Should I See an ENT? Share Your Thoughts on ENTs and Tinnitus!

[PeteJ]

I'll try to summarize this because it includes my (possibly controversial) opinion and some questions.

To be brief, I have a history of ear pain alongside my tinnitus. This pain has come and gone over the years, sometimes lasting for days or even months. I'm not sure why or how it started. It feels different from my usual hyperacusis and noxacusis, and it's hard to explain.

Typically, I get ear pain from noise, and my ears are extremely sensitive. If something touches my ear, like a tree branch, I'll have severe pain afterward. I also experience pain from wearing earplugs too often or even after using my earmuffs, which fit tightly despite being adjustable. Recently, though, I noticed a different kind of pain.

Last summer, I took off my earmuffs, and I felt a popping sensation, like trapped air escaping. Around the same time, I also took my earplugs out too quickly and ended up hurting my ears. I even had pain near the joint just below my ears. This pain persisted daily for a while, and I eventually realized I was clenching and grinding my teeth. I've since started using a mouthguard, which I hope will help, as I also get frequent headaches.

With the pain flaring up a few months ago (it has only recently subsided), I went to my family physician. Because I'm on disability, I'm supposed to inform him of any physical or mental health changes, and worsening symptoms count as a change, right? He set me up with an ENT appointment. I told him I appreciated his help, but I felt that an ENT wouldn't be able to fix this. I have a severe condition, and I doubt they can do much. However, I agreed to go because refusing might look like I'm resisting treatment, which is not ideal when you're on disability.

The ear pain has improved since then, and I'm not sure if it's because I've become aware of the clenching and grinding or if the mouthguard is helping. I'm uncertain, but I do have the ENT appointment scheduled. I've considered canceling because it's in another city, and my car needs suspension work. Plus, I'm skeptical about ENTs. Based on online reviews, they seem ineffective for cases like mine. Most of them see patients for general nose and throat issues, and I've read horror stories of people who ended up worse off after certain tests or surgeries.

I've thought about rescheduling with a local ENT just to get a hearing test. I doubt they can help, but it might at least show my doctor that I'm following through with treatment. I know there are tests like tympanometry and suction tests, which some people say made their conditions worse, so I'd likely avoid those. That's part of my issue with ENTs; I feel like they could actually make things worse. Am I being too critical? Do you think I'm exaggerating how ineffective they are? I've just heard so many stories about people not finding relief through ENTs, and I'm skeptical based on typical experiences.

What do you think?

 

[Michael Leigh]

That's part of my issue with ENTs; I feel like they could actually make things worse. Am I being too critical? Do you think I'm exaggerating how ineffective they are? I've just heard so many stories about people not finding relief through ENTs, and I'm skeptical based on typical experiences.

I am sorry to hear that you are experiencing so much difficulty with ear pain, @PeteJ.

ENT doctors are highly skilled physicians who treat medical conditions affecting the ear, nose, and throat. I think you should see an ENT so that your ears and auditory system can be examined. Accept whatever tests you are advised to have and "stop" reading negative comments from people who do not give these health professionals the respect they deserve.

ENT doctors do not treat tinnitus, but they can often treat underlying medical conditions within the auditory system that cause tinnitus, and there are many. However, when tinnitus is noise-induced, as I believe yours is, then a referral to an audiologist who specializes in tinnitus and hyperacusis management may also be required.

Please read my thread: Keeping Things Simple with Tinnitus.

I wish you well,
Michael

Keeping Things Simple with Tinnitus

Keeping Things Simple with Tinnitus People have often told me the onset of their tinnitus felt like riding an emotional roller-coaster, because no two days ever felt the same. I agree with this analogy as I think back to my own experience 27 years ago. The sudden impact of severe tinnitus and...

www.tinnitustalk.com

 

[Varda]

they can often treat underlying medical conditions within the auditory system that cause tinnitus, and there are many.

It might be helpful to start a thread listing some treatable medical conditions that can cause tinnitus. The only one I've heard of so far is otosclerosis.

Beyond that, I've struggled to find examples of anyone receiving successful treatment from an ENT. In fact, there are plenty of cases where people have had their tinnitus worsened by MRIs, microsuction, and acoustic reflex tests.

 

[Michael Leigh]

Beyond that, I've struggled to find examples of anyone receiving successful treatment from an ENT. In fact, there are plenty of cases where people have had their tinnitus worsened by MRIs, microsuction, and acoustic reflex tests.

If by "successful treatment" you mean addressing tinnitus, please note that ENT doctors do not directly treat tinnitus itself. Instead, they often treat underlying medical conditions within the auditory system that may cause tinnitus. This does not mean they can "cure" tinnitus. However, if it's possible to address the underlying cause, whether through medication or surgery, then tinnitus symptoms could potentially be reduced.

Anyone who develops tinnitus should consult an ENT doctor. However, if the patient is not experiencing symptoms like deafness, balance problems, acute ear pain, or dizziness, they don't need to see an ENT doctor immediately. It's often recommended to wait 4 to 6 months before seeking an ENT consultation. There's a good reason for this, which I explain in my thread: Tinnitus, A Personal View.

It's possible for tinnitus to worsen after microsuction. This is usually because olive oil ear drops were not applied adequately, typically three times a day in each ear for ten days, to loosen the wax before the procedure. Personally, I've had microsuction three times without issues, despite my tinnitus sometimes reaching severe levels.

Some causes of tinnitus that require examination by an ENT specialist and audiologist include:

• Hearing loss
• Impacted earwax
• Ear or head injury
• Ear infection
• Ear diseases (e.g., otosclerosis)
• Side effects of certain medications
• Emotional stress
• Temporomandibular joint (TMJ) disorder
• Meniere's disease
• Acoustic neuroma
• Pulsatile tinnitus
• Exposure to loud noise
• Age-related tinnitus
• Eustachian Tube Dysfunction (ETD)

 

[PeteJ]

My appointment was rescheduled from that October date since I didn't have a ride. I since arranged a ride - and it's this week.

I read over a few links, including this one:

ENT Appointment... What to Do? What Tests NOT to Do?

So I have an ENT Appointment on Monday and I'm kinda freaking out!! I've read on this forum that people say DO NOT have the "Acoustic Reflex Test" or "Tympanometry" tests as these will make your tinnitus much worse! The hearing test seems to be ok. I certainly don't want to do anything to make...

www.tinnitustalk.com

I'm uncertain about what to do at the upcoming appointment. I was considering declining all tests except the hearing test. Is there a way to ensure they don't use loud beeps? Is it a separate part of the test, and if so, should I specifically request they omit any part with significantly louder sounds? I know they typically start with very soft tones and gradually increase the volume, but I want to avoid the loud parts altogether.

Honestly, I don't want to go because I don't think it will be helpful. The only reason I'm going is because my family physician insisted on it. He made this appointment some time ago when I was experiencing chronic ear pain, which wasn't my usual pain. It wasn't related to hyperacusis or noxacusis. I think it may have happened because of my earplugs and earmuffs—once, when I took them off, air got trapped, and it somehow hurt or injured my ear. I went to see my doctor because the pain wasn't going away, hoping to get some medication. However, all I received was naproxen. I also went because I'm supposed to keep my doctor updated on my health since I'm on disability.

I'm worried that if I decline the tests, my doctor will interpret it as me avoiding or rejecting treatment. That's not the case. These tests won't accomplish anything and could potentially make things worse, as some people report. All I want is for the ENT to confirm that there's nothing more they can do, acknowledge my hearing loss (which I already know about), and maybe see if there's any update in the hearing test results—if that's even necessary.

Sometimes they try to clear out ear wax as well. I know to only allow manual cleaning, but should I decline even that? My ears are extremely sensitive. My friends and family have noticed that even light touches, like branches brushing against my ear, can cause pain. So I think I should tell the ENT that my ears are unusually fragile and sensitive, and that I'll only agree to the hearing test, provided it doesn't include loud beeps. However, I don't believe any of this will change much. It'll only confirm the hearing loss, something my doctor already knows. Unfortunately, he doesn't really listen to me. I had to return to him repeatedly to get disability forms filled out, and it was only approved after he finally wrote a letter of support.

When I tell him that my tinnitus is severe and loud, that it bothers me constantly, and that I experience recurring ear pain along with hyperacusis and noxacusis, he still insists that seeing a specialist would be beneficial. I don't know what caused my ear pain last time, but it seems that pressure changes and any kind of impact or force on my ears are extra problematic now, causing more pain than usual. It's incredibly frustrating because I feel that nothing will help, and I don't want to go if there's a risk of making things worse.

This version organizes your thoughts into clear paragraphs and makes the tone more concise while preserving the meaning. Let me know if there's anything else you'd like adjusted!

Any advice?

 

[Tweaker]

My appointment was rescheduled from that October date since I didn't have a ride. I since arranged a ride - and it's this week.

I read over a few links, including this one:

ENT Appointment... What to Do? What Tests NOT to Do?

So I have an ENT Appointment on Monday and I'm kinda freaking out!! I've read on this forum that people say DO NOT have the "Acoustic Reflex Test" or "Tympanometry" tests as these will make your tinnitus much worse! The hearing test seems to be ok. I certainly don't want to do anything to make...

www.tinnitustalk.com

I'm uncertain about what to do at the upcoming appointment. I was considering declining all tests except the hearing test. Is there a way to ensure they don't use loud beeps? Is it a separate part of the test, and if so, should I specifically request they omit any part with significantly louder sounds? I know they typically start with very soft tones and gradually increase the volume, but I want to avoid the loud parts altogether.

Honestly, I don't want to go because I don't think it will be helpful. The only reason I'm going is because my family physician insisted on it. He made this appointment some time ago when I was experiencing chronic ear pain, which wasn't my usual pain. It wasn't related to hyperacusis or noxacusis. I think it may have happened because of my earplugs and earmuffs—once, when I took them off, air got trapped, and it somehow hurt or injured my ear. I went to see my doctor because the pain wasn't going away, hoping to get some medication. However, all I received was naproxen. I also went because I'm supposed to keep my doctor updated on my health since I'm on disability.

I'm worried that if I decline the tests, my doctor will interpret it as me avoiding or rejecting treatment. That's not the case. These tests won't accomplish anything and could potentially make things worse, as some people report. All I want is for the ENT to confirm that there's nothing more they can do, acknowledge my hearing loss (which I already know about), and maybe see if there's any update in the hearing test results—if that's even necessary.

Sometimes they try to clear out ear wax as well. I know to only allow manual cleaning, but should I decline even that? My ears are extremely sensitive. My friends and family have noticed that even light touches, like branches brushing against my ear, can cause pain. So I think I should tell the ENT that my ears are unusually fragile and sensitive, and that I'll only agree to the hearing test, provided it doesn't include loud beeps. However, I don't believe any of this will change much. It'll only confirm the hearing loss, something my doctor already knows. Unfortunately, he doesn't really listen to me. I had to return to him repeatedly to get disability forms filled out, and it was only approved after he finally wrote a letter of support.

When I tell him that my tinnitus is severe and loud, that it bothers me constantly, and that I experience recurring ear pain along with hyperacusis and noxacusis, he still insists that seeing a specialist would be beneficial. I don't know what caused my ear pain last time, but it seems that pressure changes and any kind of impact or force on my ears are extra problematic now, causing more pain than usual. It's incredibly frustrating because I feel that nothing will help, and I don't want to go if there's a risk of making things worse.

This version organizes your thoughts into clear paragraphs and makes the tone more concise while preserving the meaning. Let me know if there's anything else you'd like adjusted!

Any advice?

You may find peace of mind by seeing an ENT specialist, but be cautious about the types of tests they perform. This is based on my personal experience. A standard audiogram has always been fine for me. Tympanometry has also been okay when it only tested middle ear pressure, but be aware that acoustic reflex testing is often included with tympanometry these days—a fact I did not realize two years ago. This test involves loud beeps, so you'll know to stop if you hear them. Unfortunately, I was caught off guard, and since the day of that test, my tinnitus has become permanently severe. It's my biggest regret, but I have to try to deal with it.

I've had tinnitus for 14 years, and it had become manageable—until that test changed everything. Now, I struggle with suicidal thoughts again because it's so loud and distressing. If you're concerned about an underlying issue, an ENT visit may be worthwhile, but approach any testing with extreme caution and be aware of the risks. While some people may have had acoustic reflex testing without problems, it's a known contraindication for tinnitus and hyperacusis, and it is generally not recommended.

 

[PeteJ]

You may find peace of mind by seeing an ENT specialist, but be cautious about the types of tests they perform. This is based on my personal experience. A standard audiogram has always been fine for me. Tympanometry has also been okay when it only tested middle ear pressure, but be aware that acoustic reflex testing is often included with tympanometry these days—a fact I did not realize two years ago. This test involves loud beeps, so you'll know to stop if you hear them. Unfortunately, I was caught off guard, and since the day of that test, my tinnitus has become permanently severe. It's my biggest regret, but I have to try to deal with it.

I've had tinnitus for 14 years, and it had become manageable—until that test changed everything. Now, I struggle with suicidal thoughts again because it's so loud and distressing. If you're concerned about an underlying issue, an ENT visit may be worthwhile, but approach any testing with extreme caution and be aware of the risks. While some people may have had acoustic reflex testing without problems, it's a known contraindication for tinnitus and hyperacusis, and it is generally not recommended.

Thanks for your thoughts and insight! I didn't expect a reply before my appointment tomorrow.

I'll try to explain my situation a bit more clearly. I'm not looking for "peace of mind" and don't expect any real benefit from this appointment. Maybe I'll get an update on my hearing, right? The reason I even have this appointment is that I couldn't convince my family physician it would be pointless. I actually discussed this with him a couple of months ago. (By the way, I got this appointment only about two months after our chat, which was surprising. The first time I ever scheduled an ENT appointment, it took around six to seven months!)

I went to my family doctor initially because I was experiencing awful ear pain. It seemed to result from inserting or removing my earplugs too roughly and from an incident where I felt a "pop" in my right ear while taking off my industrial ear muffs, which seemed to trap some air. Afterward, I had ear pain in both ears to varying degrees for weeks—no, months. My entire summer was spent dealing with ear pain. Whenever it seemed to subside a little, something would happen (often without explanation), and the pain would return with different levels of severity. This was one of the rare times when both ears were hurting simultaneously.

I'm on Disability in my country, so I need to keep my doctor informed about my health conditions. I thought I should let him know, even though I believed he wouldn't be able to help. He gave me naproxen for the pain and set up the ENT appointment. I tried explaining that it was probably pointless, but he insisted it could help to at least see an ENT. He's aware of my ongoing ear issues and thought it might be worth trying. But honestly, in my opinion, doctors and ENTs often don't know much about these issues. Most of the time, tests don't help; there's nothing they can do to improve the condition, and I feel like they don't really care. In the worst cases, their interventions can actually make things worse—as happened to you and others.

I'm considering going to this appointment only because I've already canceled once (I didn't want to drive), and now I have a ride. I still don't want to go, but I'm unsure how to avoid it again. I'm thinking of just agreeing to the hearing test/audiogram and declining the others. Why risk it, right? They're not going to figure out why I had that ear pain. My ears are seriously messed up now—damaged, fragile, and sensitive. I don't post here as often, but I still have ear issues almost daily. My tinnitus is worse too. I don't know how severe tinnitus can get, how loud someone's tinnitus can become. Mine seems to worsen periodically, and the baseline often stays at that "worsened" level. It's loud all the time, with spikes that grow more intense. It's hard to explain. The ear pain is usually triggered by noise, and it eventually subsides, but I also sometimes wake up with ear pain. I thought it might be from grinding or clenching, but I recently got a guard. It might also be from rolling onto my ear in my sleep, which puts pressure on it. Other times, the pain is from something hitting my ear, like a branch.

Sorry to ramble! Jeez... who's going to want to read this? Thank you for your reply. I really appreciate it, and I hope your tinnitus is manageable. It's tough to deal with.

P.S. I have anxiety and feel pressured to go through with the tests because I worry the doctors might think I'm "resisting treatment." I have a medical review due next year, which is typical for Disability. I need my doctor to understand I'm not resisting but that I have to avoid tests that could worsen my tinnitus and ear issues, which is why I'm on Disability in the first place. I feel they could easily interpret my avoidance as causing or contributing to mental health issues, which is how the medical establishment tends to respond to tinnitus complaints.

Is it probably safe to do an audiogram? What about the OAE, TEOAE, and/or DPOAE?

Taking a fresh look at otoacoustic emissions

www.entandaudiologynews.com

 

[PeteJ]

If anyone's interested, I went to my appointment. I declined the tympanometry test but did go through with the hearing test. Everything went as expected—nothing particularly good, but also nothing bad. Thankfully, I didn't regret any tests, nor did any noises negatively impact me, even though it was in a different city.

I'm not sure what else to say, but if there are any questions, I'll follow up. Thanks for reading, anyway.