The Valsalva Maneuver Substantially Lowers My Tinnitus

[Poseidon65]

Okay, I think my story with the Valsalva is not quite done yet. Over the past few days, I've done the Valsalva a couple of times, and have experienced substantial lowering of my tinnitus each time.

Here is what I can say at this point:

• The Valsalva is much more beneficial to one of my ears (the left) than the other. The left ear is also my "bad ear," i.e. the one with the most tinnitus.
• In the past, tympanometry tests I've had done show that in my left ear, the middle ear pressure is negative. On two separate reading, the pressure has been -106 daPa and -73 daPa. By contrast, my right ear has positive pressure.
• Apparently, negative middle ear pressure is indicative of Eustachian Tube Dysfunction (ETD).
• Tinnitus can be a side effect of ETD.
• My tinnitus is definitely noise-induced, but I also believe that the negative pressure in my left ear could make the tinnitus worse than it otherwise would be.
• When my left ear is ringing loudly, I would say that subjectively, a Valsalva reduces the tinnitus volume by 80%. It is a very substantial reduction, definitely beyond a placebo effect for example.
• The reduction in tinnitus volume for me is reasonably durable. For example, if I equalize the left ear in the evening, then the tinnitus will still be at low levels when I wake up.
• The duration of benefit may relate to "how long after the Valsalva it takes for the middle ear pressure to return to its negative baseline state."
• My guess is that, if my left ear pressure were positive rather than negative, the Valsalva would have much less noticeable benefit (as is the case in my right ear).
• I suspect that the co-presentation of "noise induced tinnitus" as well as "mildly negative (not severely negative) middle ear pressure" is not something that an ENT would often see. For example, no ENT would think that my left ear "needs ETD treatment" or "is responsible for my tinnitus" based purely on the pressure reading alone, especially if I tell the ENT that I have noise-induced ear damage (which I do). So I understand why an ENT might not think to advise equalizing my ear pressure in order to improve my tinnitus symptoms.
• In the past, I have experienced that "too much Valsalva" can be a bad thing, in that it really aggravates my highest-frequency tinnitus tone. Basically here, I think occasional Valsalva (e.g. every few days) is okay, and lots of Valsalva (e.g. several times a day, every few hours, ...) is not good.
• So going forward, I will try to do a Valsalva only occasionally, when my left ear is on the much louder side.

I will also point out this earlier comment from @Dirtworks, which my points are along the line of

@Poseidon65, very interesting, but to me we should be able to draw some conclusions from your observations on the Valsalva.

Can we not conclude that your problem lies within your MIDDLE ear? The part of your ear that is affected by the Valsalva.