Does Reactive Tinnitus Usually Implicate Noise-Induced Tinnitus or an Acoustic Trauma?

Basically what the subject says.

I don’t think I’ve ever seen anyone who has tinnitus clearly linked to a neck injury or ear infection mention that their tinnitus fluctuates with noise exposure. There was recently a thread on Facebook where the question was if an MRI made people worse and an overwhelming majority said no and there were hundreds of responses which was honestly very surprising.

I take one quick shower and my tinnitus spikes to insane levels, meanwhile some have 120 decibels going for close to an hour and are basically unaffected. Thoughts?

 

Hi @Orions Pain.

Just following up, I have similar effects of a "reactive" tinnitus albeit it is very mild. I hear it over showers and such other "louder noises" but its pretty calm in silence. I had an MRI done about a month ago when I was at least a week into tinnitus and it had no effect on me although I had some ear protection on. It never increased or decreased. So not too sure what that is all about. I believe I suffered an acoustic shock where my tensor tympani is constantly reacting possibly causing the tinnitus? I have no idea but I will find out more at my next ENT appt today.

Hope you heal soon!

 

Hi @SeanD5054! Happy to hear your MRI didn’t worsen your tinnitus. My personal theory is that TTTS itself doesn’t cause tinnitus, it’s just one of the symptoms of a noise injury. My tinnitus appeared several months before my TTTS did at least but I also have hyperacusis.

What was your acoustic shock?

 

I have the same experience, barely anyone in my local Facebook group complains about MRI making their tinnitus worse even without using ear protection. And my tinnitus goes berserk after showering or blow drying my hair with earmuffs on...

I was wondering whether different types of tinnitus typically have different triggers? Noise worsens noise-induced tinnitus, ototoxic meds have an affect on ototoxicity-induced tinnitus? So if you are unaware of your root cause, what spikes you, maybe can imply what did you in? Or is there no connection?

 

Yes it’s so strange! From what I understand there are a ton of “causes” or things that may lead to tinnitus, but that’s not necessarily saying there are the same amount of mechanisms (structurally speaking) within the ear causing the tinnitus.

For example, we know medication is ototoxic. We know that loud noise is also dangerous. What I want to know is how different is the damage itself? If it’s essentially hair cells damage from either ototoxic drugs or noise, then shouldn’t the tinnitus be fairly similar as well? Why do some people have ear pain and hyperacusis from headphones for years, and no significant hearing loss while someone who has Meniere’s and SSNHL may have tinnitus and temporary Hyperacusis but not as severe as the headphone example.

I understand that right now the answer is it’s all genetic so these are hypothetical questions of course. But it really is strange. The hyperacusis aspect of it is the strangest of all.
I wonder what the common factor is.

 

Yes, I believe it can. Literature states that the muscle involved in the opening and closing of the ET (which theoretically is the cause of somatic tinnitus, regardless of where ETD stems from) is directly attached to the tensor tympani muscle, a muscle directly linked to hyperacusis. It’s very sneaky.

I also think - although hyperacusis it’s not on my radar right now and hope it never will be - that TTTS is just muscle spasms stemming from spasms in the TMJ area, so an underlying issue must be present (malocclusion etc). TENS can supposedly help a lot with muscle tension and spasms. I think hyperacusis improves because this very tension gradually subsides so the muscle relaxes. I wish I had a definite answer for everything. However, for sure, somatic tinnitus should not be left untreated, with or without hyperacusis. Expanding on your initial question, the neck is not the root cause. Yes it can mess you up but it ain’t that. It’s ETD, supposedly from muscle dysfunction (repairable or not) and sadly this whole thing influences the tensor tympani (thus we have direct influence inside the ear and ossicles) and it also influences the eardrum, I’ve heard stories of inverted ones etc. Now, add to this formation of cholesteatomas, go figure. I don’t think alterations of ossicles are easy to happen (someone did mention you can break them) or chilesteatomas to easily form there so it’s probably what I wrote few lines above. People with hyperacusis definitely have to be cautious. The very fact that hyperacusis improves though shows that the hypothesis can be true. For someone with hyperacusis, definitely an MRI is not advisable. I had one without hyperacusis but with bad pressure and my eardrum sure felt that. The very anxiety it creates is enough lol.

 

I'm also interested in understanding this. My tinnitus is caused by anti-depressants. 2 weeks into the medication I noticed sharp sounds like plates clicking, clapping, the tv and my even laughter caused a sharp/pain discomfort in my ears - was this hyperacusis? I subsequently developed full blown tinnitus in both ears.

The noise I hear is constant but if I'm having a long conversation on speaker phone, the volume and intensity of the tinnitus increases. Any time I have to focus to hear a sound, the tinnitus spikes just for a 5 minutes. But if I listen to an ambient diffused noise from good speakers it stays constant.

 

@Orions Pain

Sorry for the late response. My acoustic shock/trauma was my daughter screaming (fairly high-pitched) in my ear. I got tinnitus a few weeks after that. However, my ENT suggested that there is no way I got tinnitus from my daughter. He feels it was my anxiety after the trauma and TMJ, which my left side is off which is where the tinnitus is. I'm hoping it's TMJ and not noise related, however I need to do another MRI to rule anything else out.

 

I've had reactive tinnitus many many times, but I'm not sure what caused my tinnitus to begin with. What I DO know and figured out is my tinnitus becomes heavily reactive when I'm feeling down, anxious and/or depressed. I haven't had it now for a long time (knock on wood).

 

@donotringatme

I am scheduled to get an MRI done of my inner ear this Friday. You think this is not advisable? Yes some noise definitely flares up my tinnitus but a month and a half ago I had one done and I felt no difference to my tinnitus. Mostly like running water or extremely loud screams makes my tinnitus act up but it settles after an hour. Mostly I feel that it is the higher frequency sounds that makes my tinnitus act funny. My ENT wants to rule everything out but he sincerely feels that my TMJ is causing my issue. I have done an ecog test and vng which indicated no Meniere's so I guess this will be the test to see if there is nerve constriction occurring or some sort of damage.

 

@SeanD5054 MRIs aren’t reliable scans to show issues with nerves, just a heads up. Just came here to say just because the previous one was okay, doesn’t mean this one will have the same outcome. The scan of the inner ear is one of the loudest you can get and it’s highly unlikely that they will find anything remarkable. The majority of people here have clear MRIs and it’s a huge risk but of course there’s always a chance it won’t hurt you.

If you had nerve damage you would know by now through symptoms. Nerve issues are largely diagnosed through symptoms and not through imaging. If your ENT thinks it’s TMJD you’re better off finding a place that does 3D imaging of your jaw versus an MRI (which are mostly used to rule out things like tumors, MS, or Chiari malformation).

 

@Orions Pain

Thanks for the reply, I definitely feel like I have acoustic shock that caused the TMJ, I have mid ear ventilation issues that causes some blockage and distorted hearing.

These are signs of acoustic shock and ETD. I feel that doctors don't really know much about acoustic shock since it is different than acoustic trauma. Where I had no hearing loss within the normal tested range. I feel like my issues are continual pattern of some stress and anxiety where I realized during the first week of the trauma I was grinding my teeth way more than usual. I had serious neck tightness and got numbing/tingling feeling around my face, neck, and arms and legs all on the affected side of where my trauma occurred. ENT was insistent that my daughter could not have caused these issues, but it seems to be all in line with acoustic shock. I am hoping I get the sound sensitivity back to normal and maybe the rest of the symptoms will clear away. I feel I do not have true hyperacusis though. Just sensitive to louder sounds. I may pass on the MRI overall then. I feel that if my symptoms improve maybe I will do it to be sure.

 

I also developed TMJ from hyperacusis due to grinding/chronic stress.

 

My tinnitus is very reactive and I am sure it wasn't caused by noise damage.

 

I would assume it implies acoustic trauma. At least that’s how mine acts.

 

I had very reactive tinnitus for 9 months after ototoxicity. I don't think it's exclusively to noise at all.

 

Just thought I would add more info to the thread. My tinnitus is extremely noise reactive.

My "event" happened suddenly at night while sleeping. I was in recovery from a severe motorcycle accident that happened about 3 months prior to the "event".

I woke up with total hearing loss in my right ear and severe reactive tinnitus/hyperacusis. It is sometimes referred to as SSHL (Sudden Sensorineural Hearing Loss). I had all the tests including an MRI. Nothing shows a reason for my "event."

The doctors could not say if the motorcycle accident was the cause. My feeling is that it was.

Anyway, there has been no change in the last two years. Still deaf on right side and still living with reactive tinnitus.

 

This is interesting, I had the same cause. My son yelled in my ear, but I've wondered if it could be the first time TMJ or ETD from swimming all summer. I was also very stressed at the time. It's interesting that so many of us have depression or anxiety before it happened.

twa