michael

 

[matt89]

Thank you for your kind comments on my thread, Hyperacusis, As I See It, @matt89. I encourage you to explore my other threads, as most of them are written to help people cope with noise-induced tinnitus and hyperacusis. In particular, please pay attention to the thread Can I Habituate to Variable Tinnitus? I believe this might apply to you, especially since you've experienced a second noise trauma.

In the UK, it is standard practice that anyone who visits their GP for tinnitus and is then referred to an NHS ENT clinic may face a waiting time of up to six months for their first appointment. There's a good reason for this, which I explain in my thread Tinnitus, a Personal View. However, if a person experiences hearing loss, balance issues, dizziness, or severe ear pain alongside their tinnitus, they are often fast-tracked to ENT.

When I consulted an herbalist, my GP had already referred me to an NHS ENT clinic. I was trying to help myself in the meantime. My GP emphasized that the best long-term care and aftercare for tinnitus are provided through the NHS and that no private practice in the UK could offer comparable support. Over the years, I have found this to be true.

Although the ear fullness and muffled hearing had resolved by the time I saw the ENT specialist, I still suffered from severe tinnitus and hyperacusis.

It's important to note that quiet rooms and environments are not ideal for people with tinnitus and hyperacusis. It's helpful to have low-level sound enrichment playing in the background. Some people with severe hyperacusis believe that staying in quiet surroundings will promote healing, but unfortunately, this often worsens the condition. Hyperacusis needs to be treated, and in some cases, this may require the assistance of an audiologist specializing in tinnitus and hyperacusis management.

It would be best to give your ears and auditory system time to heal. Please print the threads I have mentioned and refer to them often; this will help reinforce positive thinking.

I wish you well,
Michael

May I ask what caused your acoustic trauma back in 1996? I browsed through your posts but, unfortunately, couldn't find any information about it.

Also, if I'm correct, you did not have any hearing loss in the audiogram after the trauma, right?

One more question regarding the muffled hearing perception you described as "hearing underwater." You mentioned that this sensation disappeared after about six months. Would you say your ears "opened up" again, restoring clear hearing, or was it more like your brain adapted to the underwater hearing, making it your "new normal"?

I appreciate your reply. Have a nice weekend!

 

[Michael Leigh]

May I ask what caused your acoustic trauma back in 1996? I browsed through your posts but, unfortunately, couldn't find any information about it.

My acoustic trauma was caused by headphones. I used them a lot over a long period of time and at a volume that was too high without realizing it.

Also, if I'm correct, you did not have any hearing loss in the audiogram after the trauma, right?

After I developed tinnitus and hyperacusis, I suspected that my hearing was impaired. My appointment to be seen at ENT was 6 months away. Throughout this time I was taking the Magnesium tablets and Ginkgo Biloba that my Herbalist advised. When I was seen at ENT, my audiogram showed I had no hearing loss. In fact, the doctor said my hearing was above average.

One more question regarding the muffled hearing perception you described as "hearing underwater." You mentioned that this sensation disappeared after about six months. Would you say your ears "opened up" again, restoring clear hearing, or was it more like your brain adapted to the underwater hearing, making it your "new normal"?

My hearing probably "opened up" again, as you mentioned. Whatever had affected me back then, I am pleased that my situation improved. What I believed happened is what my Herbalist, who knew a lot about tinnitus and acoustic trauma, said.

She said the auditory system mainly consists of nerves. I had suffered a huge noise trauma caused by using headphones over a long period of time and at too high a volume. This resulted in me developing tinnitus, hyperacusis, and numbness throughout the whole of my head. The feeling that my head was underwater felt real and was very frightening.

Looking back, I now know that I had tinnitus long before I had the full-blown acoustic trauma that my Herbalist spoke of. I remember late at night when it was very quiet, I could hear ringing but thought nothing of it. By the morning, the ringing was gone because my normal everyday sounds in the environment were masking it. Although I had heard about tinnitus back then, unfortunately, I didn't know much about the condition.

In all the years I have corresponded with and counseled people who have suffered an acoustic trauma and developed tinnitus and hyperacusis, none of them have mentioned the acute numbness in the head or the feeling that their head was under water.

You need to give yourself the time for your ears and auditory system to heal. Take things slowly.

I hope you have a nice weekend, too.

Michael

 

[tomytl]

My acoustic trauma was caused by headphones. I used them a lot over a long period of time and at a volume that was too high without realizing it.

After I developed tinnitus and hyperacusis, I suspected that my hearing was impaired. My appointment to be seen at ENT was 6 months away. Throughout this time I was taking the Magnesium tablets and Ginkgo Biloba that my Herbalist advised. When I was seen at ENT, my audiogram showed I had no hearing loss. In fact, the doctor said my hearing was above average.

My hearing probably "opened up" again, as you mentioned. Whatever had affected me back then, I am pleased that my situation improved. What I believed happened is what my Herbalist, who knew a lot about tinnitus and acoustic trauma, said.

She said the auditory system mainly consists of nerves. I had suffered a huge noise trauma caused by using headphones over a long period of time and at too high a volume. This resulted in me developing tinnitus, hyperacusis, and numbness throughout the whole of my head. The feeling that my head was underwater felt real and was very frightening.

Looking back, I now know that I had tinnitus long before I had the full-blown acoustic trauma that my Herbalist spoke of. I remember late at night when it was very quiet, I could hear ringing but thought nothing of it. By the morning, the ringing was gone because my normal everyday sounds in the environment were masking it. Although I had heard about tinnitus back then, unfortunately, I didn't know much about the condition.

In all the years I have corresponded with and counseled people who have suffered an acoustic trauma and developed tinnitus and hyperacusis, none of them have mentioned the acute numbness in the head or the feeling that their head was under water.

You need to give yourself the time for your ears and auditory system to heal. Take things slowly.

I hope you have a nice weekend, too.

Michael

Hello Michael,

How long did it take for your hearing and everything else to stabilize after the second setback? Although I know it usually takes time, I'm very anxious this time. I'm currently in week 7.

Thanks.

 

[Michael Leigh]

Hello Michael,

How long did it take for your hearing and everything else to stabilize after the second setback? Although I know it usually takes time, I'm very anxious this time. I'm currently in week 7.

Thanks.

Hi @tomytl, thank you for your message.

I had my second noise trauma in 2008. It took four years to habituate for the second time. I have explained this in my thread, "My Experience with Tinnitus". Please read it, as I think you will find it helpful.

Please also read "Can I Habituate to Variable Tinnitus?" It explains some of the ways tinnitus can change after a person has suffered a second noise trauma and how to habituate to it. I have gathered this information from people I have contacted over the years who have suffered a second noise trauma.

In 2010, after having TRT for the second time, my ENT doctor and audiologist told me that I have a severe form of tinnitus that they don't often see in other tinnitus patients. I was then prescribed Clonazepam and advised only to take it when the tinnitus was severe. I have found it very helpful for the past 13 years.

Please keep in mind that we are all different. My habituation process and, subsequently, the way the tinnitus has behaved over the years after my second noise trauma may not be the same for you.

Unfortunately, since February of this year, my tinnitus changed for some unknown reason and at times has become extremely difficult to manage. I am certain it has nothing to do with noise trauma. I don't want to go into further detail at the moment. Hopefully, by the end of the year, I can give an update on what I have been going through. I was in two minds about whether to divulge this information, but now I feel it would be remiss not to submit it because someone might find it helpful.

All the best,
Michael

 

[tomytl]

Hi @tomytl, thank you for your message.

I had my second noise trauma in 2008. It took four years to habituate for the second time. I have explained this in my thread, "My Experience with Tinnitus". Please read it, as I think you will find it helpful.

Please also read "Can I Habituate to Variable Tinnitus?" It explains some of the ways tinnitus can change after a person has suffered a second noise trauma and how to habituate to it. I have gathered this information from people I have contacted over the years who have suffered a second noise trauma.

In 2010, after having TRT for the second time, my ENT doctor and audiologist told me that I have a severe form of tinnitus that they don't often see in other tinnitus patients. I was then prescribed Clonazepam and advised only to take it when the tinnitus was severe. I have found it very helpful for the past 13 years.

Please keep in mind that we are all different. My habituation process and, subsequently, the way the tinnitus has behaved over the years after my second noise trauma may not be the same for you.

Unfortunately, since February of this year, my tinnitus changed for some unknown reason and at times has become extremely difficult to manage. I am certain it has nothing to do with noise trauma. I don't want to go into further detail at the moment. Hopefully, by the end of the year, I can give an update on what I have been going through. I was in two minds about whether to divulge this information, but now I feel it would be remiss not to submit it because someone might find it helpful.

All the best,
Michael

Thank you very much for your valuable information. I understand that no two conditions are exactly the same, and each case progresses differently. No one truly knows what is happening inside the inner ear or during auditory processing, except that when a specific frequency is lost, it is often attributed to dead hair cells.

Despite this, I sometimes find myself hopeful, believing that living somewhat normally with impaired hearing might be possible. The pressure in my ear is incredibly uncomfortable, and its constant fluctuations make it difficult to adapt, as the intensity is always changing.

Lately, I've been pushing myself to engage in excessive endurance sports, hoping to improve blood circulation to every last corner, including possibly around the inner ear. My hope is that this might help deliver the Magnesium, coenzyme Q10, Zinc, and Betaserc to the affected areas. After exercising and experiencing changes in altitude, my ears often feel even more blocked, and the tinnitus grows louder. However, I do end up tired and exhausted enough to get a better night's sleep.

I also wish you the best possible recovery in your current situation.

Thanks,
Tom

 

[Michael Leigh]

Lately, I've been pushing myself to engage in excessive endurance sports, hoping to improve blood circulation to every last corner, including possibly around the inner ear. My hope is that this might help deliver the Magnesium, coenzyme Q10, Zinc, and Betaserc to the affected areas. After exercising and experiencing changes in altitude, my ears often feel even more blocked, and the tinnitus grows louder. However, I do end up tired and exhausted enough to get a better night's sleep.

Thank you for your kind words on my recovery, Tom. It is a work in progress.

I hope the pressure in your ear and impaired hearing improves with the methods that you are trying. However, I suggest you seek the help of an ENT doctor and audiologist if you haven't done so within the last year.

I say this because it's important to know what is causing your symptoms and whether they are related to your tinnitus. You have had tinnitus for ten years, but the cause is unknown. Tinnitus can appear for no reason but usually something causes it.

If your impaired hearing is caused by hearing loss, your ENT doctor and audiologist may suggest you wear hearing aid(s). I think the ear blockage you mention needs to be investigated by an ENT doctor.

I hope you start to feel better soon,
Michael

 

[tomytl]

Thank you for your kind words on my recovery, Tom. It is a work in progress.

I hope the pressure in your ear and impaired hearing improves with the methods that you are trying. However, I suggest you seek the help of an ENT doctor and audiologist if you haven't done so within the last year.

I say this because it's important to know what is causing your symptoms and whether they are related to your tinnitus. You have had tinnitus for ten years, but the cause is unknown. Tinnitus can appear for no reason but usually something causes it.

If your impaired hearing is caused by hearing loss, your ENT doctor and audiologist may suggest you wear hearing aid(s). I think the ear blockage you mention needs to be investigated by an ENT doctor.

I hope you start to feel better soon,
Michael

Hi Michael,

Yes, I have visited an ENT several times, but no one has figured out why I am under this pressure. It's different from the pressure I've experienced with my hearing loss. It mostly increases when I speak, which is very strange.

My current issue started after a DJ event where I was using my custom silicone earplugs. Maybe the occlusion caused my ear to act up.

I'll continue taking Magnesium, Zinc, Coenzyme Q10, and Betaserc, as well as running uphill to improve blood flow and tire myself out for better sleep.