Theory: ETD the Root Cause of Somatic Tinnitus

[donotringatme]

I have a theory regarding somatic tinnitus in people with no hearing loss and it may include some with hearing loss.

The root cause is ETD. What causes ETD is what we must address.

ETD increases middle ear pressure. More pressure causes the ear drum to be stiffer. Stiffness of the ear drum causes the bones responsible for transmitting sound waves to malfunction, which causes tinnitus. The malfunction meaning eardrum stiffness and not anything severe or irreversible. The stiffness of the eardrum has a direct relation to pitch. The more stiff an eardrum is, it influences the part of cochlea responsible for high Hz. On the contrary, an eardrum moving too much influences low Hz.

This can explain why we have a static - in my opinion caused purely by increased middle ear pressure - and a high pitch that may or may not alternate.

Why it alternates I think depends on three things: middle ear pressure changes, outer ear pressure changes and muscles and those can change a dozen times per day which can explain why some experience frequent pitch changes.

If middle ear pressure worsens, the tinnitus worsens. If outer ear pressure increases, I bet you your tinnitus will improve for a minute as the pressure comes closer to equalizing but the aural fullness remains so the sensation is going to be bad. Muscles affect the ear and movements can pull on it, affecting the eardrum, thus affecting the bones, thus affecting the tinnitus, muscles such as the SCM. Literature states also that the back of our ear plays a supporting role at helping the eardrum endure ear pressure differences.

Other muscles that may affect this are face muscles, directly influenced by the jaw. Imbalances are created by the mouth IMO, not a severely messed up jaw. One however must address the jaw because it's all related. Muscles, ligaments, glands, it can create an absolute mess that FYI is the root cause of the ETD in the first place. Inflammation or anatomical changes that need to be addressed. This is why steroid medications help as they reduce inflammation and ETD is also reduced. Others are completely cured by addressing sinus infection, ETD resolves, eardrum returns to normal function, bones too, tinnitus is gone.

Neck also plays a role because it directly affects the ear and also the SCM and the muscles of the face and the posture, posture affects our face, even contributes to bone altering position and fascia (not augmentation as this is impossible).

So, inflammation and strain in such conditions is certain. It develops slowly, it leads to ETD, ETD is not understood immediately especially in cases of no sinus infection or fluid presence (aka mechanical issue) so pressure builds up, eventually tiring the eardrum to the point that it starts to act up, since the bones behind it malfunction.

This also explains why PET hear a completely different low Hz pitch, since the pressure and eardrum are the exact opposite.

Neck then has nerves that can modulate the ear so if you go and irritate that nerve, your tinnitus will increase momentarily. In that sense, it contributes to the issue but I don't think it's the main problem.

The funny part now is how to address ETD, because you can't really directly address it. You have to do this backwards by addressing everything else, as everything else contributes to its development. That means addressing your pelvis, core, upper back and neck (as neck issues stem from below), then focusing on your face, knowing that everything below the head no longer contributes negatively. Of course this takes time, effort, money and someone who knows what they do.

Now, you can focus on the face which is an absolute mess so an MRI has to be done, there are some that allow you to also do various jaw movements to monitor ET function. Since most - if not all - can detect ETD in one or all movements of its function (swallowing, chewing, yawning), it's obviously a jaw and mouth mechanical issue. Myofascial release and medication help but to permanently alter something, one must address the mouth and consequently the teeth and tongue. From malocclusion to improper tongue posture or forces applied. An MRI and CT will hopefully show what's going on and one can start addressing everything slowly and see whether there is improvement or not. So, I don't think it's a nerve being pinched (especially if you have discomfort only and no severe pain) or something hitting the ear canal etc.

During the past few days I tried things. I tried dietary changes, tried ACV, tried tiring myself etc. Those, including cold showers, avoiding caffeine, calming the nervous system down, ALL help modulate tinnitus. However, it remains the same. What do I mean? It changes from better to worse based ONLY on my ETD. ETD worsens with certain movements or positions, tinnitus increases. ETD improves, tinnitus decreases. The ONLY thing that considerably helped was a week of cortisone, because it greatly reduced the inflammation, thus improving ETD, but not addressing the root cause. I doubt blood pressure and relaxation techniques do anything more than addressing muscle tension.

So, if you have somatic tinnitus, do a test to measure your middle ear pressure, have the ENT closely monitor your eardrum condition, take a close look at the ET using a camera through the nose and also monitor any hearing loss once per month.

If this theory is correct then tinnitus should be eliminated completely once one fixes ETD, perhaps not instantly, But if the conditions for an ear to heal are present and nothing intervenes anymore, it should heal in quick time and THAT is the point where I do believe nerve healing protocols can indeed help.

 

[donotringatme]

From further monitoring, it seems that things are not that simple. Position of the head and neck plays a huge role in modulating tinnitus and for the occurrence of fleeting episodes, so there is definitely a big influence in the ear itself. Lying down on my right side with my arm under the pillow provides me with a 1-2 seconds "eeee" tinnitus, more like a fleeting episode but not really.

This, I think, can't just be due to pressure in the middle ear from ETD due to gravity / position. There must be nerve issue that occurs based on gravity / position / tension and worsens the ET function and the ear. Either that or the changes in the jaw based on position leads to that phenomenon. Point is something gets jammed. My ET function is improving slowly. Avoiding strenuous activities helps. The initial loud "eeee" is gone, a mild static remains and even that goes away completely sometimes during the day (ears closed, quiet room, no sound at all but a sensation/sound of pressure/fullness that we all have pre-tinnitus, just more prominent). What I don't know and probably never will is which came first and which second, which influences which, I think at this point they all (ET, neck, jaw) are working together in malfunctioning and causing tinnitus. I'll use this thread to post my progress over the next 30 days, details about physiotherapy protocol and see what happens. I've experimented with diet (salt and sweets, ACV and juices) so far and it has had zero impact, negative or positive, to tinnitus. I sincerely doubt it's a blood circulation / pressure issue present (which is good).

 

[donotringatme]

Post physiotherapy and tinnitus goes in loudness levels of day one every time.

Protocol is TENS, TECAR, laser, manual treatment on knots and trigger points of neck and upper back, starting decompression table on Monday and still looking for jaw doctor. The goal is to loosen muscles, heal nerves, realign spine, strengthen muscles, adopt proper postural habits.

I assume that depending on one's country and region, you will or won't have access to physiotherapists with machines. Or they will be chiropractors that crack your spine and work manually. In my humble opinion from what I've seen so far, YouTube routines and self experimenting won't cut it. Cracking one's neck and massaging won't cut it. I think one at least should try and demand transparency from his chiropractor. Also, neck-only treatments won't cut it, since those stem from abdominal imbalance, unless it's a direct injury to the neck.

The jaw is just ridiculous, people can't wait to just charge you splints and send you home. Absurd. The same goes for prolotherapy I've seen advertised online, as it is only creating inflammation to wake everything up, this doesn't solve anything.

Fact remains that the worse the aural fullness, the worse the tinnitus, with a minor independent (or not) influence from the neck (can be independent and due to a separate nerve compression ie or it can just be the more irritation = worse tinnitus). Either way, can't understand if those nerve endings being compressed / irritated act alone or just happen to influence an already existing tinnitus.

Aural fullness that goes almost completely away at times, I've caught myself having no tinnitus for a minute or so and the mildest of tinnitus for a few minutes. As soon as it returns, static is obvious and as soon as I lie down on my back (thus compressing my nerve endings on the neck) the "eee" returns in a mild form. Stressing the neck either by walking a lot, standing for long hours etc is producing the same "eee", so whatever nerves are irritated or compressed, do so regardless of position, as long as gravity and tension are similar. Thus I believe the neck does play a role, considering sudden neck movements close to injury gave me (and others too) tinnitus episodes of a few seconds before the permanent tinnitus occurred. So I think static = middle ear pressure and any form of "eee" = somatic, translating to nerve compression, vessel compression, god knows what, something that has a relation to the ear though (so one can count the nerves and vessels influencing the ear). Either that or it could be tension alone, excluding nerves and vessels (that truth be told lie deep), so muscle tension, inflammation, contraction, increasing based on posture and gravity, complimentary / nearby muscles acting negatively to the ones directly correlated to ears and thus the tension creates the "eee" sounds. That's a bullshit theory though because why on earth would tinnitus increase when someone uses a laser deep to irritate the nerve? So, muscles must be responsible for the aural fullness / ETD (especially when no sinus infection is present).

I'm repeating myself but this thing has pissed me off like nothing else. Nothing has disturbed my sleep like that in the past.

Anyways, so, IMO

- Muscles => ETD
- ETD => static CRT mild constant tinnitus
- Muscles / bones / posture => Nerve irritation => high pitch "eee" tinnitus that can be modulated, naturally by manipulating all those that cause it (muscles, nerves, posture).
- ETD worsens => static increases and by the theory of the eardrum, "eee" May increase too (ETD worsens means more pressure, means stiffer eardrum, means cochlea's high pitch tone area)
- ETD improves => static decreases and by the same theory, "eee" decreases if no direct nerve irritation augmentation isn't present
- Direct nerve irritation => "eee" increases temporarily
- C1 and C2 reverse curve, C1 and C2 nerve endings compression, elevated head lying down, any form of suboccipital pressure, suboccipital tight muscles => possible root cause of "eee" tinnitus and definite cause of "eee" aggravation
- C6,C7 muscle spasms and accessory nerve theory suggesting it may be also causing "eee" tinnitus and a possible accomplice to aggravating existing tinnitus
- SCM and mastoid process with the dozen nerve endings underneath it, suggesting also a possible cause of "eee" tinnitus and a possible accomplice to aggravating existing tinnitus
- If one cannot equalize pressure at all in one or all three of classic jaw / movements (swallow, yawn etc) then => probably the face is contributing to or causing ETD

It would be very interesting to make a poll for people with somatic tinnitus or idiopathic or even those who aren't sure if they have acoustic trauma, to test their ET, have and upload their tympanometry test and we can conclude if elevated middle ear pressure is present, then everyone can try to chew and yawn and note if they can equalize pressure or not. I can't accept that a young boy or girl have their jaw pushing against the ear causing tinnitus but I can definitely see how a prolonged ETD (due to anatomical or jaw for them or neck & jaw for us) problems can be a real cause, universal, detached from diets, blood pressures and all that. I didn't figure out I had ETD when I generally am cautious of these things and I must have had that for at least 2 months. Imagine how long someone else can have it for. I don't believe tinnitus starts within a day or a week or randomly. One must really push it and create the necessary environment for it to occur. That's why it doesn't occur at once, it usually causes a few mild temporary episodes or gives us a bunch of fleeting episodes, or we have terrible itch that we can't explain etc. I also do think that many instances of H stem from this situation, as it's confirmed that sound amplification is due to muscle dysfunction. It is not psychological, although I can see how one can become overly cautious when mild sounds feel like stabbing them.

Let's see how this pans out.

 

[donotringatme]

Tinnitus completely resolves for a minute once I find a neck and jaw position that they both are in what feels as a natural proper alignment and not jamming each other (completely straightening the area right under the occipital bone(?) and making a chin tuck but not forced, just giving more room for the lower jaw). Coincidentally, ETD vanishes, the pre-ETD feeling returns and even stays when chewing food, the jaw has zero discomfort while chewing and it reminds me I once had a face that didn't feel like shit. As pressure from holding that position builds about 2-3 inches below the occipital bone, the entire thing collapses. ETD returns, jaw discomfort returns, neck discomfort returns and a discomfort / pressure is created in that specific area below the occipital bone, an instinctive urge to stretch my neck sideways returns, my upper back seems to be giving up. The neck area that gets the pressure is - coincidentally again - the area that I was hyperextending or torturing during watching television while lying down or staring at my phone. I've been doing some reading on the TMJ in this forum and seems like tongue posture and thrusting may actually be behind all this. An upper jaw remodeling, lower jaw dislocates or at least bite changes, that leads to occipital issues, neck issues, traps collapse from pressure, SCM takes over, SCM pressure results in forward shoulders (which I weirdly had every morning waking up), positional changes occur, ET is partially blocked / malfunctioning, tinnitus hiss commences. I tried standing still staring at my phone while sitting down to see what happens. Neck pressure building up, jaw tension building up, occipital pressure increases, that somehow sneakily increases ETD pressure from tension in the area probably and guess what, fleeting "eee" episodes commence followed by a more stable "eee" that I am able to slowly take down if I lie down and rest but not before slight alterations to it occur because of my head in the pillow and changes in jaw pressure in that position. That explains why tinnitus may worsen initially when lying down but waking up in the morning, having slept on my back only and like a piece of wood, results in no "eee" whatsoever, apart from the hiss that's there due to the ETD. Thus, I do believe that ETD alone is responsible and there isn't nerve compression, there is however compression in the ET and if taken beyond a certain threshold, it creates the high pitch "eee". Which again, explains why a cortisone treatment that reduces ETD (whether tension / mechanical or from sinuses) reduces the tinnitus. So, even small changes in a dysfunctional ET, can result in great changes in the tinnitus, I think because of the impact on the eardrum and the chain of bones attached to it and with each other, responsible for transmitting sound waves. Which is also why when pressure builds up based on position, sometimes the eardrum will flick and give a whoosh. The good news I guess is that a semi-functional ET gives us time, because if at a slightly different altitude or environment your ET equalizes pressure, it means it isn't dead. I believe that at least the trigeminal nerve plays no part because if it did, the palatini muscle wouldn't function at all(?) and there would be constant pain or at least stabs.

It's also funny that a member here that hasn't logged in some time, Ocean, mentions that pelvic issues may actually play a part and I believe they are the culprit because a dysfunctional body starts from the pelvis and core, not from top to bottom. So, addressing the neck alone won't do much long-term.

 

[donotringatme]

Upon further attempts to modulate it, trying to elongate my neck and tuck my chin in a bit, however this time attempting to take the balance off my neck muscles and redirect it where it should go, to my core, it's not easy and takes a good amount of "feeling" your own body. Well, doing so, ET finds immediate relief, tinnitus literally disappears (always with ears closed for 5-10 seconds test) and I'm only left with that stupid "whoosh" feeling because ET aren't exactly cured so an amount of pressure is still there, however the pre-ETD feeling of actual clear, clean, healthy ears comes back momentarily and it's good to know. However, inability to maintain this position returns with a vengeance, with considerable masseter discomfort, ETD on full force which actually causes discomfort / very slight pain to the eardrum, occipital discomfort, as well as some very mild discomfort in the zygomatic bone or whatever the hell its called.

I don't understand how exactly this whole thing works tbh and only theorize for some parts. I know the hiss is pure ETD. But the "eee", whether it is with ears closed, focusing on it or in silent room, don't know if it stems from ETD alone (and eardrum messes up the cochlea temporarily) OR if it solely comes from nerves being pressed, irritated and such (because that changes during the day based on activities, stress on the nerve areas etc, so it does make sense). It could be the nerve passing through TMJ and muscles around there or it could be the stupid nerve endings on the back of the neck, so we are talking "2 types of tinnitus", a hiss and a high pitch tone, the latter clearly in a mystery relationship with nerves. However, I don't know if it is CAUSED by that or that simply the nerves irritate the tinnitus. I can also assume that since the high pitch can go away completely, it can't be a permanent damage to the cochlea stemming from a somatic initial cause, ETD, pressure to the ear from TMJ and such. So that's good. It is also good that from all I've read here, not a single person has non-noise induced tinnitus without ETD. I guess the only way to find out is to restore full function to the ETD and give it a few days for an obviously irritated eardrum to relax, then see if both the hiss and the pitch disappear.

Attempting to equalize pressure through a variety of ways works some times and doesn't work other times, it seems to go hand in hand with pressure gradually building up in the upper neck and also lying down where the same pressure on the same area also builds up. Valsalva works but is dangerous, there are 5 more ways like swallowing with nose closed, making the K with your tongue and such. Failure occurs almost always when lying down for a long time, as any attempt (carefully) leads to the whoosh sound and a feeling of the eardrum saying "stop it". A very slight pain forming a 2 inch line right under the ear canal aligned with the lower jaw vertical bone occurs. Equalizing pressure success provides relief but temporary. The more it does, the more the tinnitus feels gone. It's not just closing the ears or seeking it, the very feeling of having clear almost breathable ears makes the whole thing a lot better. Swallowing and chewing give the gluey click of trying to equalize. Yawning frequently fails and feels as if it worsens the pressure, occasional whoosh sound occurs too. I am able to activate my muscle that contracts the eardrum (I think everyone can?) so the same whoosh sound occurs, it lets you know things ain't so good up there. Occasional drainage occurs through the day so that tells me ET do work and no fluid is present or pain for that matter.

Next stop ear MRI, MRA, TMJ scan and orthodontist opinions.

 

[donotringatme]

After more extensive self-testing, the truth is probably not so simple.

Injuries in the pelvis, abdomen, or general instability in the pelvis is associated with all this. The upper back curves to balance everything, diaphragmatic breathing is impacted from weak or strain abdomen, therefore muscles in the neck take over to elevate the chest and help breathing. This creates massive tension. It's stated that imbalances then occur everywhere, right sternum side losing balance with left and becoming dominant, therefore scoliosis can occur, feet can lose balance at stepping (meaning the outside of your feet take most force for touching the ground). I have literally all of these things. Neck took over the job of my abs. I never knew it can lead to such issues so soon. This type of instability also leads to the temporal bone being messed up and eventually c1 and c2 nerves being squashed. Straight neck obviously occurs, SCM puts massive tension on the ears and deep neck muscles go to sleep. The clavicle can go out of place sort of sticking out. Loss of diaphragmatic breathing especially on the left side disrupts the vagus nerve. The entire mess created described before leads to anatomical changes in the jaw (and the entire face usually leading to misalignments of the eyes, jaw etc) so TMD and - probably - ETD occurs.

It explains why when I wake up I can listen to the high pitch. When I sleep sideways, I can. If i attempt to sleep on my stomach, I sure can a lot more. When I put stress on my neck or my traps, it worsens for quite some time, same when I just walk or stand for some time. Yet when I wake up and get out of bed, there is a brief time that it disappears, almost. even completely. So why? I think it is because something is being compressed or stressed. There are only two areas this can happen. The back of my neck, in the c1, c2 and c3 and my SCM/traps as I instinctively used to raise my arms back over my head in the side when I slept (subconsciously to take tension out, and also had rounded shoulders in the morning upon waking up pre-tinnitus). So, it's the whole body malfunctioning but the direct issue for tinnitus is SCM, traps, c1, c2 and maybe c3. So, when I'm up, for some time, gravity does its thing and postural changes or simply pressure issues high pitch. When lying down, pressure on the pillow does the same, high pitch occurs. So it can be a vessel issue, or a nerve issue, combined with muscle spasms/tension. There are certain nerve endings that can do that, @Greg Sacramento and his theory on the accessory nerve is probably on point.

Now, the static though, that is NOT from those issues mentioned. I know people will laugh at me but I think the static and the pitch are two different types of tinnitus. The static is from ETD, chronic ETD is rarely solves as it stems from god knows what (when there is no inflammation) so when there isn't any fluid buildup, it tends to stay semi-working, leaving the static due to middle ear pressure being higher than normal. It doesn't mean you can't equalize momentarily, it means it doesn't work perfectly. This is why some people find relief and lose the high pitch but stay with the static (and claim they only hear it if they close their ears).

Another theory is that the vagus nerve is pinched, which can cause high pitch allegedly and that IMO is the theory of "tinnitus from stress". Now, how can you go find out it's being pinched, that I don't know. I know it messes up your sympathetic-parasympathetic, creates food allergies and such.

All that explains why people modulate tinnitus through muscles, through nerve irritation, through diet (salt, coffee, alcohol, altering circulation, cold showers etc), depending on the root cause. For me for example, diet changes absolutely nothing, whether I bathe in table salt or eat like a monk, so I guess there isn't any blood flow involved, it's probably nerves. Nerves in the body and not the "oh it's the brain nerves", as sleep would theoretically make tinnitus low enough to disappear. It doesn't. Also, ETD worsens while sleeping and I know there is sort of a pressure increase because if I try to Valsalva, it won't happen, my eardrum vibrates slightly and tells me "don't do it, stay as you are". So, theoretically, static should increase and high pitch too - if ETD was the sole cause. Yet why is it when I walk for a while or am up for long time or am stressing my neck, that I can easily equalize pressure and get rid of static BUT high pitch remains (in fact loud)? So, anyway, yeah. Two types of tinnitus.

On top of that, depending on the severity of all the above and their impact on the inner ear, some will develop hearing loss, fluid, even mess their ear and increase tinnitus, so while I'm sure CBT is a must and does work at blocking the sound (I'm already habituated to it for the day except for night yet), one must keep searching for a solution. And this is where the hard part is because the jaw may be influencing, for example, the ET alone. Yes but how do you fix it? This may be a neck and posture issue going on for years, leading to a faulty position of everything which led to your jaw being like that. Wearing a splint isn't gonna cure it. It may address the impact of the jaw itself to the tinnitus but also it might not. It might even make it worse because the big problem isn't being addressed.

I guess this is why many people don't get rid of their tinnitus. I will do my best to document everything I do for the next 2 months in terms of healing the nerves, restoring neck curve and vertebrae's to theoretically fix any nerve issue. The same for the SCM and the front of the neck and shoulders, as it is stated THAT alone may have trigger points and lead to pain and tingles in the entire arm, mistaken usually for cervical issues.

We'll see how this pans out.

 

[donotringatme]

Another night of a ridiculous 4 hour sleep followed by a semi-sleep-semi-awake 2 & 2 hours.

I went through the entire ten pages of some guy named Engineer who had ETD.

I have been reading on muscles and how they can affect the ear structures, combined with a few very interesting posts by @Greg Sacramento and @oceanofsound26.

I have a feeling that there is no vascular or nerve issue being the root cause. I think those two simply act as modulators but manipulating them never eliminates tinnitus. This is funnily enough extremely similar to hair loss. If you have it, everything seems to modulate it but nothing cures it.

So, for people with sinus infection and congestion, the road is pretty clear. Fixing it fixes ETD, tinnitus is gone.

For us with clear sinuses though and a mechanical issue, it isn't so clear and it gets ridiculous when you start searching for nerves and vessels. But here is my new theory as I advance in this fucking stupid ringing that apparently can destroy your body, mind and life worse than a third-degree abdominal strain.

My theory is that mechanical ETD is a real thing and it is chronic. It has to come from surrounding elements, which means the muscles around it and the jaw itself. Now, when the ENT goes up your nose with his camera and smiles saying the ET entrance shows no inflammation, you scratch your head. If it is allergies, take antibiotics and check for any improvement or not. If it is muscle-related, muscle relaxants and myofascial treatment along with an orthotic can solve that mystery.

I wrote that position and gravity affects tinnitus so does excessive strain. Sleeping on my back affects it, standing up for too long affects it, lifting heavy stuff affects it, go figure. Well, I refuse to accept that my neck creates tinnitus because I have a 96-year old aunt who doesn't know what tinnitus is. Also, a ton of people I know whose necks are bad and they only know silence. So, no.

What I do think happens is either a persistent middle-ear condition related to the Eustachian tubes (allergy, inflammation, fluid, infection, a tired eardrum) that if cleared, can restore silence. Or, the structures of the ear are being pulled, thus causing an imbalance that translates to tinnitus, pain and so on. The only muscle that can do that alone as far as I know, is the Sterno-cleido-mastoid. If it is a team effort, then the upper neck and jaw can also do that.

Whichever it is, the reason we experience tinnitus is from two things: 1)middle ear pressure & the failure to equalize or drain fluid and 2)eardrum complications, either from ETD itself, chronic earwax, infection, inflammation, doing stupid stuff like what that Engineer guy posted OR muscle tension and dragging influencing the eardrum and the external canal.

So, Eustachian tubes and eardrum, that's it. Everything else, the nerves, the vessels, the brain, the stress, the presidential elections... all circumstantial. They all modulate it but not cause it, including of course the misaligned jaw pressing on the auditory nerve. Well, i have never seen a case of jaw misalignment that has no Eustachian tube dysfunction so if realignment fixes one it certainly fixes the other. Whose tinnitus has ever gone completely without their aural fullness going away first?

Moments ago, I did another test. I closed my ears in the classic manner, pressing the Tragus with my finger to close the ear canal. I closed it and this time kept it closed. I waited. Before doing that, I was positioned in my bed, on my back, monitoring the stupid high pitch tone being stable. Back then, on pre-tinnitus days, if a "fleeting episode" arrived, I would close my ears the same way and release, fast, a few times. It would make the tinnitus dissipate and disappear into the abyss. Well, I said, let's see what happens to the tone when I close those ears and elevate the pressure outside the eardrum and then release slowly. Well, the pitch slowly faded away but upon release, seconds later, a loud pitch came (the one I had on day one) and fortunately left 15 seconds later upon me getting up, cursing and gently massaging my ear, so I was left with the same - inaudible for some - high pitch / static. I'm well aware many would kill for this kind of tinnitus.

What happened was I messed with my eardrum and middle ear pressure. That is all. No strenuous activity, nothing. In the early days, my eardrum would flick, as if it was confused from pressure, asking me "where do I go dude, right or left?".

So, back to ETD. The "ill" condition of the middle ear and the eardrum, creates tinnitus. It comes to a point where the ear says "wake up stupid, I'm dying here". Everything else, suddenly, becomes a modulator. Same as hair loss. You didn't know they exist but suddenly ah, they are messing with you. They are the cause.

No they aren't. If we get down the rabbit hole of probable causes, you will end up thinking the spiritual energy on your right toe is responsible for tinnitus. It's actually though the most simple thing: your ears. What do I have wrong with my ears? Oh I have a ridiculously high middle ear pressure, fullness, crackling and my eardrum is either mildly inflamed, heavily inflamed, reverted or about to blow up. Definitely not normal.

I also read somewhere that the Eustachian tubes can get progressively dry. I don't know if that thing is true but I guess it can make some sense if you take into account dry mouth, bad breath, GERD, and whatnot. Probably not a thing but GERD is true to be causing ETD to an amount.

I also test the pop thing and how it relates to tinnitus, because I don't believe that all ETD relieves are the same. Example: I manage to pop my ears after several attempts by opening and slightly tensing my jaw, ok great. However the pop does not feel the same way a pop feels when you equalize pressure (you all know that feeling, one that lasts and sort of takes the fullness away and you go aaaah nice, it's as if I have new ears). The pop I mention is more like crackling, clicking, some stupid momentary pop. Well, if that happens, the tinnitus either doesn't change or actually increases. I think this is because either pressure increased (probably not), pressure suddenly changed and changed again (since you're not cured so elevated pressure returns shortly after pop) or because of the impact the pop attempt has on the eardrum.

The only times I found complete tinnitus relief in this 5-6 weeks of ridiculousness and sleep deprivation was when I had an actual pressure equalization that seemed to last. That happened only when I was driving to a slightly higher altitude or that the car had uhm, air conditioning but not from the engine, just "air blowing from outside", it's some stupid feature. The fact is that it forced some equalization, which gave me the pre-tinnitus feeling and also a mild drainage (which I guess doesn't have to mean massive fluid behind the eardrum).

So, the easier it is for the Eustachian tubes to equalize pressure or the more frequently it is possible, the less the stress on the eardrum, the less the tinnitus. Even upon complete cure of the ETD, I believe tinnitus may take a while before eventually going completely away, as the eardrum heals from the shock. I believe if the SCM directly messes up your ear, it may not go away completely, but I can't accept that there are some billion elders out there without tinnitus, don't tell me their atlas is fine or that they're massaging their SCM. Many have hearing loss (naturally occurring) and zero tinnitus. Not many, all of them. No tinnitus... well, I guess it must be that they don't complain or aural fullness and you don't see them taking their dentures off to open their jaw trying to hear a pop.


E. T. D. That's the enemy. The end boss. First you may need to go through mini bosses like bad physiotherapists, insurance, neck, MRI, CT, go through the ENT village where all the useless peasants are and serve no purpose at all, then fight the SCM mini boss and the TMD boss.

Tinnitus has to be the stupidest, most ridiculous non-curable non-disease I've ever seen. Period.

 

[donotringatme]

Just had a Halls Original Coolwave watching Nadal dismantle Djokovic while all my friends are cautiously making fun of me chewing gum and drinking beer. Since my nostrils are clean, anything I do for nostrils actually gets up to my ET fairly easily. It felt really nice and popping ears became slightly easier. As soon as I finished the caramel (mint, whatever you call it anyway), I went to the bathroom, it being completely silent, I wasn't exposed to loud noises, wasn't running, was just sitting in a neutral position for the past 45 minutes. Guys, I kid you not, dead silence. I closed my ears, had the usual stupid muff sensation because hey, ears ain't fine yet. Waited, nothing. Opened them, looked up looking for it, it didn't come. Ever so slightly back now (at levels only audible at night). With the easier opening of the tubes also VERY VERY slight sensation of pain for a sec in the eardrum area and going an inch below that, in line where my jaw goes laterally but just behind it. Pressure and discomfort in my masseter returns shortly after, c1 and c2 tension ever so slightly and some behind zygomatic and eyes. The change of pressure in the ears happens so fast it's ridiculous. It all occurs when I try to repeatedly pop my ears by opening my jaw and tensing the mandible (masseter probably and whatever is lateral).

Haven't tried melatonin yet but starting tonight, sleep has to get better. Haven't started a hardcore diet yet but planning to. I will report back if it has an effect. I want to help as much as possible through writing down my own stupid journey to the Eustachian tube resolution, hopefully before the end of the year.

 

[donotringatme]

Taking my first 1 mg of melatonin did absolutely nothing. I will continue taking it for a week and seek counseling, sleep is the main issue now, not tinnitus. I hope I can come back having won this and will document everything.

 

[donotringatme]

First therapy treatment with Quantum machine, replacing old TENS, this one automatically finds the muscle and works at that depth. Followed by manual treatment on he SCM, Scalenes and I'll push for more treatment in the front. Manual treatment included trigger points and stretching. One small area near and under the ear feels as if it is pushing the eardrum downwards and causes ever so slight pain, so stayed away from that. Haven't touched the jaw yet. Initial feeing after therapy is positive, tinnitus is only detectable upon closing ears, static and very slight pitch, unlike previous therapies irritating the auditory nerve in the back of the head, through laser. I did also trigger points in trapezoids, neck, manually worked the muscles on c1,c2 and finally sternum and upper back (somewhat quick stretching and some chiro adj cracks).

I think there is definitely a LOT of room for improvement. ET have NOT improved by treatment so far so I don't necessarily expect a massive improvement. Right neck turn being the only one modulating tinnitus isn't something I discussed but was told doing it may be directly influencing/narrowing the ET or middle ear. Probably not, sticking to Greg's accessory nerve theory, will continue working on it. Lying down is evident that my head tilts to the left slightly and my jaw misaligned to the right.

Lots of room for investigating, I'm positive this can be solved as well as for MANY more people.

I will also be doing allergy tests, after reading a relevant thread here. I do have a theory regarding tongue posture, GERD and mouth, that the ET can dry out and thus become dysfunctional. I've no idea if this has any ground, probably not.

There is definitely either an allergy or inflammation going on as Cortisone definitely helped a ton during the second week reducing tinnitus to the current level (static, high pitch tone rarely reaching initial levels, rarely having fleeting episodes anymore or sudden onset of loud different pitch, yet it can happen only when lying down on a pillow slightly elevating the neck OR when sitting down with forward head posture looking at phone or book for prolonged periods of time, it lasts 10-15 seconds). I don't observe a difference in ET when that happens so my guess is muscle spasms create the loud temporary episodes as they did before (when I was modulating my tinnitus with neck movement).

So, three types of tinnitus.

- Static = ETD, audible as an aural fullness sensation especially when closing ears

- High pitch tone = variable throughout the day, worst at night and after stressing the neck and jaw muscles, prolonged periods of time where the neck needs to hold head in place I guess. Variability ranges from 1 to 3, 1 being when rested a lot or not fixated on it, 2 being lying down, especially on the side placing arm underneath the pillow, 3 being when lying down on back, lying down improperly, stressing the neck, stressing the jaw by chewing hard food, irritating the auditory nerve on the back of the head with a laser, or putting a heat pad there.

- Various tones = temporary in duration, longest I had was one hour once, others are 10-15 seconds, happen less frequently as treatment follows, most likely are due to muscle spasms (as Greg correctly mentioned to me plenty of times), as they occur at times where my trapezoids and Sterno-cleido-mastoid are indeed involved but when I'm still, not when running, usually in improper and stressful positions for the muscles and head. They are either high pitch, middle pitch or even low pitch, sounding like kettle, train, airplane etc. I have no idea if this is actually pressure buildup around the ET, irritating a nerve or if a muscle is dragging the ear, thus influencing the cochlea or eardrum itself. It doesn't really make much sense to be a nerve irritation in the back of the head because I have done this directly and it ONLY increases the classic high pitch tone. So there is something else going on, it isn't the auditory nerve, it's the ear itself. Besides, when it happens, I can actually feel it in the cochlea area and as if something twists or snaps (can't explain it, it's a feeling only somatosensory freaks will pick up). Since it isn't the nerve and it's supposedly the ear, it may be true that pressure actually builds up and sets it off. Who knows.

- Fleeting tinnitus = happens rarely, flash bang mostly, hearing is gone and tinnitus too during that but it's so fast and so scary that until you react it is gone. May it be gone forever.

So, ETD can be due to inflammation, allergy or TMD (muscles squeezed, ET squeezed, nerve pinched, swollen glands, dental infection etc), so addressing it may in fact cure tinnitus completely. I have read about ET lesions, never confirmed that anatomical changes from neck and jaw can actually change the angle of the ET, making them closer to those of children, straighter, I would assume those cases would definitely have fluid buildup and otitis. I suppose MRI, MRA, CT (for the face&head) and cone beam scan are necessary.

As @Greg Sacramento - again - has brilliantly mentioned, splints won't correctly address the TMD issue if the neck (front and back) are actively sabotaging the whole thing by manipulating the position of the head and jaw. Same goes for jaw muscles.

So, one needs to address the neck (front and back, manual release, laser treatment, TENS, TECAR, QUANTUM, to name a few) by loosening everything to jelly and then strengthening while realigning if need be. Needs to address the facial muscles (I have absolutely zero clue there yet but laser treatment in the masseter area I did, didn't seem to help much, so probably needs manual). And also needs to address the jaw itself, by checking teeth, gum, bite, glands, for infection or nerve irritation, check tmj for dislocation, cartilage wear etc, then proceed to correct any issues present.

By doing all that, one can successfully correct ETD permanently and restore balance to the ear by having total equalization 24/7, thus letting the eardrum heal, thus promoting proper function of the bones signaling to the cochlea and therefore allowing for complete tinnitus relief.

One last note, sleep is of paramount importance and I was told that by my physiotherapist too. Sleep deprivation will definitely slow process down even severely impact it. Sleep alone can allow for one to heal much faster.

God bless.

 

[donotringatme]

I think I have driven my nervous system at this point thus I'm going away from the forum. I documented my thoughts and information in attempts to help and I hope one day I'll be able to post in success stories, whether it's habituation or - hopefully - complete remission.

I leave a link of a good ENT in my country whose website has well-detailed information about all ear problems, including ETD, as means to help, it also mentions treatments. Translating should work fairly well I think.

To be continued.

FYI @KWC take a look at it because it also has other conditions that may very well relate to yours.

 

[donotringatme]

Alas, here we go.





This is it. These two videos describe in actual detail many if not all the complications arising in the Eustachian tubes. There are a few more videos I found about a "pseudo tympanic membrane" and cholesteatoma which you can find online easily and basically can be the culprit of your tinnitus or temporary hearing loss and pressure but likely not.

So, ETD. In short, it can be always closed which you will definitely feel. Or always opened which you will also feel since Patulous ET has very specific symptoms.

Our case, for 95% of people, is the stupid tinnitus accompanied by aural fullness and increased middle ear pressure. Increased middle ear pressure means your ET do not function properly. Do not let anyone tell you the opposite. Poor function puts us all at many risks, from cholesteatoma to otitis media to hearing loss to tympanic membrane rupture. You should avoid the valsalva at all costs, avoid getting on planes and diving.

The ET thus is a very stupid part of human anatomy that has two muscles responsible for its function, the palatini muscles. One contracts first then the other one does. If these two muscles or one of them do not contract at all or even properly, you get partial function. We can get block from adenoids, from allergies, virus, infection, etc.

The point is the ENT MUST perform the check using the tools in the video and MUST ask the patient to do all movements listed in the videos to DETECT any dysfunction and if he must, he should go INSIDE the ET with GREAT care NOT to push air beyond a certain threshold in order to protect a possible thin / irritated tympanic membrane. It's THIS way how an ENT can actually DETECT ETD.

Which of course isn't what my ENT did (he just went in and saw the entrance lol). ENTs are absolutely useless.

There is evidence suggesting impacted tonsils, malocclusion, TMD and neck actually CAUSING ETD, which I think is the ROOT cause of the problem. Now it is true that nerves can influence as well but I stand by my thought that it does NOT cause it. It CAN modulate it A LOT though.

So, now u know what needs to be done. The TMJ "specialist" therefore needs to have an actual video footage of this examination so he can then know how to proceed. If, for example, it is a muscular issue, he needs to know this before making a splint or whatever it is he is making. The physiotherapist also needs to know to maybe work on the muscles responsible for possibly causing a malfunction. And if it is enlarged adenoids, you can remove them. If it is an inflammation, you can use medication to get rid of it.

Now, if it is a narrow ET, I assume keeping it clear and possibly having it under check is a must but even if it is narrow, it still HAS to work properly and WILL. If it is patulous, I haven't read much about it but besides surgery I would seek myofasfial treatment because you may be able to restore function in the palatini muscles and the soft palate.

The tongue, teeth and bite are absolutely positively related to all this, I knew from day one that my stupid tongue "technique" for a "better jaw" actually sabotaged everything. I wait for TMJ appointment and will update.

There is no way in hell a healthy ear will have tinnitus if there isn't noise trauma or something growing. Let's all fix this dysfunction and get our sanity back.

When you go to the ENT, insist from the beginning to have both written / printed form of results for the other tests and video record of the ET test, handing him a list of possible causes for him to CHECK FOR beforehand, list of causes can be found in the two videos. There is no such thing as increased ear pressure, fluid and tinnitus in a healthy ear.

There are also videos of the palatini muscles you can check out and a few other ones starting from the jaw and extending back to the neck (I forget the one but it can easily cause the mandible to push backwards and mess up the upper neck).

EDIT: some first relevant links:
http://scielo.isciii.es/pdf/medicorpa/v12n2/03.pdf

https://www.treatingtmj.com/tmd/ring-in-the-new-ear/

To put it together, a thorough proper examination of the ET can determine what exactly is malfunctioning and then can focus on treatment. Months before tinnitus started I could feel anatomical changes in the masticatory muscles, then my bite, then my neck and then it hit. I'm almost certain that a LOT of others here have the same issue and their tinnitus can be eliminated.

If you find something, make sure to report back, it would help.

 

[donotringatme]

https://www.practicalpainmanagement.com/amp/166

May the reader be reminded that the eustachian tube is a passage between the oropharynx and the middle ear. The recurrent soft tissue infections with swelling caused compression of the auditory tube by continuous palatine muscle hyperactivity and started the heterogeneous referred pain to the TMJ mechanisms. Compaction of the anterior-posterior length of the palatal shelves and maxillary bone caused severe retrusion and over-closure. This is a typical extraction-retraction scenario that sometimes results from extraction of the first bicuspid teeth. Although this patient had these teeth removed when she was 16 years old, the adult malocclusion that she exhibits now is a result of gradual tooth and boney changes over the years. The maxillae and the mandibular malrelation may not have caught the attention of the ear doctors or the orofacial pain specialists.

https://occlusionconnections.com/tmj/ear-congestion-feelings-2/

Chronic contracture of the medial pterygoid can impair normal funciton of the tensor veli palitini muscles as it descends vertically between the medial pterygoid plate and pterygoid muscle and can be entrapped when the medial pterygoid is in dysfunction, preventing normal dilation of the eustachien tube lumen.

https://itshowyoubite.com/vertigo-dizziness/

A malfunction of the Eustachian tube would lead to pressure buildup. This can be due to inflammation or infection, or a muscle spasm of the muscle that controls the opening of the Eustachain Tube, the Tensor Veli Palatini. The nerve that controls the contraction of this muscle is called the Medial Pterygoid nerve which is part of the Mandibular nerve which controls the muscles that determine the way we bite. If the Medial Pterygoid muscle is in spasm (as in TMD) then the Tensor Veli Palatini muscle would also spasm resulting in a blockage of the Eustachian tube.

 

[donotringatme]

So, physiotherapist did TENS, some new stuff, trigger points in my trapezoids released, worked my upper and middle back, started doing 2 exercises for postural changes and eliminating the trapezoids from the game. Zero help for tinnitus but lots of help in general.

The issue with ETD persists and it seems that everything around it - muscle wise - affects it. Lying down right now as I'm typing this, aural fullness is increased, as if the muscles in my jaw are pushing at it. It seems that whenever c1, c2 and the mandible are involved in relation to gravity and their relevant muscles contracting, ETD changes occur as well as some very loud - and thankfully rare - tinnitus episodes (not fleeting ones) only on my right ear (tinnitus onset occurred by flicking my left ear canal though, go figure).

Three pieces of the puzzle left.
A) ETD => detailed endoscopy to determine what exactly causes the failure to equalize pressure.

B) TMD => proper work to the muscles, protocol for the misalignment, scans done for ruling out infection creeping or tonsils messing something up.

C) c1, c2 further work done to the alignment and muscles involved to help the auditory nerve, curve and the mandible itself.

Part C has been worked on a lot, has not yielded permanent tinnitus reduction, more like no reduction at all but needed to be done as it affects B.

Part B I haven't even looked at yet and I think it's where the solution lies. Had to work C first and B may be also directly influencing A, so need both C and A done beforehand.

Part A is tomorrow. It rules out everything and gives a single cause hopefully and hopefully treatable as well, I assume relatable to B.

Incoming diet:
- beets, orange, green apple and carrots juice 3/day with analogy 2-4-4-2
- cucumber, tomato, onion and oregano salad 2/day with main meals
- probiotic yogurt with 40 grams of Fitro, 10 almonds, 2 Brazil nuts, 2 bananas for breakfast
- 3 liters of water / day
- green peas with potatoes and turkey 2/week, lentils 2/week and brown beans with sardines 2/week as main meals

Avoidances:
No alcohol
No coffee
No candy, sweets, sugar
No breads at all
No cheese at all
No extra salt
No milk

This is about as healthy as a Greek diet gets before the super hardcore stuff.

Night routine:
1mg of Melatonin (been taking it for 3 days so far)
Possibly Valerian root soon

Let's see how this pans out.

 

[donotringatme]

Long Term Outcomes of Cross-Hatching Eustachian Tuboplasty

This is the single cause of somatic tinnitus. Rule out far more serious ear disorders and get to this quickly as ignoring it can lead to more serious issues.

Of course, ETD could not possibly be easy to treat or detect which is why this forum and about a hundred other pages online don't know what is going on. Now we do. Your tinnitus is because of ETD and ETD only.

Taken from the article, are some useful parts. Needless to say, you probably have to hold a gun or a knife against the ENT's head in order to have a proper endoscopy with a video capture, not to mention that treatment for this, depending on results, may only be surgical, unfortunately. However, for many, a partially working ET aka no fluid found but pressure builds up, may be saved.

So,

Exclusion criteria were allergic rhinitis, laryngopharyngeal reflux and other type of otologic or nasal surgery (those can cause ETD too).

Axial and coronal computer tomography scans of the ear were taken for measuring the width of the bony portion of the Eustachian tube (ET) and the cartilaginous portion morphology, studied while the patients performed the Valsalva maneuver, as well as identifying the internal carotid artery and the relationship with the ET.

The radiological pathology of the cartilaginous portion of the ET was classified based on mucosal intraluminal swelling as normal, or swollen/opacified (which means you have to check both the bony potion and the cartilaginous and the carotid artery).

All patients underwent a trans-nasal endoscopic slow motion video analysis (SMVEA) of their Eustachian tubes, done with a 30˚ view angle using a rigid Hopkins rod endoscope measuring 4.0 mm or 2.7 mm diameter (there are more but ask your ENT beforehand which one he operates and state what you want with it).

The ET medial structures and valve were examined.
Subjects were asked to repeat the letter K, to swallow and to yawn for better viewing of the palate, medial cartilaginous lamina, tensor veli palatine muscle (TVPM), levatorveli palatine muscle (LVPM), sphenopharyngeousmuscle (SphM) and record valve dynamics in both normal and forced motion modes (ALL of those are of paramount importance to check during this procedure, demand a video copy so you can show it to other ENTs if the one making the endoscopy is a useless tit).

All patients underwent auditory battery tests: pure tone audiometry, tympanometry, Eustachian tube—tympanometric tests (which is also mandatory before the endoscopy, also checking the tympanic membrane to see its condition and fragility).

Special attention was paid to examining the ET valve, TVPM, LVPM and SphM areas. Mucosal contact areas, polypoid or granulomatous tissue were studied in detail. Anatomical variations, such as altered cartilaginous spring of the posterior cushion, abnormally wide or thick posterior cushion, valve morphology, pronounced superior direction of the lumen and valve or absence of the posterior cushion cartilaginous super-structure (congenital or iatrogenic) were also noted and recorded. Obstructive and/or hypertrophic areas of the tube were confirmed by instrument palpation and direct visualization and its direct impact to the valve area was recorded. A tonsil mouth gag was inserted and the mouth opened (This part mentions areas to focus on and also complications that we may be having, many of which CAN be caused by prolonged improper bite and misaligned jaw, stiffness of the neck or upper back just contributes more to this development).​

 

[donotringatme]

This is it. Eustachian tube dysfunction, the root of evil, took me forty five days to determine exactly how to approach it.

So,

- it can be the muscles responsible for operating it being jammed by other muscles (which would explain a misaligned jaw or discomfort so the issue here isn't the joint and the socket but the INFLUENCE the TMD has on the ET itself, which of course requires CT and endoscopy the way previously mentioned).

- it can be inflammation that dies down (explains success stories mentioning a pop)

- it can be partial dysfunction and mucus or whatever (explains the thread from Engineer stuffing his nose with sinus meds going back and forth)

- it can be all the other things listed such as bony portion issues or a dozen other things such as adenoids going in the way during opening-closing etc, watch the videos, read the article, write them all down, go to the ENT, make him regret the day he met you.

I don't know if ear pressure changes to the eardrum during the ETD phase are responsible for tinnitus changing multitude of tones but it sure is at night where slight neck position alterations do produce a different tone and some I'm sure experience some more fullness or a tympanic membrane quick flick. I know I do. Since I'm familiar with hair loss, the same thing occurs here, where everything else seems to modulate the condition. The situation of tinnitus is ON, so any irritation of the auditory nerve, even the slightest, will lead to the maximum tinnitus loudness and pitch that the current middle ear pressure allows for. That's my theory. That's why for example, I have a pressure of x2 because my ET works partially yes? So when I lift two grocery bags or tire my trapezoids, this travels up to my neck and consequently my auditory nerve or it can even be the sternocleidomastoid and the nerve there, simply by gravity, muscle spasms, muscle tension. So THAT is modulating your existing pitch created by the abnormal condition of the middle ear. That... is what is happening. This is why you can modulate tinnitus by turning your neck over, I bet you though for many, if you turn the neck and actually hold it there it may dissipate back to pre-modulation too. If you just tense your neck, it will do the same. If you tense the jaw, protrude mandible, all those influence the ear area. Pressing the temples, same thing.

Having said that, I do not know if severe changes in one or many of those modulating areas can actually CHANGE the tinnitus for the worse permanently. I would say yes but I think the tinnitus basis is certainly held by the tympanic membrane and the pressure condition that exists in the middle ear. Now, if that is left as such for long, I will say it doesn't lead to hearing loss without presence of fluid. Which is why many people have the same inexplicable tinnitus for years without hearing loss and obviously the criminal negligence of ENTs and their "you're ok" diagnosis serve to throw us all away from the correct path.

I exercised proper tongue posture by holding and at nights thrusting my tongue to my upper palate, some of you may know it as mewing. When I said later on that this is what caused tinnitus, everyone obviously laughed at me. Well, simple things such as changing tongue habits or leading to minor but significant remodeling could easily cause misalignment and hypertrophy of the ET or any of the other problems mentioned. Since not everyone is as stupid as me to do this technique, it's obvious that something else plays a vital role and that is the mouth. The bite, the chew etc, those form and alter the muscles. This isn't a week's job. This took me two years to manifest and I believe more than 2 months for it to malfunction.

So there you go. We aren't jamming the trigeminal nerve, or the facial nerve, or the cranial nerves. We have a tiny dysfunction in the ear that leads to this mess. Stories online of ETD resolving and instant resolving of tinnitus simply confirms it. Engineer's thread with him constantly unblocking his ET and eliminating tinnitus back and forth also confirms it.

This also explains why a splint doesn't cure tinnitus for a lot of people, for some it worsens it. I think it's because it is not treating ETD and might actually either worsen it by putting pressure on a modulating area close to the ear (the way the jaw shifts) or it can be coincidental by just the ETD worsening or some other area such as the neck worsening and thus worsening the tinnitus temporarily (as you won't usually irritate the nerve permanently, which also explains why people get ups and downs to their inexplicable tinnitus, huh).

It also explains why people who catch a cold get spikes. Worsened ETD, possible fluid or no fluid, same thing, tympanic membrane takes the hit, we get a pitch. I have had 4 different slight variations of my constant high pitch and all of them when I had pressure change or MY TYMPANIC MEMBRANE moved. This is why I said days ago that if I focus on tinnitus it can kind of change. Well, if you focus on it, I assure you that you modulate both the pressure and you're activating (slightly) the muscle responsible for the eardrum (some can do it some can't).

I was busting my head trying to figure out how the hell can I have tinnitus from my auricular nerve being pinched... or how the jaw can pressure my ear canal (what?) and give me tinnitus... or how the damn nerve endings at the back of my neck - which are evidently not that far deep but still who hasn't got a stiff neck? - could instigate tinnitus.

I truly believe I'm right, here. I do think that eardrum perforation, scar tissue etc, damage to the eardrum that is, can actually cause permanent tinnitus even if ETD is fixed due to the movement / mobility it will have. Which is why putting tubes there is a horrible idea. For patulous ETD I honestly don't know but I believe there may be a way to manipulate muscles and palate into a tighter cartilaginous portion of the ET but that's just a guess.

I would say that someone who hasn't had repeated otitis media and someone whose palate elevates normally and someone who can feel and control mucus secretion from ET to his throat and someone who has no fluid build up, means there is no birth defect or a need for surgery. So it probably is a treatable condition. I don't know how a hypertrophic muscle there can revert but I assume the exact opposite of what made it hypertrophic, relax. Anyways.

 

[donotringatme]

Muscles relevant to ET:

• Tensor Veli Palatini: The tensor veli palatinitenses the soft palate and by doing so, assists the levator veli palatiniin elevating the palate to occlude and prevent entry of food into the nasopharynx during swallowing.

Insertion: Palatine aponeurosis
Origin: Medial Pterygoid plate of the sphenoid bone (scaphoid fossa)
Nerve: Medial pterygoid of mandibles nerve

• Levator Veli Palatini: Levator veli palatini elevates the soft palate and pulls it slightly backwards. This action together with the action of musculus uvulae closes the passage between the nasopharynx and oropharynx, facilitating the act of swallowing and preventing the food from passing to the nasopharynx.

Insertion: Palatine aponeurosis
Innervation: Pharyngeal plexus
Origin: Petrous part of the temporal bone & inferior/cartilaginous part of the Eustachian tube

• Salpingopharyngeus: The salpingopharyngeus is known to raise the pharynxand larynxduring deglutition (swallowing) and laterally draws the pharyngeal walls up. In addition, it opens the pharyngeal orifice of the pharyngotympanic tube during swallowing.

Insertion: Blends with palatopharyngeus muscle
Origin: Inferior/cartilaginous part of the Eustachian tube

• Tensor tympani: Tensor tympani acts to pull the handle of malleus medially. In turn, the handle of malleus pulls on the tympanic membrane and tenses it. The increased tension reduces the amplitude of the tympanic membrane oscillations and thereby reduces sound transmission to the vestibular window.

Nerve: Medial pterygoid nerve from the mandibular nerve (V3)
Origin: Eustachian tube

Also, it appears that tensor tympani is actively involved in tinnitus stemming from ETD stemming from TMD. Worth a read:

https://www.elsevier.es/index.php?p=revista&pRevista=pdf-simple&pii=S2173573510700053&r=495

It mentions: The TT muscle, during its reciprocal contraction with the TVP muscle, thus produces an internal deflection of the tympanic membrane, which appears to break the seal of the mucous membranes of the isthmus of the Eustachian tube.

the contraction opens the Eustachian tube and aerates the tympanic cavity. These normal physiological mechanisms may be hindered by TT muscle hypertonia during TMD, which would be expressed as a tubal dysfunction and accompanying symptoms: subjective hypo and hyperacusis, tinnitus, vertigo, otalgia, sensation of ear fullness and even otitis media.

TMD produce tension and contraction of mastication muscles, including the TVP and TT muscles. So, their dysfunction could alter the physiology of the ET and middle ear bones.

If the mastication muscles are hypertonic due to TMD, it is also very possible that the TVP and TT are too, given their common V3 motor innervation. Having a spastic TVP muscle would impede the normal opening and closing of the Eustachian tube by contraction and relaxation of this muscle (patulous tube or ear fullness sensation).

 

[donotringatme]

So, in other words, somatic tinnitus onset is the word "dysfunction".

The main player is ET, the condition is ETD, the evidence being increased middle ear pressure seen with a tympanic membrane test.

The common cause stated is TMD, the common condition is muscle spasms, which means there may be spasms of the TVP and TT, thus influencing directly the tympanic membrane and the ossicles. So it isn't the pressure alone to the tympanic membrane - that I hypothesized before - , it is actually the TT and the pressure together. The perfect storm. This I think now explains why postural changes modulate tinnitus, from bending to strafing to stressing to biting, chewing, clenching or anything else.

I guess correcting the TMD can theoretically restore proper function by taking away the muscle tension and malfunction issued from improper bite, misalignment etc. The trick of course is to manage it, since the neck can sabotage this as it directly impacts the jaw. The upper back impacts the neck, the core impacts the upper back and the pelvis impacts the core. I think nerves don't play a part here at least for most cases. I guess nerve damage shows more than "maybe a tiny bit of muscle dysfunction". Irritation may occur though but this is me hypothesizing, the nerve endings are ridiculous anyway, no one in their mind would try to find that.

Bottom line? We are all F'd.

All we can do is (1)manual treatment for facial muscle tension release, (2)get an orthotic to correct TMJ while monitoring and manipulating the neck and trapezoids, (3)not get cold/flu. In hopes of restoring ET function completely which I assume restores or has to restore proper function to the TT muscle, thus restoring ossicles and tympanic membrane function.

I assume that the frequent or infrequent changes in tone or new pitch episodes we experience may be the TVP spasm, thus TT spasms too even for a split second, confusing the ossicles and the cochlea(?).

 

[donotringatme]

Just to put a full stop at this for a while, here is a sum up:

Tests for the TMD to do: CMS, EMG, ESG, CBCT, MRI, X-rays

Additional tests: ET endoscopy with recorded video footage and careful diagnosis, Tympanometry with printed results, Audiogram with printed results

Treatments that seem to work for TMD: TENS, manual release, orthotic

Supplementary treatments (neck): TENS, TECAR, acupuncture on trigger points, CT for an accurate atlas view(?) (dunno if this is possible, @Greg Sacramento will know for sure).

Fun fact: orthotic treatment directly impacts shoulder stability and strength. Nuts.

 

[donotringatme]

It appears the chapter of ETD is almost done for. I will share a detailed endoscopy and diagnosis of my ET next week. It seems a new chapter opens called "oh how I messed up my jaw by clenching and applying tongue force to my upper palate". To be continued.

 

[donotringatme]

Yeah, trying to find tinnitus root is a joke. An absolute joke.

Apparently, the cartilage between the condyle and the socket has nerve endings and they relate to the ear, the outer ear for sure but I think whole ear too (?). So when a condyle acts up, it may irritate a nerve, nerve gives tinnitus. Or, muscle tension from a malfunctioning TMJ creates ETD, ETD creates tinnitus. The upper neck in c1 and c2 has nerve endings that connect to other nerves that can cause tinnitus.

I believe modulation monitoring is key to get closer to the problem. I was wrong about ETD being independent and the sole cause.

I think the neck, unless there has been injury, isn't really a root cause. The sternocleidomastoid though can directly influence the jaw and act as a modulator, with the usual movements of the neck etc. It further shows that the jaw is the culprit, the jaw is the one universal thing in all humans regardless of age that can be implicated in tinnitus. Sure, Eustachian tubes are too but we can't know which provokes which and which sets tinnitus on but we know both definitely modulate it severely. A cold can cause a massive spike, jaw discomfort does the same.

I read there is no actual scan to show all the nerves in the jaw and ear area, the area of interest. I still want to pursue a CBCT 3D of my neck to determine atlas misalignment if it is possible.

Tinnitus has not really changed much. Brain starts to habituate. It does change for the better in the morning upon standing up. It does change for the worse after eating hard food or doing strenuous activity, during which I sense that my jaw sort of tenses or both it and my sternocleidomastoid do. It does change for the worse for the ear pressing against the pillow when I sleep sideways, the other ear seems to be unaffected. Therapy with LLLT for the jaw area today seemed to significantly reduce tinnitus for a few hours.

What is the most weird thing is that I can honestly reduce or eliminate tinnitus by pushing my tragus to pluck my ear, release and do it again for 3-5 times. I don't know if I am pushing a nerve branch related to the one irritated or if I am just creating pressure closer to the negative one in the middle ear from ETD but it does work. It works for few seconds of course.

The TMJ dentist saw an overbite but not severe. Saw a single tooth in my right lower molar area that obstructs the upper palate from moving freely right and left as the tooth is pointing a bit outwards. Saw movement of the lower jaw to the left as I open it. Saw slight deviation of the lower jaw to the right when mouth is closed. Pressed on various points in the jaw area and inside my mouth that caused a lot of pain/discomfort and told me I have severe muscle tension all around, which could alone cause ETD.

@Greg Sacramento I will be having a CBCT scan of both my jaw sides, the panoramic x-rays I have are trash because they do not show the condyle enough and the mouth & head position are such that the condyle isn't on its proper testing phase during the X-ray. Dentist suggested to first take the CBCT and then determine if I need a guard or a splint.

 

[donotringatme]

There are three main theories behind why problems with the TMJ may cause tinnitus, or make it worse. Firstly, the chewing muscles are near to some of the muscles that insert into the middle ear and so may have an effect on hearing, and so may promote tinnitus. Secondly, there can be a direct connection between the ligaments that attach to the jaw and one of the hearing bones that sits in the middle ear. Thirdly, the nerve supply from the TMJ has been shown to have connections with the parts of the brain that are involved with both hearing and the interpretation of sound. The general discomfort associated with TMJ problems can also aggravate any pre-existing tinnitus.

@Greg Sacramento if you could expand on these three hypothesis made in this text I would be grateful (whenever you're free and feel like it of course).

 

[Gareth Davies]

Did anyone every tell you, you are a genius @donotringatme ?

Because you are!

Keep it up!

 

[kamil1364]

Oh dear, how do I even fix this mess lol.

Normal audiogram even in extended range, people tell me it's hidden hearing loss (how to even measure that).

Now this ETD thing, and my ENT just told me to get used to it.

People commit suicide because of it, yet no one gives a ***k to at least suggest any way of possible treatment.

You are really a genius.

 

[donotringatme]

Genius my a**.

Guys, here is the verdict from going to more physiotherapists: it's a skull bone issue, a nerve irritation issue or a muscle dysfunction issue. Manifests as cranial dystrophy, pain, joint issue, muscle tension and/or Eustachian tube dysfunction. You can try some stuff, even splints but it's literally walking in pitch black.

I am prescribed Seroxat and Seroquel to get serotonin back up and sleep. I honestly don't give a F if it stays or goes, as long as I can habituate fully and sleep like old times.

There is no beating this thing. Accept it, embrace it, move on. If you can get 8 hours of deep sleep on demand anytime, you're healed. I didn't get a single pill in my life before and I've been through some bad stuff. I'll take them now because of a tiny sound. So that's my only advice: treat the nervous system, don't be me trying to find a "cause", get sleep sorted.

God bless.

 

[donotringatme]

However, I continued the tests. The theory does seem to stand as the primary suspect.

I had all my family members perform tests in their Eustachian tubes. I have family members with tinnitus, nothing at all and some with legitimate jaw problems, both movement and nerve / pain wise.

They all performed swallowing, chewing and yawning tests. The ones with healthy ears experienced no gluey/crackling sounds at all. I mean NONE at all whatsoever. That is how a healthy ear and Eustachian tubes should be like. The family members with jaw problems I specifically triple checked, they also do not EXCEPT for OCCASIONAL such sounds in the AFFECTED by TMD ear. Less than 50%. Their healthy ear experience no such sounds. Believe me, I had them do it during 72 hours and they were about to drug me to leave them alone. But alas, we did it.

I had a day trip with my gf and all my friends to eat out during the day to a place that was in a certain altitude. During the altitude changes, my ears would pop, equalizing the pressure as a function but doing it repeatedly as the function is clearly not 100% proper. This irritated my tinnitus and caused it to go to week-1 levels almost. It subsided later on.

Therefore, ears that crackle and feel gluey point to Eustachian tube dysfunction. If ETD is present, you WILL have tinnitus. If you completely correct it, tinnitus goes away. There are so many cases of people online who literally state they get dysfunction for less than 72 hours and experience tinnitus whose pitch and loudness matches the severity of the fullness.

I will repeat that the tensor tympani muscle is connected to the palatini muscle, this can explain TTTS, TT spasms (which I also had in the beginning), indicate muscle tension, palatini dysfunction therefore ETD, etc. This could mean a mechanical issue, stemming from the usual suspects such as cranial bones remodeling, nerve irritation, jaw and bite etc, not necessarily dysfunctional in X-rays. It could also mean allergies, scar tissue, hypertrophy of the tubes (this I think stems from improper muscle co-op), check the videos listed in posts up.

My tinnitus slightly improves since onset as the tubes seem to slightly improve too. What started as massive pressure and fullness, inability to produce equalization or even gluey sounds when yawning / opening mouth, now crackling sounds occur always and better equalization, yet not even close to proper. Mind you I'm not on any medication yet and my sleep has been an absolute mess so my nerves are definitely not masking anything as they aren't improving.

Come to think about it tbh, medication and supplementation for the nerves may just be a masking agent rather than an actual move towards curing tinnitus itself (which is why cold showers and tapping the occipital works momentarily at eliminating tinnitus). Since nerve irritation is also accused of causing tinnitus though, it may not be that simple.

I've also had earwax deep in my ear canal from using Q-tips for years. I suspect it was actually very close to my ear drum, causing a slight irritation to it and change to the outer ear pressure in regards to how it was perceived by my eardrum. So, I think it was actually matching closer to the increased middle ear pressure from ETD. Eventually, Q-tips and my ear poke/jiggle to my outer canal and the wax buildup may have broken that pressure balance, causing tinnitus. ETD certainly did not come in a day. Maybe there is more to it, who knows.

Clearing wax, letting an ear drum heal and restoring ET function I think can eliminate tinnitus of a somatic / unknown cause.

Remains to be seen. I have an endoscopy with video record booked, let's see how this pans out.

 

[Greg Sacramento]

if you could expand on these three hypothesis made in this text I would be grateful (whenever you're free and feel like it of course).

I have posted those hypothesis, but I also posted other causes including mentions within your discussion above. A complete history of events such as dental visits, any whiplash/posture problems is needed to conclude. Most important is bacterial - inflammation input primary or secondary.

 

[donotringatme]

I have posted those hypothesis, but I also posted other causes including mentions within your discussion above. A complete history of events such as dental visits, any whiplash/posture problems is needed to conclude. Most important is bacterial - inflammation input primary or secondary.

Okay.

I had scans, no infection in teeth or gum or jaw.

A month before tinnitus I went to the dentist because my front upper tooth chipped. I was a nail biter. He filled the missing part and then sort of slathered the whole front part up to the gum with the same material, to give it a smooth look. I remember my jaw felt "iffy" and tired during the day, from keeping it open for long.

I also used two thin dentures matching my teeth and filled them with liquid (peroxide I think?) to whiten my teeth and keep the dentures in for an hour. I was doing that for a month or two, I think I used it last time 2-5 days before tinnitus began. No pain, no swelling, the liquid is a transparent one kept in syringes in the fridge, you fill the dentures with it.

Those are the only two dental work I've done.

Another theory is such:
I was clenching while I was pushing my tongue to my upper palate, more during my sleep. My temporalis muscles were bulging, which points to a 'backward bite'. There are two big masticatory muscles that are attached to the mandible: the temporalii and the masseters. The first one (temporalii) brings the jaw up and back, the second one (masseter) up and forward:

When one is using the temporalis too much, he may end up dragging the teeth and the palate towards his temples, which would make the bite feel tense, which does happen to me. Then, as the mandibular joint pushes against the ears, this could very well cause tinnitus. In theory, the solution this would be learn to chew/clench up and forward (pure masseter activation), which would drag your teeth away from the ears, alleviating the tension.

All jokes aside I think this is what caused my tinnitus. The text is taken from another forum and isn't written by me but from someone else. I don't know how valid the "mandibular joint pushes against the ears" is as a statement. Can it physically happen? Can a scan properly show it, @Greg Sacramento?

 

[Greg Sacramento]

temporalis muscles

What you mention with this is often a concern as the temporalis brings the jaw up and back. For those who sleep with a hand on TMD side under the temporalis as with applying palm of hand pressure, damage can be done to the jaw and temporalis causing headaches.

He filled the missing part and then sort of slathered the whole front part up to the gum with the same material, to give it a smooth look.

Did your nail biting also damage your gum?

 

[donotringatme]

Did your nail biting also damage your gum?

No. I've been told my gum and teeth roots are normal. I don't have bleeding, pain or anything.