Tinnitus Spiking/Worsened by ENT Examinations?

[Bill_]

I went to see my ENT the other day because I have a little i eczema in my right ear canal (nothing serious though). It caused me a bit of a clogged feeling though and my ENT said she wanted to do a hearing test, a tympanogram and a measuring of the hair cells just to be sure it's nothing else.

The hearing test itself was no problem, but the other two felt somewhat uncomfortable (i.e. loud). They lasted only a few seconds (the hair cell measuring was some kind of cricket-like noises for maybe 6-10 seconds per ear).

After the appointment I got a really bad headache and my tinnitus became noticeably louder.

Has anyone else experienced this? If so, was it just spiking for your tinnitus or permanent?

 

[dpdx]

No as long its not CVEMP, Caloric, ECOG, and Acoustic Reflex.

 

[Bill_]

No as long its not CVEMP, Caloric, ECOG, and Acoustic Reflex.

No, I just found out the correct term for that test is "otoacoustic emission test".

 

[dpdx]

No, I just found out the correct term for that test is "otoacoustic emission test".

not at all I did that many times and nothing happened.

 

[Bill_]

So maybe the tympanometric test ? It was a series of sounds of which only the last one (high pitch) felt uncomfortable. After she did it on the left ear I asked her not to do it on the right but she said it would be important to check at least the swinging of the ear drum so she would do the first sound .
It really did not feel "crazy loud" but my T has gone from a 2-3/10 to a 5/10 since then accompanied with a really bad headache (that went away after a night of sleep)

Still, i'm worried this could be permanent

 

[Arseny]

So maybe the tympanometric test ? It was a series of sounds of which only the last one (high pitch) felt uncomfortable. After she did it on the left ear I asked her not to do it on the right but she said it would be important to check at least the swinging of the ear drum so she would do the first sound .
It really did not feel "crazy loud" but my T has gone from a 2-3/10 to a 5/10 since then accompanied with a really bad headache (that went away after a night of sleep)

Still, i'm worried this could be permanent

I had experienced a spike with ear fullness after OAE and audiogram, but it was right after some noise exposure. My ear were very sensitive at that time.

Are you sure doctor didn't perform Acoustic Reflex test?
"It was a series of sounds of which only the last one (high pitch) felt uncomfortable"
Tympanometry doesn't make any high pitch sounds as far as I remember, but some doctors do acoustic reflex test right after tympanometry without telling you.

 

[Bill_]

I had experienced a spike with ear fullness after OAE and audiogram, but it was right after some noise exposure. My ear were very sensitive at that time.

Are you sure doctor didn't perform Acoustic Reflex test?
"It was a series of sounds of which only the last one (high pitch) felt uncomfortable"
Tympanometry doesn't make any high pitch sounds as far as I remember, but some doctors do acoustic reflex test right after tympanometry without telling you.

That might be the case - I tried calling my ENT to ask but she's busy atm. I'll try to figure that out.
What's strange though is that the T seems to be louder overall (like in the middle of my head) but the loud noises (which may or may not have been the acoustic reflex test) were only in my left ear....

 

[Arseny]

That might be the case - I tried calling my ENT to ask but she's busy atm. I'll try to figure that out.
What's strange though is that the T seems to be louder overall (like in the middle of my head) but the loud noises (which may or may not have been the acoustic reflex test) were only in my left ear....

Do you have results that look like that? (bottom half of the picture)

I have a few sounds in my left ear (low pitch and Morse code they are coming mostly likely from ETD/TTTS), but the main sound is in the left side of my head. High pitch 15000 hz hiss. Sometimes it feel like it's coming from middle of my head or both ears, but with sufficient masking it becomes apparent that it's mostly located in my left side of the head.

Click on the picture to enlarge it.

 

[Bill_]

Do you have results that look like that? (bottom half of the picture)

I have a few sounds in my left ear (low pitch and Morse code they are coming mostly likely from ETD/TTTS), but the main sound is in the left side of my head. High pitch 15000 hz hiss. Sometimes it feel like it's coming from middle of my head or both ears, but with sufficient masking it becomes apparent that it's mostly located in my left side of the head.

Click on the picture to enlarge it.

View attachment 25226

I just had my ENT on the phone. She said there was definitely no acoustic reflex test, only Audiogram, OAE and tympanometry (the latter of which does contain some measurement of reflex but nowhere near anything like acoustic reflex test.)
She said she can guarantee that none of these tests went beyond 90dB. She also said that it might be possible that one of the frequencies used in the test came close to my T's frequency and therefore may have caused some kind of "resonance effect" which should be temporary.....

I guess I'll just have to wait. Took a 500mg magnesium and zinc though - just in case

 

[Arseny]

I just had my ENT on the phone. She said there was definitely no acoustic reflex test, only Audiogram, OAE and tympanometry (the latter of which does contain some measurement of reflex but nowhere near anything like acoustic reflex test.)
She said she can guarantee that none of these tests went beyond 90dB. She also said that it might be possible that one of the frequencies used in the test came close to my T's frequency and therefore may have caused some kind of "resonance effect" which should be temporary.....

I guess I'll just have to wait. Took a 500mg magnesium and zinc though - just in case

90 db? 80 db inside your ear is enough to cause damage to some people. Sorry I don't want to cause you additional distress, but several people got their tinnitus from acoustic reflex test alone! You can also take NAC, but it seems to be only good in preventing damage. I think if your spike doesn't subside in a few days you should consider steroids (within a week of this episode) and HBOT if your tinnitus really jumped from 2 to 5. This is a very big increase.

Can you share a photo or a scan of your results? You can mask out your personal info if you like. On my tests OAE shows it was 75 db. Tympanometry should be around 60-65 db.

"She also said that it might be possible that one of the frequencies used in the test came close to my T's frequency and therefore may have caused some kind of "resonance effect" which should be temporary....."
She just made it up to make you feel better. You should experience residual inhibition from listening to the frequencies of your tinnitus and not a jump from 2 to 5 that lasted several days!

 

[Bill_]

90 db? 80 db inside your ear is enough to cause damage to some people. Sorry I don't want to cause you additional distress, but several people got their tinnitus from acoustic reflex test alone! You can also take NAC, but it seems to be only good in preventing damage. I think if your spike doesn't subside in a few days you should consider steroids (within a week of this episode) and HBOT if your tinnitus really jumped from 2 to 5. This is a very big increase.

Can you share a photo or a scan of your results? You can mask out your personal info if you like. On my tests OAE shows it was 75 db. Tympanometry should be around 60-65 db.

"She also said that it might be possible that one of the frequencies used in the test came close to my T's frequency and therefore may have caused some kind of "resonance effect" which should be temporary....."
She just made it up to make you feel better. You should experience residual inhibition from listening to the frequencies of your tinnitus and not a jump from 2 to 5 that lasted several days!

Thanks for your reply. I must add that I asked her something like "but those test weren't anywhere near dangerous loudness levels? Like above 90dB?" and she replied "no, definitely not. I can guarantee that none of those tests went above 90dB"
So might have kinda "fed" those 90dB to her.

Also all this only happened yesterday. It's been 25h to be quite exact. So at least it's not "several days". I guess I'll just have to wait and see

 

[Arseny]

Thanks for your reply. I must add that I asked her something like "but those test weren't anywhere near dangerous loudness levels? Like above 90dB?" and she replied "no, definitely not. I can guarantee that none of those tests went above 90dB"
So might have kinda "fed" those 90dB to her.

Also all this only happened yesterday. It's been 25h to be quite exact. So at least it's not "several days". I guess I'll just have to wait and see

Do you have a history of reactive tinnitus or hyperacusis? Did you experience prolonged spikes before?
What did she mean by "the latter of which does contain some measurement of reflex but nowhere near anything like acoustic reflex test."
Measurement of reflex IS acoustic reflex test. There are no high pitch sounds or tones present with tympanometry. They literally just flex your eardrum with air. I did it twice and it sounded very low pitch. No discomfort at all.
You should call your doctor again and confirm that she didn't do any acoustic reflex tests and ask about the volume of the tests. Let her tell you the volume herself.
If your spike doesn't settle down by tomorrow AND you don't have history of highly reactive tinnitus then I think you should seriously consider taking steroids. They are most effective within 1-24-48 hours after onset.

 

[Bill_]

Do you have a history of reactive tinnitus or hyperacusis? Did you experience prolonged spikes before?
What did she mean by "the latter of which does contain some measurement of reflex but nowhere near anything like acoustic reflex test."
Measurement of reflex IS acoustic reflex test. There are no high pitch sounds or tones present with tympanometry. They literally just flex your eardrum with air. I did it twice and it sounded very low pitch. No discomfort at all.
You should call your doctor again and confirm that she didn't do any acoustic reflex tests and ask about the volume of the tests. Let her tell you the volume herself.
If your spike doesn't settle down by tomorrow AND you don't have history of highly reactive tinnitus then I think you should seriously consider taking steroids. They are most effective within 1-24-48 hours after onset.

Well I have had spikes before, most of them were less grave though. Also they lasted from a few hours to up to several weeks.

I don't think I can't get any steroids before Monday though. Last time I took prednisolone (oral) that caused a spike. Is IV better?
I'm just so f*cking confused -again- i don't know what to do

 

[Arseny]

Well I have had spikes before, most of them were less grave though. Also they lasted from a few hours to up to several weeks.

I don't think I can't get any steroids before Monday though. Last time I took prednisolone (oral) that caused a spike. Is IV better?
I'm just so f*cking confused -again- i don't know what to do

Steroids can cause spikes, because they affect your adrenal glands. Prednisolone might be ototoxic itself. You can consider Dexamethasone. You should try HBOT if it's available at your location.
I don't know if IV is better or not. But intratympanic injections are definitely better.

 

[Bill_]

Steroids can cause spikes, because they affect your adrenal glands. Prednisolone might be ototoxic itself. You can consider Dexamethasone. You should try HBOT if it's available at your location.
I don't know if IV is better or not. But intratympanic injections are definitely better.

Ok, just came home from ER because that was the only place where i could a prescription for steroids. The doc there (also an ENT) was very sceptic about those tests conducted, too. He was shaking his head in disbelief actually - he said she should have known that this could aggravate my T.
Well, no use crying over spilled milk i guess. I got prescription for prednisolone (oral, 10 Days, starting with 100mg) but i am kinda hesitant since i have read reports about prednisolone worsening T and i actually have experienced a spike caused by prednisone earlier this year...
Again, i don't quite know what to do....

 

[Arseny]

Ok, just came home from ER because that was the only place where i could a prescription for steroids. The doc there (also an ENT) was very sceptic about those tests conducted, too. He was shaking his head in disbelief actually - he said she should have known that this could aggravate my T.
Well, no use crying over spilled milk i guess. I got prescription for prednisolone (oral, 10 Days, starting with 100mg) but i am kinda hesitant since i have read reports about prednisolone worsening T and i actually have experienced a spike caused by prednisone earlier this year...
Again, i don't quite know what to do....

Sorry I couldn't respond right away. Did your last spike lasted long from Prednisolone? Just from one dose?
You can consider taking 600-1200 mg NAC before Prednisone. You can try IV sodium thiosulfate too to prevent ototoxicity.
I think you should stay on the safe side and take steroids, but it must be your decision.

I'm actually on third steroid course in last 2 months... 3 spikes due to noise exposure in 2 months

 

[dpdx]

I sustained hearing damage from caloric test and cvmep, those hearing tests such as acoustic reflex and ecog are most likely going to damage hearing and worsen tinnitus. I have had 8/1o tinnitus for a year after those tests, before it was a 2/10 tinnitus.

 

[Tamara]

But when you tell the professionals responsible for it, they don't believe and still think you are crazy because of their ignorance. I said that I had already noticed that it was getting worse, and I had already read several people complaining about the same thing. They said: you have to stop reading things that have no value on the internet!
They don't give the minimum value for what the people "who have the problem" say about their symptoms.

 

[Bill_]

I sustained hearing damage from caloric test and cvmep, those hearing tests such as acoustic reflex and ecog are most likely going to damage hearing and worsen tinnitus. I have had 8/1o tinnitus for a year after those tests, before it was a 2/10 tinnitus.

Had i only known that last thursday.... they did only tympanometry, OAE and some kind of reflex testing (which is not exactly the same as auditory reflex test but similar). I can't really say exactly but i think my T went from somewhere around 4/10 to a 6/10. It can handle it when its either super quiet or if i'm busy (like reading or watching something interesting on TV).
Have you noticed ANY improvement since onset? Be it ever so minor?

 

[dpdx]

Had i only known that last thursday.... they did only tympanometry, OAE and some kind of reflex testing (which is not exactly the same as auditory reflex test but similar). I can't really say exactly but i think my T went from somewhere around 4/10 to a 6/10. It can handle it when its either super quiet or if i'm busy (like reading or watching something interesting on TV).
Have you noticed ANY improvement since onset? Be it ever so minor?

no because it damaged my inner hair cells.
it was 1 minute of a 90db hearing test and then water blasted into the ears, next day I got Hyperacusis and then Tinnitus went from a 2/10 to a 8/10. (this happened January 16,2018).

 

[dpdx]

But when you tell the professionals responsible for it, they don't believe and still think you are crazy because of their ignorance. I said that I had already noticed that it was getting worse, and I had already read several people complaining about the same thing. They said: you have to stop reading things that have no value on the internet!
They don't give the minimum value for what the people "who have the problem" say about their symptoms.

they dont care about you or your health but your $$$$$
doctors are garbage.

 

[Bill_]

no because it damaged my inner hair cells.
it was 1 minute of a 90db hearing test and then water blasted into the ears, next day I got Hyperacusis and then Tinnitus went from a 2/10 to a 8/10. (this happened January 16,2018).

Sorry to hear that :/ one might say that i had at least a bit more "luck". I'm still struggling with steroids though. Just not sure if i should take them since both of my kids are sick and i don't want to contract any infections. My other ENT (not the one who did the tests) says i should take the steroids....i don't know

 

[Emperor-Drax]

Shouldn't there be a big, bold warning at the top of the TT main page that warns newbies against ENT-sanctioned hearing tests?

 

[Bill_]

no because it damaged my inner hair cells.
it was 1 minute of a 90db hearing test and then water blasted into the ears, next day I got Hyperacusis and then Tinnitus went from a 2/10 to a 8/10. (this happened January 16,2018).

BTW: did you take any steroids afterwards?

 

[dpdx]

Shouldn't there be a big, bold warning at the top of the TT main page that warns newbies against ENT-sanctioned hearing tests?

Right. I made a page for newbies to avoid ear tests which can permanently damage their hearing.

 

[dpdx]

BTW: did you take any steroids afterwards?

doc wouldnt give it to me...they thought I was crazy and made me seem like I am mentally ill when I told them that the tests worsened Tinnitus and gave me Hyperacusis (Severe).

 

[Emperor-Drax]

When my ENT referred me to a VEMP test, I was thinking "oh no... I've heard of that... the Tinnitus Talk people were talking about it. No way!"

 

[dpdx]

Sorry to hear that :/ one might say that i had at least a bit more "luck". I'm still struggling with steroids though. Just not sure if i should take them since both of my kids are sick and i don't want to contract any infections. My other ENT (not the one who did the tests) says i should take the steroids....i don't know

You need to tell them beforehand that no loud ear tests

 

[Bill_]

You need to tell them beforehand that no loud ear tests

I actually DID that! I specifically asked if any of those tests are loud in any way, because I HAVE TINNITUS! The examiner said literally that theres NOTHING to worry about. Well, you already know the rest of the story...

 

[dpdx]

I actually DID that! I specifically asked if any of those tests are loud in any way, because I HAVE TINNITUS! The examiner said literally that theres NOTHING to worry about. Well, you already know the rest of the story...

Bill, what can we do? what has happened has happened. We have to protect this last bit of hearing we have. I have Severe H on both ears and it sucks since those tests, it is not going to get better I just know it, but what can I do? its done.