I Was Habituated, Now Tinnitus and Hyperacusis Spike After Mustang Exhaust and Car Horn Exposures

[Jaysterk]

Need help and advice with this one.

I drive a sports car, and a Mustang pulled up next to me at a street light and revved it for about 6 seconds.

• The Mustang had a straight pipe exhaust and possibly long headers, so they usually clock in between 115 and 130 dB.
• A few minutes after the incident, my left ear became very hot and red. About an hour later, my tinnitus spiked from an average of 2 out of 10 to about 7 out of 10. The spike persisted for about a week.
• My car's cabin is well insulated. I tested it before by parking a pickup truck right up against the driver side door, honking for a few seconds, and capturing the inside and outside decibels with a meter. Inside readings were 71 dB and outside were 101 dB. Therefore, my car blocks around 20 to 30 dB.
• About 10 days after that incident, I was exposed to a car horn. I was standing next to a car in a parking lot when the alarm went off and it started honking. I immediately walked away but was hit by maybe 2 or 3 honks at about 10 feet from the front of the car (I was standing on the side when it happened).
• I woke up the next day with an even louder tinnitus spike, and this time a very intense hyperacusis spike that has persisted for 4 days now.

As a base:

• I've had hyperacusis and tinnitus since 2018, but for the last 3 years they have remained at a very manageable level at around 2 out of 10. I'm able to walk around and do most things without ear protection, although this was not the case in the beginning and it took a while.
• A car horn here and there never bothered me 2 weeks ago.
• My onset of tinnitus and hyperacusis started after I took Prednisone.
• This is also the first time I've ever gotten red and hot ears from a sound exposure, which is new to me.
• My spike is only in one ear; the other ear is fine.

Should I take Prednisone for this exposure or wait it out? It has been a while since I've dealt with something like this, and my ear has never taken this long to bounce back. It has been about 11 days since the first exposure and 4 days since the second exposure.

 

[Nick47]

@Jaysterk, with regard to the Prednisone, I would say a definite no. It is only indicated for SSNHL, and even then, it must be taken within 72 hours. You also mentioned that it initially caused your condition, probably as a result of rebound inflammation.

I am nearly 6 weeks into a setback. After initially aggravating my condition by using headphones on a Zoom call, I noticed the same pattern as you, where loud sounds seemed to follow me everywhere. In my case, it was dog barks, children screaming, and so on. Of course, these sounds happen all the time, but after a setback, we notice them more and feel like we cannot get a break.

Is your tinnitus very sound reactive at the moment?

 

[Jaysterk]

@Jaysterk, with regard to the Prednisone, I would say a definite no. It is only indicated for SSNHL, and even then, it must be taken within 72 hours. You also mentioned that it initially caused your condition, probably as a result of rebound inflammation.

I am nearly 6 weeks into a setback. After initially aggravating my condition by using headphones on a Zoom call, I noticed the same pattern as you, where loud sounds seemed to follow me everywhere. In my case, it was dog barks, children screaming, and so on. Of course, these sounds happen all the time, but after a setback, we notice them more and feel like we cannot get a break.

Is your tinnitus very sound reactive at the moment?

Thank you for the reply.

My tinnitus and hyperacusis actually started in 2018 from Neomycin, not Prednisone. I am aware that Prednisone is ototoxic, just not nearly as much as Neomycin.

I've taken Prednisone 4 times in the past, primarily in the first or second year of having tinnitus and hyperacusis, after sound exposure and spikes. I never had any permanent side effects from Prednisone, although I eventually stopped taking it for sound exposures because my ears gradually became stronger and I no longer needed to wear protection everywhere I went.

I enjoyed 2 years with relatively no tinnitus or hyperacusis. I was exposed to honks, alarms, fireworks, and other loud events with no spikes until these two recent exposures.

It has now been more than 72 hours since the Mustang revved, and about 75 hours since the car alarm.

I agree with your point that everyday sounds can seem louder to us after exposures that aggravate hyperacusis.

Yes, although it does feel like today my ear is less reactive.

I thought Prednisone was helpful for up to maybe 2 or 3 weeks after an incident, and that it could be used for inner ear inflammation from loud sound exposures.

I'm truly at a loss. One hundred dB or maybe 105 dB for 6 seconds should not cause ear damage, and a few car honks shouldn't either. I don't understand why this has aggravated my tinnitus and hyperacusis so much this time.

 

[Nick47]

thought Prednisone was helpful for up to maybe 2 or 3 weeks after an incident, and that it could be used for inner ear inflammation from loud sound exposures.

I'm truly at a loss. One hundred dB or maybe 105 dB for 6 seconds should not cause ear damage, and a few car honks shouldn't either. I don't understand why this has aggravated my tinnitus and hyperacusis so much this time.

The inflammatory event only lasts a few days, really.

It should not cause damage, however, recent knowledge talks about central sensitization, and that the trigeminal complex is oversensitive once you get hyperacusis. So non-damaging sounds can trigger the whole system again.

Read the Neuromed article by Dr. Hamid Djalilian on the Treatments page.