When I Plug My Ear My Tinnitus Sound Goes Away?

[Tapman 101]

Dr. Nagler,

I have only had tinnitus for about a month (December 2019). From the outset I have been able to plug my right ear (the one with tinnitus) and make the ringing/hissing stop. When I had my hearing tested, the noise cancelling headphones stopped the tinnitus for the duration of the test. Hearing tested perfect.

Also, if I play a video game with my son online with a earbud in my left ear (non-tinnitus ear) the tinnitus goes away for up to an hour afterward. Is that indicative of anything in your experience?

Is my situation an indicator of a deeper issue? My tinnitus started after I took 800 mg. of Ibuprofen one night. I also had made the decision to be angry as heck at some things in my life and not count my blessings.

My tinnitus has fluctuated a lot recently. I had 5 quieter days in the past week. Yesterday it was almost noticeable to the point where I actually went outside and relaxed in silence for a bit.. Today it is louder, but that might be due to anxiety because I feared the potential day-to-day increase from the bliss of last night. Is there a chance drastic fluctuations to the point where I had silence yesterday indicative of a recovery possibility?

What I really want to ask is, is the thing where I can block my ear and make the sound go away common? Since tinnitus is only in one ear, can that indicate a tumor or something?

Sorry for the laundry list of questions, but I am new and learning to cope (hopefully habituate).

Thank you.

 

[Dr. Nagler]

Apologies for the delay in responding, @Tapman 101. I want to give your post a bit more thought. Please check back in a day or two. Thanks.

Stephen M. Nagler, M.D.

 

[Dr. Nagler]

OK, @Tapman 101. It's a bit complicated - but before I give you my take on it, please let me share some advice that may well be worth nothing more than you are paying for it.

You are one month into your tinnitus journey, and it seems to me that you are trying to "figure out" your tinnitus. Your strategy makes perfect sense. We all do it. I know I did! But the advice I want to share with you is that the first step in overcoming your tinnitus is when you have finally figured out that you can't figure it out at all. It's when you have finally figured out that your tinnitus is going to do what it damned well wants to do (including possibly disappearing!), and in the final analysis you really don't have a whole lot of say in the matter. My views in this regard can be found in my "Tinnitus 101 for Newbies" article that I am attaching to this post.

Anyway ...

You have tinnitus only in your right ear, and you want to know why your tinnitus stops when you plug your right ear. In most cases tinnitus tends to get louder when one plugs the tinnitus ear(s) because when one hears external sounds less, one hears internal sounds more. For you the opposite seems to be occurring, and my guess is that either (1) there is some sort of tactile or somatic component to your tinnitus or (2) more likely your brain is still working on processing this new phenomenon and in relatively short order as you plug your ear your tinnitus will tend to get louder like most everybody else's. Again, it's just a guess, but that's my suspicion. What I can tell you is that what you describe does not have any diagnostic, therapeutic, or prognostic implications - at least not in my experience.

The video game phenomenon is called residual inhibition, the suppression of the tinnitus signal for a period of time after it has been masked by an external sound. There has been a fair bit of research on how a tinnitus sufferer who experiences residual inhibition might prolong it (or how a tinnitus sufferer who does not experience residual inhibition might induce it), but as yet that well is dry. Dr. Jack Vernon (1922-2010), who did a fair bit of work in this area, concluded that while residual inhibition is interesting from a research standpoint, it is relatively meaningless from a clinical standpoint.

Your asked about the fluctuations in your tinnitus and whether the fact that you had five quieter days last week and a totally silent day earlier this week was a good sign in terms of the possibility of recovery. My feeling is that it may well be a good sign in terms to your tinnitus resolving in the future - but with regard to the concept of "recovery," I believe that it helps to keep in mind that you can recover even if your tinnitus never goes away. Just something to think about.

Lastly, you write: "What I really want to ask is, is the thing where I can block my ear and make the sound go away common? Since tinnitus is only in one ear, can that indicate a tumor or something?"

So the phenomenon you describe where you can make the sound go away by blocking your ear is not common - but it is not unheard of either. In terms of whether or not unexplained unilateral tinnitus is indicative of a tumor, the vast majority of individuals with unexplained unilateral tinnitus do not have a tumor - but a very small percentage do. These tumors are benign (non-cancerous), but they tend to grow, and the earlier they are discovered, the better the prognosis. So you should definitely see an ENT, who will likely order an "MRI of the brain and internal auditory canals without and without contrast to rule out retrocochlear lesion, etc."

Hope this helps -

Stephen M. Nagler, M.D.