Acoustic Shock and TTTS — Does It Get Better?

Hello,

Long time lurker, first time poster. I wanted to share my story with what I assume is acoustic shock disorder/tonic tensor tympani syndrome from the beginning to now. Hoping someone can weigh in with a long term success story.

2.5 years ago my symptoms developed after flushing my ears out to clear impacted wax. I have had this procedure done numerous times, but this was my first time doing it myself at home. Big mistake, obviously, but this was during the beginning of COVID-19 lockdowns in the US and I wanted to avoid the doctor’s office.

My symptoms started slowly over the course of a week after accidentally blasting my ear drum with water:

• Mild to moderate fluctuating tinnitus in my left ear.
• Constant ear spasms from any level of sound.
• Constant ear fullness - sometimes from the Eustachian tube, but usually from tensed middle ear muscles.
• Facial nerve pain that almost brought me to the hospital. 10/10 at its worst.
• Hyperacusis? I honestly don’t know if I had this. I became sensitive to sound, but nothing seemed overly loud. It was mostly fear of my symptoms worsening when hearing anything 70-80 dB+. Loud noise worsens all of my symptoms.
• Clicking off the tensor valenti muscles after speaking. Not palatal myoclonus.

Fast forward to the present, 2.5 years later. This is what I deal with, and I fear it’s permanent as time drags on. I am able to live a functional life, but not necessarily an enjoyable one.

• Tinnitus was gone entirely for about a year. Now it is back to a 1-3/10 intermittent hiss.
• 3 months ago I developed what I think is dysacusis - Morse code distortion over white and ambient noise. It is low volume but probably my most annoying symptom. It appeared the morning after experiencing the worst middle ear fullness and spasming of my life out of nowhere.
• Sudden noises over 80 or so dB bring all of my symptoms back. Fullness, slightly louder tinnitus and distortions, fullness, thumping with pain, and tingling along my facial nerve where I once had pain. These will usually calm down after a day or two. Nothing is constant anymore.
• Palate clicking after talking is gone, but I can make it click voluntarily, which I was never able to do before this.

During this time I was exposed to a lot of sound. Noisy bars, weddings, children screaming, but I avoided extreme noise and always wore hearing protection when around truly loud sounds like a lawn mower or even when vacuuming. I think that exposure to everyday sounds helped me improve to this point, while a couple of further acoustic traumas in a short amount of time led me to redeveloping tinnitus and introducing distortions. There were months at a time where I wouldn’t even think about my ears, but now that my symptoms have regressed, I am afraid that I am cementing this disorder as permanent. I believe there is a large psychological aspect to this, as giving it attention only seems to make it worse.

Has anyone had success with something similar? I understand that my tinnitus is likely never going away, and I can live with that. I mostly want an explanation and relief from the neurological symptoms. I have spoken with a neurotologist who has mentioned severing the tensor tympani muscle as a possible solution, but he advised against it. I feel like an unusual case where the water physically damaged my ear more than the noise. My hearing tests are normal.

This paper is the best description of the condition that I’ve seen, but even it is sparse on treatments:

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

 

Did the constant ear spasms to any sound go away or settle down eventually? Sorry, I know you're looking for answers but the main thing annoying me are these spasms that are triggered by anything heavier then a feather hitting another object.

If you improved before, I feel like you can do it again.

 

Yes, the spasming in reaction to everything cleared up pretty early on. Now it only happens if my ears are tensed up anticipating noise or around bothersome sounds like dishes. They went from a crunching, fluttering sound to the occasional thumping. The different sounds makes me think both my Tensor Tympani and Stapedius are injured.

 

@Chap3, how is your eardrum now?

 

I am better in some ways, but not all. My dysacusis/beeping reactive tinnitus has mostly subsided, but still has flare ups occasionally. Regular tinnitus is basically nonexistent. I am thankful for that, at least. Desensitization through constant low and medium volume sounds seem to help my spams and hyperacusis more than anything, as well trying to distract myself from focusing on noise 24/7. I am convinced that the only thing that will truly fix my issues is surgery to cut the tensor tympani tendon.

 

@Chap3, well done on your reductions.

If I may ask, when you were exposing to normal everyday sounds, did your reactivity cause increases to your tinnitus? If so, how long did these increases take to return to your baseline?

Did you find this mentally taxing, having to force your way through these temporary increases or did you take it in your stride?

 

@Chap3, I'm sorry you are having ear issues again. I got TTTS from what I believe was acoustic shock 16 months ago and it has not really improved. It seems that for those that don't resolve in the first few months, the TTTS seems to be permanent, although it can improve. Periods of anxiety and stress seem to make symptoms worse for most people.

When did you notice your tinnitus diminished out of your awareness? That's great improvement!