Tinnitus Following Ear Syringing: No Hearing Loss, No Obvious Trauma to the Ear

[DominicZ]

This is my first post after reading several threads regarding ear syringing.

I had impacted ear wax that was muffling my hearing in both ears. Without doing much research, I found the first hearing center that was open during COVID-19 which performed ear syringing. I softened both ears with olive oil 10 days prior to the procedure. The procedure went well and my hearing improved vastly.

However, 2-3 days later I woke up with loud ringing in both ears. It would subside during the day to a background high-pitch sound that I could tolerate. The ringing would appear louder at night which I could often mask with a white noise generator to fall asleep. But lately the masking has not been working.

Interestingly, the ringing is worse as soon as I wake up, and even after a short nap. It has been about two months (4/28/20) since the syringing. I followed up with the hearing center for a hearing test which showed no hearing loss. I followed up with an ENT who found no obvious trauma to the external ear or eardrum.

Cut a long story short, I'm concerned this will become a chronic problem. I've tried more exercise and diet changes, but with little effect. If anything my BP has increased from a normal 125/80 to 135/90, so my doctor put me on medicine to reduce it.

 

[billie48]

The ringing would appear louder at night which I could often mask with a white noise generator to fall asleep. But lately the masking has not been working.

Welcome to the forum. Do you have very high pitched tinnitus? If so, you may want to try sounds of heavy rain, shower, waterfall, cicadas etc. That was what I had to use initially. Because of hyperacusis also, I really couldn't set the volume high enough to cover the screaming tinnitus. So don't worry too much if your masking doesn't cover the ringing. In fact, in TRT treatment, patients are told to set their masker slightly lower than the ringing so the brain will have a chance to get used to the ringing without panic.

If you are using a white noise machine which may have limited choices of sounds, you may want to try using the phone to download apps for tinnitus masking. There are many choices and you can then play them with bluetooth speaker. Some even allow you to build your own sounds for best masking effect.
Hope you feel better soon. Take care. God bless.

 

[DominicZ]

Thank you for responding to my post. Yes, it seems mostly high-pitched centered around 10Khz. Oddly, it doesn't manifest everyday. On some days, I hardly notice it because it is in the background. Then out of nowhere, it will become loud as soon as I get ready for bed. I believe it is because I'm anticipating it. It will start in the right ear and then spread to the left. Once it kicks in, I hear it all night. I've been using a phone app called Sleep Pillow which generates white noise as well as combinations of nature sounds. If I'm really tired, the app will mask it for a while and I sleep for 2-3 hours. But once I wake up, the ringing is even louder and it's almost impossible to get back to sleep. My Dr. suggested I try Valerian root which is mildly sedative and non-addictive. I'll let you know how it works. Reading your threads, you've been through a lot and I take confidence in the advice you have been providing.

 

[Mr_Orange_3737]

Hi DominicZ, I've been researching others who have had tinnitus start after syringing. My situation is similar and just started earlier this month.

Did any doctor's mention anything about Eustachian tube dysfunction? I also have no hearing loss, but all my symptoms seem related to Eustachian tube dysfunction. I also have a retracted right ear drum.

You might want to look up Eustachian tube dysfunction.

There's a lot of info about these issues individually, but I have yet to find a direct link of syringing leading to Eustachian tube dysfunction.

 

[DominicZ]

Hi Mr_Orange_3737, you raised an excellent point. I've seen two ENT's. Both seemed to rule out ETD based on a nasal endoscopy. Nevertheless, I believe I still show the classic symptoms (ear fullness, sensitivity, high-pitched ringing, etc). My tinnitus is consistently worse/louder in the morning, when I sometimes wake up congested. I've tried sleeping with a humidifier, which didn't make a difference. I'm wondering if I have some persistent low-level sinus blockage.

Did your tinnitus start immediately after irrigation and have nasal sprays or antihistamines made any difference for you?

 

[Mr_Orange_3737]

Mine started 5 hours after the syringing.

I've already been taking nasal sprays for years and antihistamines for about 1 year. It's odd because it seems like a lot of people with ETD seem to be trying to tackle their allergies for the first time, where I've already been on top of it for a while. I even have a good air purifier at home.

The new thing I picked up on was to aim the nasal spray towards your head and then towards your ear and valsalva gently afterwards. We'll see if that makes a difference.

I'm really worried that syringing causes it's own type of problem unrelated to ETD.

Let's compare more notes on symptoms. What do you notice when you do the valsalva gently? The most common thing for me is that left side pops fully and quickly and the right side (ringing side) seems to pop late and only half as much. I also get a crackle in each ear when I swallow.

Does your fullness feeling fluctuate? Mine does many times during the day.

I also do notice a sensitivity to sounds too.

Do you know if nasal endoscopy is a definitive way of testing ETD? I want to find alternatives to the tympanometry test since I heard it made tinnitus worse for some.

 

[DominicZ]

Hi Mr_Orange_3737, we appear to have some symptoms in common. Here are my responses to your questions:

(1) What do you notice when you do the valsalva gently? Initially, the good ear pops first followed by the bad ringing ear. After that, they pop together. I do notice a crackle in each ear when I swallow, but I think I've always had that.

(2) Does your fullness feeling fluctuate? Yes, worse in the morning when I wake up (and the tinnitus is louder). Decreases during day and ramps back up at night.

(3) I also do notice a sensitivity to sounds too. Same here, mostly notice it when watching TV or listening to radio in car or on cheap speakers. I appear mostly sensitive to high frequencies.

(4) Do you know if nasal endoscopy is a definitive way of testing ETD? I don't believe it is. The ENT only used it check for sinus blockage. The audiologist used tympanometry to test my eardrum mobility. It didn't worsen my tinnitus. However, it did reveal that my ringing eardrum appeared stiff or slow to respond to the air pressure test. I asked if that has a cause for concern, and both audiologist and ENT said no.

The ENT ruled out ETD, but recommended I use NeilMed sinus rinse. Like you, I'm worried that syringing causes it's own problem unrelated to ETD. The tinnitus I experience sounds like an electrical hissing.

 

[Mr_Orange_3737]

I've got some interesting updates DominicZ.

I just finished a 5 day Prednisone course this past Saturday. From what I read on these boards, Prednisone helps with EDT but also generally with a variety of tinnitus sufferers too.

So... I still have the tinnitus, but there's a unique change in the sound that I've noticed on the morning hours of Friday, Sunday, and today. When I covered my right ear (the ringing one), I heard 2 sounds. 1) The typical sharp ringing was still there but dimmed by 50%. 2) Simultaneously there is another sound that's almost like you're listening into a deep room and there's birds lightly chirping all the way in the back of the room. Basically, the tinnitus has gone down a bit.

It wouldn't stay like that though because by night time it usually went back to that higher pitched sound again. Keep in mind though that I've only had the "hear it in quiet rooms" level of tinnitus even since early on.

Here's the other odd thing that's coincided with all of this. On those mornings where I experienced this, I remember waking up side sleeping on the side of my ringing ear. This is not typical for me because I'm a back sleeper. However, I toss and turn a lot and will occasionally wake up on my side. After noticing this the first time, I remember deliberately trying to side sleep on the ringing ear when I woke up in the middle of the night or too early in the morning (happens often for me). This is not easy to do because having your ear in the pillow increases the loudness of the ringing. But it did work for me when I felt tired enough.

I've also been feeling that fullness feeling only once a day now.

These changes are subtle though and the fluctuations make it hard to say for certain what's really going on. It's still early. I'll keep you updated.

This is all to say, I'm really curious if the Prednisone has caused a shift. Not going to say for certain yet but you may want to look into it with your ENT. I should give fair warning to all that the Prednisone increases your anxiety and insomnia and thus temporarily increases your tinnitus in some instances. It was a rough 5 days, especially that first night. They didn't warn me to take all the pills in the morning at first to decrease the insomnia.

Hang in there. I'd like hear more about your situation.

 

[DominicZ]

Thanks for the updates Mr_Orange_3737. My doctor did not suggest Prednisone, but did prescribe Trazodone to help me sleep. It worked the first few days. I would sleep 4 hours instead of the usual 2 hours, but the tinnitus always seemed louder the next morning. After it stopped working, I switched to 3 mg extended release Melatonin. After about a week, I slept better (4-6 hours), felt less groggy, and the tinnitus seemed quieter in the morning. There are some days when I feel the tinnitus is "in the quiet room phase" but generally it is always there in the background. I guess I'm slowly habituating. Like everyone, I wish I could find the root cause or turn back time to before the tinnitus started. I suspect that the ear syringing caused acoustic trauma to my right ear drum or damaged a nerve. I don't know how, perhaps the pressure setting was wrong or the operator screwed up. I had my ears syringed 10 years ago without incident. Since our situations are very similar, I'm very interested in learning how your situation progresses. Are you taking any supplements that seem to be effective?

 

[Mr_Orange_3737]

I've always taken a multivitamin, extra vitamin D, and fish oil. This past month the new supplement I've been taking is Turmeric Curcumin (1000mg/day) based on researching this forum. Never really noticed a significant drop in the tinnitus right after taking it though.

I tried melatonin and magnesium earlier this month and had some of the scariest dreams of my life. I heard this could also be from marijuana withdrawal. I also went completely off alcohol and caffeine for a month to rule out ETD. These things have been part of my daily routine for years now and I do think the withdrawal has contributed heavily to my anxiety and thus the tinnitus as well.

I'm beginning to read up on the issue of ototoxicity (ear toxicity) in antihistamines which I've just started taking a year ago. Might consider taking a month off these too.

I've had success with sleep (6-8 hours). You should look up 'sound enrichment' on these forums where they say the key is to use masking sparingly and at low levels. The thing I'll add is that since my tinnitus is high pitched, water sounds combined with birds works the best. Any kind of higher pitched masking noise generally works better than say the low hum of my air purifier and allows you to set it at those lower levels. I'm also currently working from home because of COVID-19 so that helps a lot too.

I've been on the same trajectory for the past few days. In the mornings the high pitch is quieter accompanied by the birds-chirping noise, but it always returns in fluctuations after mid-day.

I just got some alarming updates after some new meetings with my 2 ENT's. So far, only my 2nd ENT has seen my audiogram. Both the audiologist (who did the test) and this ENT just said that my hearing is within the normal range at first. Last week I sent my audiogram to the 1st ENT and had a phone call and he immediately gave me very different feedback. He said that although my audiogram graph falls within the normal range, there is a slight dip in the 3 kHz frequency range. This 1st ENT seems fully convinced that this is the cause. I brought this up to the 2nd ENT in a meeting the next day and she immediately changed her narrative and started to agree with this. She said that the Predisone is suppose to be really good at dealing with EDT so now she's less convinced that this is EDT.

Both ENT's say that the dip in hearing loss is very slight though and does not qualify me for hearing aids. This could be why my tinnitus isn't that loud.

The part that doesn't make sense to me is that both ears show that same dip in the audiogram. It's odd because: 1) I only hear the tinnitus in the right ear and have fullness on just the right ear. 2) How could the syringing have done a perfectly equal amount of damage to each side even though they syringed the left 2 times and the right just once?

The frustrating thing is that every doctor so far refuses to acknowledge or even speculate on the syringing having anything to do with it. They are clearly trying to dodge any liability. I've never had experience getting legal compensation for something like this but I'd imagine it would be expensive and difficult since my insurance company is a big one. Have you considered getting any compensation, DominicZ?

I have another hearing test soon and I'm going to get feedback from a 3rd ENT. I'm also going to create another thread to specifically analyze this audiogram of mine.

 

[DominicZ]

I have been using a phone app called SleepPillow that plays white noise and nature sounds which has helped me sleep (together with the melatonin). I experimented with cutting out caffeine, alcohol, and artificial sweeteners for a week. It made no difference. My doctors deny that syringing can cause tinnitus, even when I explain that it only started a few days after the procedure. They have no other explanation other than it is a coincidence. Let me know what your next ENT tells you.

 

[Mr_Orange_3737]

There's so little info on our type of situation. I'm not sure if you've seen this study that's been posted on these forums regarding tinnitus from wax removal:

http://www.tinnitusjournal.com/arti...resulting-from-cerumen-removal-procedures.pdf

It basically says that out of 2400 patients who had tinnitus at one particular clinic, only 11 of them had it after wax removal. So I guess it is quite rare and somewhat validates why our ENTs are all so baffled. The article also indicates that all 11 of them seem to have eventually recovered based on the chart. The longest recovery time was 7 years and the shortest was 3 months. Many of these patients are quite old too. One of them even had some documented hearing loss.

I hope I'm interpreting this study correctly. You should read through it too to see if I got it right. I know this is a study just from one clinic but it might give us some hope for recovery if all 11 recovered.

 

[DominicZ]

@Mr_Orange_3737

I did see that article a while ago. I was hoping it could provide some insight into how or why syringing/irrigation could cause or worsen tinnitus. The result that many folks eventually recovered is promising for us. I'm at the 4 month mark since my tinnitus started. I'm having 1-2 good/quiet days followed by a spell of bad/loud days which usually occur after a sleepless night. The loudness and frequency change quite often, which makes it hard to habituate and mask. Nevertheless, I try to remain optimistic that it will improve eventually. This forum is a great resource.

 

[Mr_Orange_3737]

I'm having a hard time with the fluctuations too. The quiet moments kind of get your hopes up and then at night it fires back up for me.

I actually can't hear it for the most part when outdoors and in my car when the AC is on. I've been trying to go on hikes a bunch.

Do you notice noise sensitivity only indoors? I'm wondering if quiet environments feed this part of it too.

Have you spoken to your doctors about hypercausis at all? I need to ask more about this during my next visit. I use to listen to podcasts all day and now a lot of the low quality recording ones are so hard to listen to. Music is actually okay for the most part but I try to listen with the volume pretty low.

 

[DominicZ]

@Mr_Orange_3737

Frankly, I don't think any of my doctors know much about tinnitus let alone hypercausis. I've gotten more valuable information and strategies from posts by@MichaelLeigh. I don't feel pain from particular sound amplitudes or frequencies. However, I do notice that certain high pitch sounds will trigger a similar pitch in my ears. If I'm lucky, it will subside quickly. If I'm particularly stressed, the spike can last all day. I don't use headphones anymore and listen to classical music at low volume.

 

[Mr_Orange_3737]

I see, I'm not sure you have same type of sensitivity I've got then. I've heard a few times that annoyance from dishes clanking is a common sign of hyperacusis. I've been having to put things down gently. Even a squeeze bottle cap opening sounds extra sharp.

For me, all the masking sound videos on YouTube with high pitched tones seem to work better. Anything that's a R2D2 sound, crickets, birds chirping seems to disrupt the tinnitus. It surprising how I can even have those on at much lower volumes than deeper tones like say ocean waves.

Here's another article that talks about syringing and tinnitus:

https://hearinglosshelp.com/blog/ti...ng-and-middle-ear-infections-whats-the-score/

 

[DominicZ]

Thanks for the article. It's a little depressing to read. I believe the syringing traumatized my ear drums, particularly in the right ear and probably caused some high-frequency hearing loss. I keep hoping for gradual improvement because I'm having more occasional good days. But, as you have also noticed, the good days can get your hopes too high. I'm sorry to learn about you hyper-sensitivity to sound. From what I have read in posts by @MichaelLeigh it will improve as you keep protecting your ears.

 

[Mr_Orange_3737]

I'd be curious to see your audiogram. I've already taken 2.

I also bought a dB reader. I can hear my tinnitus between 30-42 dB (normal living room range). Outdoors (Los Angeles city area) is 50+ dB which makes the tinnitus unnoticeable. It's interesting how even that slight bit of a difference masks the tinnitus.

Here are my audiograms. The dip in the 3-4 kHz range is where that first ENT said I have my hearing loss. What's interesting is on the 2nd audiologist who did the hear test, I asked her 1)if she saw anything that indicated hearing loss and 2) if she saw anything that indicated tinnitus. She said no to both of those. After I told her, what that first ENT said, she was surprised and and just said that ENT's have their own way of evaluating things.

 

[Mr_Orange_3737]

Here are my audiograms:

1st test

2nd test

 

[DominicZ]

Thanks for sharing your audiograms. Mine look remarkably similar, with dips between 2-4Khz in both ears. My audiologist commented that I have the hearing of a teenager, which was flattering considering I am 63. I measured my tinnitus using a tone generator and it appears to be centered around 10Khz, which regular audiograms don't go up to.

 

[Mr_Orange_3737]

I've spoken to a 3rd ENT who also says I have no hearing loss. It's amazing the amount of mixed feedback I'm getting from doctors.

I'm trying to get to the bottom of how to properly classify our type of tinnitus. I read that if it's not hearing loss related, there's a higher recovery chance.

Can you hear your tinnitus when outdoors?

I'm glad you don't have the hyperacusis part of it. This part has been getting worse for me.

 

[DominicZ]

Yes, on bad days, I can hear it outside when I'm walking in my neighborhood which is fairly quiet. It's typically a high pitch hiss. My ENT commented that although my regular audiogram doesn't show significant hearing loss, I may still have loss at higher frequencies (> 10Khz) which only extended audiograms can measure. I haven't found a place that does those. I'm hoping for a recovery, but I'll accept a reduction in volume at least a night. I sincerely hope your hyperacusis improves.

 

[Mr_Orange_3737]

I created a post asking about my audiogram. You can find it here:

https://www.tinnitustalk.com/posts/550929/

Please post your audiogram on there too if you like. I think it's very relevant since it's so similar.

That's the first time I heard about the extended audiogram. Thanks for sharing. I'll have to look into it. Mine is is also high pitched.

Which tone generator did you use by the way? I'd like to try this too.

I can hear it outdoors only in quiet hiking areas. Since I'm in LA, most neighborhoods have constant noise in the 50 dB range.

DominicZ, where do you live?

 

[DominicZ]

I used this site to measure my tinnitus tone:

https://www.audionotch.com/app/tune/

It's approximate, but got me close. Be careful to set the volume on low.

I live in the MD suburbs, where it is probably quieter than LA (where I lived over 30 years ago). I hear the tone when I'm out walking, at home when the AC is not running, and in bed when I'm trying to sleep.

 

[Mr_Orange_3737]

Hey DominicZ, sorry, been busy with moving so I haven't checked in on these boards lately. I've also been frantically trying to find a good dentist. That's a whole other rabbit hole to go down if you search that on these boards.

How's the tinnitus situation, any improvements? Any new insights? I actually got referred over to an otologist (I didn't even know there was anything beyond ENT) and she just told me to try to stay distracted through masking and doing tasks and thinks that it should go away from 6 months to a year. Not much nuance beyond that.

Still trying to find someone who actually specializes in tinnitus. They're all so expensive and not covered by insurance so I'm stressing out over picking the right place.

I live in the MD suburbs, where it is probably quieter than LA (where I lived over 30 years ago). I hear the tone when I'm out walking, at home when the AC is not running, and in bed when I'm trying to sleep.

Where you are outdoors for sure makes a difference. There's one particular hiking place where I often hear it outside. You can get a decibel meter to see what level of ambient noise drowns out your tinnitus. I find the decibel meter gives you some relief too because it assures you that certain things aren't as loud as you think.

 

[DominicZ]

Hi @Mr_Orange_3737

No need to apologize. A lot going on these days. Hope you find a good dentist. My situation hasn't changed too much. My ENT said the same thing, which is get used to it. I was researching sleep pillows and decided to build my own by wrapping a set of small headphones in foam and stuffing them into a pillow. I then connect my smartphone and play pink noise at a very low volume. I find it has helped relax and distract me from the high pitch ringing. Anyone else had success with using a sleep pillow?

 

[Mr_Orange_3737]

I've been using the Sound Oasis machine which has this feature called sleep enhance. It slows down the sounds gradually over time and that's suppose to help your get better sleep. Not sure how legit that is, but I've still been able to get 7-8 hrs no problem every night since this all started.

One thing about masking is I noticed I get desensitized to sounds very quickly. I have to always change the type of sound frequently so I have a wide variety of the youtube ones saved. If I wake up in the middle of the night, I'll change the sound on my sound machine.

 

[DominicZ]

I had a similar sound machine, but it had limited choices. When not using the sleep pillow, I play sounds from my phone to a bedside speaker via Bluetooth. I get better sound quality and more variety. I too noticed that I would have to change the sounds occasionally as my brain got used to a particular track.

I'm having more good days since I've been sleeping better, but the bad days always seem worse. Tinnitus is such an asymmetrical enemy. Just when you think you beat it, it finds a new way to intrude. Reminds me of plugging a water leak in my basement. The water always finds another crack to get through

 

[Mr_Orange_3737]

Yes, at some point I need to figure out how to just loop a huge library of saved YouTube videos on random at low volume all day. It'd be great to even add pauses in between them somehow (or maybe filler videos of noises that don't work as masking).

I wonder what effect it would have if this daily masking process was more passive (just hit play once in the morning) and constantly randomized with a lot of variety. Maybe it might aid further in taking your attention away from the tinnitus.