LLLT Treatment Journal (for TTTS?)

I decided to make a journal, following @luka 's lead, in order to better organize the laser treatment plan for my ear problem.

Background:
2 years ago I suffered from hyperaucusis, which finally went away. Honestly I didn't know what it was at the time. All I knew was that in the very beginning certain sounds would bring me to my knees. Physical pain from noise, I couldn't believe something like this existed. I had other health issues that plagued me as well, so I guess I just rode it out and it went away. As my health improved, so did my ears.

Unfortunately, my ears were still sensitive even despite me thinking I had healed completely after H, because on the 4th of July in 2014 I was exposed to a flare gun. My right ear suffered greatly. It started ringing, felt full, distorted sounds, and people sounded like robots. It scared me so bad. I went to the ER who said that my ear had suffered barotrauma, that there was no tear in the eardrum, and that it would heal. I had no idea about steroids at the time, or I would have done them. Now I know that for serious ear issues and ENT is necessary asap, not the ER.

2 weeks went by and my ear greatly improved. However, it was still not healed. I still had fullness, a soreness when exposed to sounds, popping, clicking, tinnitus that would at times seem so minimal but then react greatly to noise, and slightly dulled hearing. I could not equalize my ear normally (I always explained it as a balloon expanding). A fluttering in my ear would also happen sometimes. I got an audiogram about 1.5 months after the event (it is attached here).

I'll summarize to say I saw several ENTs after this point, to no avail. My diagnosis were to wait it out, maybe it's nerve damage, and then finally an ENT who used a camera to look inside my ear. He said he believed it to be TTTS.

Due to my central nervous system issues in the past, possibly, my CNS reacted greatly to the noise, causing some damage/muscle contractions, and has never returned back to it's relaxed state (at least fully). I just don't know. I do know that in my case it is not a psychological problem.

I did start treating, after reading many links about LLLT from @FERNANDO GIL , @Nick J. , @attheedgeofscience. I started following several others of you who are also working on LLLT therapy. I read about the importance of protecting my ear, and started wearing an earplug in my affected (right) ear. The fullness slightly improved, and my fluttering doesn't happen as much with the earplug in place (unless I stretch for some reason). However, still having issues so I decided I would try LLLT.

I got my frequency hearing test (also shown below) before I started treating. This was after a couple of months of wearing an earplug, so it's interesting to see that my high frequency hearing on my bad (right) ear, was actually super good, higher than 0, -20db at 20Hz. I assume that my hearing was most likely worse before I started wearing my earplugs, especially due to the fact that I am primarily right-dominant (spoke on the phone on the right ear, etc). Now, it is the best ear "hearing-wise."

One thing that is really interesting, is that I always felt my Eustachian tube was acting strangely after my noise trauma. The Eustacian tube possibly not working as well, and that air-balloon feeling in my ear. I asked the doctor who performed my frequency hearing test to please do an Eustachian tube test as well. My right ear showed a much different graph than my left ear. When I do the valsalva maneuver, the eardrum tends to feel more stuck, and then slowly deflates again. My left ear, naturally flicks in and out very quickly, it does not do the expanding feeling.

Anyway, I have been doing LLLT therapy after discussing more with @FERNANDO GIL and will post how I have been treating below a bit later today. I will be better at reporting results, any changes here on this post.

Thank you for reading! Any thoughts/input you all have is treasured by me. Also thank you to all of you I have been in contact with. I hope to have a healthier right ear again!

Best~

 

Sorry I am running out now but I will post my test results in a bit! Thanks!

 

Which test was that? Tympanometry?

 

hey @Nucleo sorry I didn't see your post earlier. I'll post the rest of my tests tomorrow but no, the test is an ETF (Eustacian Tube Function) I believe.

The first audiologist did not perform this however. She did OAE (which apparently was in the normal, though I know sometimes normal can be on a spectrum). She also did the audiogram up to speaking range and a tymponometry.

It was when I eventually did my high frequency hearing test that I requested this Eustacian tube test as well. An earpiece suctions to your ear and then you hold your nose and blow out when asked, then after a few seconds you are asked to swallow. At this point pressure coming from the tube makes your ear feel as if you are in a compressed area. Your E tube response is recorded. Here's this test attached

 

Eustacian Tube (bad ear is on the right)

No diagnosis other than "it seems like your right ear responds better to pressure than your left."

Which is definitely not the case. Quite the opposite.

Thanks will write more later!

 

So the graphs you are showing are not normal tympanograms but the eustachian tube function tests?

If so, it looks to me the analysis is correct. Your right ear shows like it's equalizing the pressure whereas the left one does not respond at all to pressure gradients.

 

@Nucleo yes that's right. This is not a tympanogram.

I know, it's very strange.

This is how it looks, you're right. However when I asked the person testing he said it was an imperfect test which is why it's not really used. He said if my right ear is my troubled ear, that now we can see it is not working the same as it used to, (the same as the left). It was really just validation of the popping/clicking etc. that I feel in my right ear now after noise damage. One thing that happens when I blow my right ear is that the eardrum gets stuck, until I swallow and it slowly contracts. The left ear doesn't do this. Instead, the left ear clicks normally out and back into place very quickly, which is apparently too quick to be captured on the test. I love scuba diving and I never had issues equalizing my ears. After this problem in my right ear it feels like I would run into trouble. I am really hoping this resolves :/

 

@felinefine

So do you have regular tympanograms available?

 

@Nucleo ok finally here they are.

Here is the tympanogram

 

Here are my OAEs

 

Here was my first hearing test (speech frequencies) a month and a half or so after my trauma

 

Here is the high frequency hearing test done before my LLLT treatment. I had been wearing an earplug for months in my right ear before this hearing test.

I'm not sure why the high frequency portion is written out differently.

Left ear- fine
Right ear-the one that is giving me problems

 

There's no signs of obvious trauma to either ear. The high frequency test seems weird to me. It would seem you can still hear up to 20 khz, assuming -20 means a reduction of your hearing threshold by 20 db. Is this the case?

Anyways, this really tells us pure tone audiograms are of little help when it comes to finding the etiology of tinnitus.

 

@attheedgeofscience if you don't mind I would really like your analysis/thoughts on my tests.

 

@felinefine - do you experience fluttering of your eardrum or middle ear myoclonus?

 

Aren't they the same thing?

 

Thanks, a very interesting thread.

My interactions with doctors have always been really crap, and I don't think any of them have done any of the tests required to define whether I do have the myoclonus in the middle ear. MY H hasn't gone away at all, it's stayed stuck over the years and gotten slightly worse at certain points too, but I feel muscles in the ear vibrating like crazy with the pain, it certainly isn't phantom pain, and it's always a lot larger pain with the start of a sound than with the sound itself, and people say the former is related to TTTS while the latter would be related to Stapedius muscle issues, so I'm going to go to a bunch of ENT to ask them about this.

What do you think is the logic behind laser working for TTTS if it dr wilden claims that laser gives energy to the inner ear cochlea? Wouldn't it be a bit far fetched if this laser energy would help the inner ear, the inner ear would tell the brain no problem now, and the brain would go back to the middle ear and tell the tensor or stapedius to chill out?

Also, I'm surprised there isn't more controversy between the literature that talks about stapedius/tensor endoscopic cutting curing T and H (and some making it worse) and the literature that talks about the wonders of TRT. I'd be satisfied with an epic rap battle of history between the two.

 

Go for it Ja. I've debated similar points only to hear crickets chirping. Unfortunately there's this orthodoxy that won't go away.....

 

Stapedius muscle myoclonus doesn't cause a fluttering of eardrum as far as I know. The term "middle ear myoclonus" contains both tensor tympani myoclonus (fluttering of the eardrum) and stapedius muscle myoclonus.

 

Hello Felinefine,

I am new in this forum but i already post in 2 blogs (last one from Luka and LLLT also)...
Lately i take much time to read some blogs here and yours left me curious because your symptoms are much like mine / and similar story about ENT (many of them)....

I stayed with hearing loss in the left ear after an acoustic trauma in 2012 and one of things i have complained to doctors is this issue of left ear pressure and a constant need to make the valsalva maneuver... act that only relieves for a few seconds.... another symptom i still have (and no one was able to explain to me ...) is: i became to get a high sensibility in the left side of my face (especially between the eye and the ear) ...

Someone with these symptoms after an acoustic truma and hyperacusis??

Did you started already with LLLT?

I am thinking about LLLT seriously (as all methods that I have tried over the last 3 years do not satisfy me)...only a slight improvement in hyperacusia since i started TRT treatment...i would say about 10% improvement / very little for what spent i guess...
(and pills...i will take no more!)

Please keep in touch with your results!

Until new efective research appears / All the Best,
Ricardo