Eustachian Tubes Not Working Properly: How Could Acoustic Trauma Cause This?

Tests have shown my Eustachian tubes do not work properly.. how could this happen from an acoustic trauma? gives me a constant sensation of plugged ears. Drinking and poor nutrition seem to make it worse as well as loud noises. The more clogged my ears feel, the more my tinnitus shows up and the more sensitive I become to noise. I probably have tried popping my ears 50 times a day for the past year and a half, sometimes I experience minor relief (good nutrition, exercise and spicy foods help sometimes). I can make my ears click all the time by moving my jaw, tilting my head etc. I have fantasies of my ears having this huge pop and my life returning to normal, though I know that will never happen, I will work hard toward easing my symptoms..Anyone out there experiencing the same thing and/or have any useful info? thanks...

 

How do you try and pop your ears?

 

You should look into an Otovent kit or an EarPopper

EarPopper you can find here:

Home Version: http://www.amazon.com/dp/B00449CW36/?tag=tinntalk-20

Pro Version: http://www.amazon.com/dp/B005FCBTGW/?tag=tinntalk-20

 

@Ken Berquist You have Eustachian tube dysfunction or ETD.

Have you tried nasal steroids? They make take several weeks, but they will stop your Eustachian tube swelling and your ears will subsequently normalize.

I would NOT pop my ears with ETD. Why? Because the ETD gives you abnormally high pressure in your ears. If you force your ears to pop, the pressure will be relieved but it may back up into your cochlea and worsen your tinnitus. In addition, your ETD is a symptom of something, not a disease by itself. Just popping your ears will not relieve the underlying cause. That cause is probably from inflammation, which may be directly related to noise damage. It's not unusual to have aural (ear) fullness after an overexposure to noise. That fullness will either resolve in time as your ear heals, or you can help it resolve through the use of nasal steroids.

I had ETD and popped my ears and I got chronic tinnitus. (The story is more involved than this, but the factor precipitating the tinnitus was one ear pop. The doctor said the ear pop gave me a barotrauma.) Ear popping is only safe when your Eustachian tubes are functioning somewhat normally.

So ask your doctor about nasal steroids. For chronic ETD, your doctor can insert ear tubes that might resolve the pressure. I believe they fall out after a while but are useful short term. There's also a doctor in MA that does a procedure called a Tuboplasty that might help. But it is only for severe cases.

Here are references to procedures known to alleviate ETD. Discuss options with your doctor:

http://surgery.about.com/od/proceduresaz/ss/MyringotomyEar.htm

http://www.enttoday.org/details/art...tion_for_Chronic_Tube_Dysfunction_and_Pa.html

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Just by plugging my nose and blowing, they never really pop though... i can make my ears click (especially my right one) by tilting my head side to side.

 

THanks, I'll look into it, though I'm apprehensive that something like that could worsen my condition.

 

THanks! Hope i dont need surgery! I'll talk to my audiologist about nasal steroids. It's so hard to resist attempting to pop my ears, i try do it 50 times a day though they never pop. I', curious if you know anything about binaural beats and tuning forks to treat tinnitus?

 

@Ken Berquist Sorry to hear about your ETD but at least they have a cause for your tinnitus, right? And the good news it is treatable. Nasal steroids are great for this and shouldn't do you any harm. I've used them for a long time due to summer allergies and they do help my ears feel better too.

You can also see if you can take a decongestant like Sudafed with it on the advice of your doctor. I'm not sure it does anything to double it up and the community is pretty split on whether decongestants do anything anyway.

Generally they tell you to play the wait and see game with ETD which can be quite uncomfortable. If the steroids don't work after a month and it still bothers you would tubes be an option?

I spent years thinking I had ETD and researching it only to find out I have TMJD instead. But hey, I'm glad all that information came in useful. Best of luck on your path to recovery.

 

How long can etd last? Im sure the dysfunction doesnt stop once a cold or allergies let up.

 

I would steer clear of the Ear Popper or syringing. That stuff can really screw up your ears. I also would stop popping my ears on a regular basis. As @jazz said, nasal steroids usually bring down the inflammation that can cause ETD. Those who have severe, chronic problems sometimes need to have tubes or grommets installed inside their ears to help them drain.

I wasn't aware noise exposure could cause ETD. I thought it was usually related to a cold, ongoing sinuses issues, problems with the way your sinuses are structured, etc. It definitely can make your ears feel clogged and weird, though, as well as increase sound sensitivity.

Whatever you do, I would advise not flying until you get the problem resolved. If your tubes shut down, you can quickly get water or mucus trapped in your middle ear, which can lead to barotrauma or a ruptured ear drum on descent. ETD, which led to barotrauma on a long flight, caused me to have permanent tinnitus.

 

One draw back to Sudafed,if your on any BP tablets,you can't take those tablets,there lies a problem all round if you've got allergies.so never over the counter buy Sudafed,I nearly made that mistake,could have caused me trouble if the pharmacist hadn't checked on meds I was taking,as you can buy these in any supermarket,just in case anyone is on BP tabs.Always check .Dont know about nasal decongestants,maybe same applies in relation to some meds.

 

Yes it's always a good idea to check drug interactions before taking anything even if it's OTC.

If I remember right Sudafed/pseudoephedrine also interacts with SSRI's/antidepressants and you're not supposed to be on the same time.

 

I'm still lost about how exactly noise exposure can cause ETD.

 

I'm not a very science-y or biology oriented person and I get a lot of remarks that my ETD in my one ear could have been caused by noise exposure. Anyone who has the correct info want to explain how that works? I've looked all over the internet for an answer and I haven't found one yet.

 

I also wonder the same thing -> how can noise trauma and ETD go hand in hand as we know in many of our cases. They shouldn't be related.

 

If this is possible, I can only guess why it could happen.

Either that the amplitude and intesity of the soundwave is so great that it causes obstruction to the openings of the eustachian tube and/or sets off an inflammatory process that clogs the tube (not sure if this is even possible).

Or that the muscles share some of the same nerves, and when the nerve is injured or irritated, all the muscles that connects to its endings and receives motoric signals from the injured nerve is affected.

Or that the brain sends motoric signals to the group of those muscles and instructs them to contract because of the fear of sound.

Or that the neck and/or muscles of mastication has become too tight, which results in additional load on the tensor tympani in order to keep the correct tension to the tympanic membrane and when exposed to noise and maybe the fear of sound will put even more strain to this muscle that doesnt seem to work in isolation, and it might affect the surrounding muscles as well, like the muscles that opens and close the eustachian tube.

Or that some people that suffers from anxiety and/or stress tends to build up more muscle tension in general, which also could affect the muscles in the middle ear and those associated with the eustachian tube.

Or hypertonic muscles.

Or that the middle ear muscles (tensor tympani and stapedius) does not work isolated but is rather grouped up with the muscles associated with the eustachian tube (levator veli palatini, salpingopharyngeus, tensor tympani, tensor veli palatini), and if one muscle has been working too hard and become too strained or inflamed and does not work properly, for example because of exposure to high levels of noise, it might affect the other muscles in that group as well and prevent the tube from function properly.

I would think the latter.

Just a guess though, as I really have no idea, and I dont feel like reading up on it at the moment

@derpytia

 

I don't buy it. I think ETD is pre existing and then once T sets in, ETD exacerbates the problem.

 

Thanks @Mr. Cartman Interesting because I got my ETD a few months before my T set in and it came out of nowhere quite honestly. My ears were normal and I was listening to music (at a safe level i THOUGHT) before bed and when I stood up from my desk, boom my right ear felt so clogged and it never has gone away. I went to a doctor and he pronounced it as ETD and said there were nothing I could do about it really. But I've always wondered if maybe my ETD was a precursor to my T and I should have listened to my body more and lowered the volume of my music or limited the exposure to it even more than I did at the time...

 

Ya me too, but thats what my audiologist said...

 

I have flown several times without any problems, perhaps the sensation that makes me think i need to pop my ears is just from my timpani-tensors when they harden/tighten up. Sorta have mild P.T.S.D., triggers a fight or flight when i hear loud noises or when i anticipate them.

 

@Ken Berquist do you mind giving some detail on what tests you were given? I've learned to open and close my Eustachian tubes pretty much at will, but I do have a different sensation in my symptomatic right ear versus the left. My visit to the ENT was a frustrating experience, and I don't recall being asked anything about ETD, so I'm wondering what there might be about your case that would lead to the diagnosis.

Thx in advance!

 

I don't remember the name of the test but my audiologist performed eat by placing little suction cup like things on my ear and she had me swallow water and yawn etc... she offered me no treatment for it but i am hopeful that nasal steroids will help.

 

When I got tested for my ETD, the doctor had me plug my nose and close my mouth and swallow as he looked in each ear to see how the eardrums moved. He noticed that in the ear I have ETD in the eardrum did not move as much and that was his first clue to diagnose me for ETD.

 

I had something similar done but the doc hooked me up to a machine with some suction cup like things on my ears...

 

I'm wondering if I should try to see a different ENT. Mine just seemed disinterested and moved me on to the audiologist as soon as possible.

@derpytia did your doctor suggest any useful treatment?

 

@rtwombly Not really. He just said it will either go away or it wont. But he wasn't an ENT but he seemed to know a lot more about ears than most ENTs I've seen did.

 

I find that very interesting what you just wrote.. "and when I stood up from my desk, boom my right ear felt so clogged and it never has gone away". The same happened to me when I made a very sudden neck movement. I cannot exactly pinpoint what went wrong, but it affected my ears indeed, just like you describe. If it was ETD or not, I dont know, but I think it was something else at play that made those ETD symptoms, as my eustachian tube seems to work perfectly, but I still have that weird feeling in my ears, although it is much better.

And you say that you listened to sound that you thought were safe.. Maybe it was.. And that its not related to your inner ear at all.. Theres a ton of things that seems to be able to produce tinnitus.. You have two muscles in your middle ear, four muscles are associated with your eustachian tube, the tympanic membrane, middle ear ossicles, the round and oval window that separates the middle ear from the inner ear, neck problems can certainly produce tinnitus, as well as jaw problems, even the muscles. Thoracic outlet syndrome which I have read can produce tinnitus, inflammation of blood vessels, wax buildup, neurological conditions, irritated and / or injured nerves, tooth abscess, toothache, eczema in the outer ear, dehydration, allergy, migraine.. .. and the list goes on..

Even a danish ENT I read about (previous posted in this forum) found that muscle tension to the neck and jaw directly affects how the tympanic membrane reflects light. This was published in 1960-1970 something, and later I found a correlation between tinnitus and headaches due to muscle tension in neck and jaw which directly or indirectly affects the tensor tympani and alters the tension on the tympanic membrane (published by the headache clinic or something like that).

If I remember correctly, you sometimes got an intermittent tinnitus while turning around in bed..
I have the same stuff happening from time to time, and when I was lying in an ackwards position in my bed, my tinnitus would disappear completely. Also happened when I stretched certain muscles.

I also have to say that my tinnitus has pretty much faded away though, and Im not really able to notice it during the day unless it is very quiet, but this annoying weird ear feeling still remains to some extent..

It sounds like you somehow decided to believe that you have damaged your hearing because of loud noise, but seriously, that does not need to be the case! Even strain or injury to the sternocleidomastoideus seems to be able to produce a piercing tinnitus all by its own.

 

The first tinnitus tone I got in my ETD sounds like a high pitched whistle and I've heard form those with noise induced tinnitus have the same tone so I'm inclined to believe that it's from that (plus I already had slight high frequency hearing loss from childhood thought that never gave me tinnitus). I just feel kinda stupid for getting the T to be honest. :/

 

I think most people have some degree of hearing loss though, and that its normal as we age..

I remember when I was a kid, I found that when I took a hammer and softly knocked it on a metal plate (a sound that was not very loud at all), I got this high pitched solid tone in my ears, and afterwards the tone morphed into a hiss, and then it went away (and the only way to trigger this by a soft/low sound was that the sound had to be of a very sudden onset and I kind of had to have the expectation of the sound). When that happened I could clearly feel physical movements inside my ears, and I was so intrigued by that. I didnt know much about the ear at that time, but I did realize that there was some kind of a protective mechanism that was operated by muscles inside the ear and that it was able to produce both a solid tone and a hiss most certainly without damaging my hearing.

Also when I was yawning I would get this hiss in my ears. I have read a littlebit about it, and it seems to be pretty common indeed, but I cant find any solid conclusion as to why this happens. Some believe its because of nerves being pinched by muscles when the mouth is kept open, some believe its because of pressure change in the inner ear, some believe its the muscle spindles or the golgi tendon organs, I believe its because of a pull on the temporal mastoid process caused by the suprahyoid muscles and possibly the lateral pterygoid muscle that affects the alignment of the middle ear ossicles, but cant say for sure.

My sister got a high pitched whistle in her ears when her neck was tired, but it went away when she tilted her head.

I think we have a lot to learn when it comes to tinnitus, and in many cases, if not most, it could be that theres something else at play than the good old broken hair cell theory. The potassium channel theory is interesting as well, but I suspect that the "abnormality" in those potassium channels could exist in most people with tinnitus, even if they are related to the outer / external ear, middle ear, inner ear, muscles or the DCN (if that theory has something to it) as it seems like those channels are one of the last pathways the auditory signal propagates (if that is the correct term) before it enters the limibic and auditory cortex (please correct me if Im wrong).

I think that the some of the potassium channel theory could be put to the test if one compared the potassium channel activity in two individuals, one with tinnitus, and one without. Then replicated the first persons tinnitus and played the sound through an earbud or headset into the ear of the individual that originally did not have tinnitus.

I think tinnitus related to the tympanic membrane could be put to the test by comparing sound vibrations on both sides of the tympanic membrane to the microscopic scale, and tinnitus related to the middle ear could be tested by comparing vibrations of the tympanic membrane against vibrations of the oval window. I would think that could provide clues about the tapping of the ossicles as well.

I suspect that intermittent / fleeting tinnitus is related to middle ear adjustments, including the tympanic membrane, and could be put to the test if one was able perform functional imaging of what changes that took place in the auditory meatus while it happens (if it has the accuracy needed).

What I also found interesting is while reading through some of the literature, it seems like people that suffers from migraine or migraine-like symptoms, tension headaches or anxiety are more at risk of developing tinnitus, even tinnitus related to noise. This happens to be the case with a number of people I have talked to as well.

Im just thinking out loud, and Im no expert, but I hope that more technology will be made available and more research will be carried out for this stuff

I hope that your tinnitus will go away on its own, and I believe it will die down in time. Lets stay optimistic
It seems like a cure can be on its way as well.

If you are interested in neuroscience, potassium channels and the relation to tinnitus, I suggest reading through some of
@benryu 's posts, as he seems to be one of a kind (thanks for providing all this great information)

 

derpytia
Not sure if this is relevant or helpful but after reading @Mr. Cartman posts I started looking around the internet and came across a couple of links that may interest you

http://clinicaltrials.gov/show/NCT02114762
http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=10545203.PDF

Mark