Sudden Tinnitus Spike and Mild Hearing Loss: I'm Freaking Out and Don't Know What to Do

[Alexandor Scott]

Hello all,

I hope you are all doing well and staying safe. A little background about myself, I'm 31 years old and have had tinnitus and hyperacusis for 7 years now after a night out at a club in Miami. My Tinnitus has been rather mild from the onset, and I usually only hear it when I'm in quiet places or when I have earplugs in. I've habituated rather well over the past few years. There have been months at a time where I haven't noticed my tinnitus much, and even when I have I haven't been bothered by it at all. Even when it's been spiked at times 'd just think "man that's loud today" and move on with my day. My hyperacusis has been more severe and has limited my life a bit. I never leave home without earplugs and even with them there are lots of things I can't do.

Anyhow, last night I was sitting in my living room watching a movie when I started hearing some loud ringing in my right ear. It sounded like it was coming from one of my appliances so I plugged my ears and the sound dissipated. When I unplugged them it came right back. I didn't think much of it until the movie ended and I went into my bedroom where it's quieter. At that point, I realized that the ringing in my right ear was actually increasing in response to pretty much every sound that I was making. If I spoke, the ringing would increase dramatically until I stopped. My baseline in my right ear was also higher than usual, and I noticed a feeling of fullness and a decrease in my ability to hear out of that ear. I figured this would settle down over night, but I figured I'd go and see an ENT today just out of an abundance of caution.

At my ENT visit today, I started with an audiogram (with earbuds first and then some device that sat above my ears.) I had a few other tests run, only one of which I really know the purpose of (one shot a small puff of air into my canal. One was buzzing with a series of beeps, and the other was supposedly testing hair cell reactions?). Everything came back normal (my hearing was less than 10db across all frequencies in both ears), however there was some mild hair cell dysfunction indicating previous hair cell death (presumably from the event that caused my tinnitus and hyperacusis, since I haven't been exposed to anything too loud since). Based on a comparison my audiogram from 2013 and my audiogram from today, as well as a physical exam, the Doc said sudden sensorineural hearing loss was not present and that my change in hearing was likely a result of me being overly focused on it. I should also mention, he did clear a bit of wax out of each of my ears. Neither of them were impacted though,

Tonight, my right ear has stopped the loud increases in response to sounds, for the most part. It does still seem a bit spiked (my left is spiked a bit now, too), but not as bad as last night. I have a bit of fullness and warmth in my right ear still, and I think my hearing is still slightly decreased, but I can't really tell. If I'm being honest, I wear earplugs so much nowadays I don't know what things are supposed to sound like without them in, so it very well could be that I'm hearing normally but that it seems abnormal to me when I take the plugs out to listen.

I'm wondering what you all would advise me to do from here? Would it be worth seeing another ENT to get a second opinion? I was thinking I may ask for steroids just in case this is mild SSNHL but I'm not sure if that is overboard? I'm just really scared that if I don't do something, things will never get back to where they were before last night and that thought just scares the crap out of me. My mental health has never been the best, and it's worse than usual right now with the lockdowns and everything, so I really can't handle things staying this way. Any advice from you wonderful folks would be appreciated.

 

[Bill Bauer]

Tonight, my right ear has stopped the loud increases in response to sounds, for the most part. It does still seem a bit spiked (my left is spiked a bit now, too), but not as bad as last night. I have a bit of fullness and warmth in my right ear still, and I think my hearing is still slightly decreased, but I can't really tell.

I think if you were to have a spike you would Know. It sounds like your spike is fading.

I was thinking I may ask for steroids just in case this is mild SSNHL

Makes sense to me, but I don't have a medical background.

Any advice from you wonderful folks would be appreciated.

The fact that it is fading is a very encouraging sign.

 

[Alexandor Scott]

I think if you were to have a spike you would Know. It sounds like your spike is fading.

Makes sense to me, but I don't have a medical background.

The fact that it is fading is a very encouraging sign.

Thanks for the reply, Bill! It definitely seems that the spike is fading a bit. It's still above baseline, but nowhere near as bad as yesterday. The thing I'm really not sure of is whether or not my hearing is actually decreased or if I'm just overly focused on it.

I'm have a virtual apt with a second ENT today regarding the Prednisone so fingers crossed they will prescribe it.

Its definitely encouraging. I'm still pretty anxious since it's not down to baseline but I'm not panicking like I was last night at least.

 

[Juan]

I have been there. Very similar situation, several times. Don't do steroids, it is not worth it.

If you want me to be honest, I think this is just the course of hyperacusis and tinnitus. You probably are starting to have less quality hearing, even if the input (what the audiometric tests shows) is excellent (less tan 10dB, that's very good hearing).

Losing quality on the sound input can be due to aging but also, and very likely, a result of mechanisms of hyperacusis and tinnitus that as of today are not properly understood. So the best you can do is relax, not overworry about it, and give it time.

My feeling after years with this always has been that our hearing rearranges itself after noise offences to drive sound in the most efficient way. My personal feeling with sound is that even if you lose hearing on a frequency, your ears, and hearing structures will try to work in the most efficient way to make the most of whatever hair cells or hearing remains.

Many ENTs wont be so clear as me about the quantity (input of sound) / quality divide, but a good ENT, someone experienced, should agree with this. The downside is, there is really no fix for this so far. You can use common sense and eat healthy, try to fend off stress, do a bit of exercise, go for a walk, etc but there is not much more than that.

Some people embark on a never ending process of try and error sampling drugs or supplements, but I wouldn't advise this. I have tried a few things, but some people on the forums have tried a lot of things. Even having sampled few things I have had a bad experience with prednisone (nothing awful, but it wasn't nice... really), and some other people have had horrible withdrawal symptoms from benzos and other stuff. As for tinnitus, you probably know that most supplements are just scams, they don't work..

 

[Bill Bauer]

It definitely seems that the spike is fading a bit. It's still above baseline, but nowhere near as bad as yesterday.

Awesome! It can take weeks before one notices fading. You ought to end up being ok.

 

[Bill Bauer]

regarding the Prednisone so fingers crossed they will prescribe it

It is not clear whether or not it is a good idea to take it, now that your tinnitus is beginning to fade. Prednisone can have side effects:

Because of taking prednisone for my tinnitus, I then got more serious problems, I was examined for 2 months because I felt terrible. It turned out that I had developed adrenal insufficiency from taking prednisone. And 3 months later, it persists. What's the reason for this, nobody knows.

 

[Gabriel5050]

If you want me to be honest, I think this is just the course of hyperacusis and tinnitus. You probably are starting to have less quality hearing, even if the input (what the audiometric tests shows) is excellent (less tan 10dB, that's very good hearing).

Very interesting point you raised there. There must be a quality aspect that gets overlooked by 90% of ENTs. Some have a speech recognition test, which might be a more accurate result, since humans don't communicate through those damn beep sounds. Imo quality of hearing is something researchers should also consider

 

[Juan]

Very interesting point you raised there. There must be a quality aspect that gets overlooked by 90% of ENTs. Some have a speech recognition test, which might be a more accurate result, since humans don't communicate through those damn beep sounds. Imo quality of hearing is something researchers should also consider

There are several types of speech in noise tests. Some are carried out wearing headphones: you hear white noise or changing noise (white noise changing in tone or volume) on one ear and words in the other. The noise can be set to be heard through your ears, eardrum, or through bone conduction. I think with some equipment they can also set the noise and the words at the same ear, overlapping.

There is another even more realistic tests that is carried out with speakers like 2m away from the patient. Each speaker delivers sound in the direction of one ear. There is noise on one side and speech or some text read on the other. With this some people realise that they cannot make out individual words (out of conversational context) when they are in a noisy environment.

In a way, in real situations, the brain is filling the gaps in conversation for the missing words, and these tests of speech in noise make it clear that some individual words are just not perceived, and the patient is just guessing for what the particular word played may be.