Newbie — Tinnitus at 20 Years Old with Questions

Two-year lurker here. I'm a 20-year-old college student from Texas who first developed tinnitus in November 2016 when I was 18. I was sitting at my computer after a long car ride and had a brief moment of vertigo that lasted for about 10 seconds coupled with extremely loud tinnitus. The vertigo never came back but the tinnitus stayed, though thankfully at a reduced volume from initial onset.

Since that point, I have been to an ENT and an ear specialist clinic. My audiogram and extended frequency audiogram is normal, I have no history of excessive noise exposure nor was I exposed to any excess noise before my onset, no history of ear infections, didn't correspond with any illness I can remember, no ototoxic drug use, etc. My ENT flippantly suggested in January 2017 that it was probably a "blood clot" but my neurotologist noted 1 1/2 years later that an ischemia to the blood supply of the ears would have much more severe immediate symptoms than what I experienced. Basically, I'm somewhat at a loss and wondering if y'all can point me in the right direction.

My tinnitus is polytonal (a low hum, mid-frequency tone, and whistling, fluctuating hiss). The hiss is the only thing I can hear in my daily life unless I'm in a totally silent room, then the lower tones and hums seem to overwhelm it. The onset with dizziness suggested to me initially a vestibular etiology, but I really see no possibility for that -- Dr. Assar Bjorne explored the relation between cervicogenic and jaw problems with tinnitus and vertigo and found correlations and possible causations, so it seems to me that other causes may exist for the vertigo origin. I had dental surgery (to remove ameloblastoma) a few months before the tinnitus began, and also had wisdom teeth removed, which promoted malocclusion problems. Previously I had extensive orthodontic treatment and braces in my teens. I also have forward head posture and mild scoliosis, and occasional upper back and shoulder pain. I can modulate the hissing tinnitus noise noticeably by opening my mouth widely, manipulating my jaw, and it gets perceptably worse when I bend over if the tinnitus is loud to begin with. I had a transient worsening with a neck maneuver that compress my upper cervical vertebrae: loud bilateral tinnitus ensued and went back to normal in around 2 minutes. From what I can tell, this is more likely somatosensory over vascular etiology. A 48-hour increase was noted a few hours after a severe tension headache (I get these infrequently, it's not a common thing I deal with). Finally, I get muscle spasms in my ears sometimes and what I believe is called tensor tympani syndrome.

It's a lot to deal with, and if you've made it this far, I appreciate it. I just need some advice to move forward with this. I'm a severely anxious person as is so this has not been an easy two years, primarily due to my tinnitus. I was on Klonopin for several years due to my anxiety problems, but stopped over a few months about a year before my onset, so I can't see a correlation there. It is obvious to me that there exists a correlation between my dental work and jaw problems as well as neck/postural problems and my tinnitus, especially when it comes to modulation. It's sometimes very striking -- I can completely abolish the hissing part of my tinnitus when it's loud if I open my mouth widely, and immediately after stopping it returns with a higher level. This rebound effect subsides after about 30 seconds.

I will be getting an MRI done (belated, I know) soon to test for evident brain abnormalities such as vestibular schwannoma and vascular compression. I have read some encouraging reports on TMJ treatment (Wright & Bifano, Gelb, etc.) on tinnitus as well as physical therapy-based treatment on upper neck (Bjorne, Sanchez, etc.). I found this case report which is similar to mine aside from the age difference.

I just want to know, if I can, what's causing my problem. I realize the more realistic goal is improvement or therapy over total resolution, but I'll take what I can get. I want to go for causal treatment first, and if that fails, symptomatic treatment such as benzodiazepines, Neuromonics, vagus nerve therapy (I'm a student at UT Dallas so that helps), something like the UMich timed signal device, etc. In terms of causal treatment: orthotic, cervical collar, physical therapy on neck, postural work? What should I do? I've narrowed down the scientifically accepted causes of tinnitus from this flowchart to those few things.

Thanks for reading.

 

HI @Berydu

Many things can cause tinnitus but usually something is responsible. You have had some tests and awaiting more hopefully, you will be able to get some help. Although your tinnitus wasn't probably caused by exposure to loud noise. I am just curious to know if you were a frequent user of headphones/headset before the onset of the tinnitus? Do you use headphones now even if it's just occasionally and at low volume? If you do then I advise to try and not use them too often and keep the volume as low as possible. If you go to places where loud music is played: clubs, concerts etc then use noise reducing earplugs but still be aware loud sounds can make tinnitus worse.

Please click on the link below and read my posts that may be of some help.
All the best

Michael

https://www.tinnitustalk.com/threads/new-to-tinnitus-what-to-do.12558/

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

 

The Vetigo and tinnitus together is a common sign of sudden sensori-neural hearing loss, you should have got a steroid and took magnesium and b-12 then to get as much hearing restored as possible. However I can't confirm this.

I'm glad you got tested above 8khz, but you still very well could have hearing loss.

Speech in background noise and complex listening environments such as music can sound muffled and distorted even if slightly and this form of hearing loss is enough to cause tinnitus.

http://hyperacusisfocus.org/innerear/#hiddenloss


Please don't waste money going ENT to ENT they can't cure you.

TMD and Cervical issues can also contribute to tinnitus.

 

I do feel like my tinnitus has gotten slightly worse over the last few months in particular -- I can now hear it over my white noise machine. I've had a few bits of temporary noise exposure -- was in a small room where everyone cheered for like 15 seconds which was very loud, loud motorcycle passing by, loud karaoke bar for a few hours. But these just seem like more or less everyday noise occurrences and I don't want to dial up the neurosis I already have by obsessing about avoiding such situations. I mean, I will adapt within reason, but it just seems weird to me that these things would make it intractably worse.

Thanks for the advice. No, I was not a frequent user. I use them more often now to play music when I'm in a quiet room but I play on the lowest possible setting.

I didn't have any perceptible hearing loss, though. The vertigo only lasted for 5-10 seconds anyway and wasn't strong.

 

That would do it or make it worse unfortunately.

 

These all happened after onset. Karaoke was the only avoidable situation here. The other two are just life events and there's not much I can do about them. I'm already an anxious person so I really can't dwell on these circumstances too much.

 

I'm an anxious person myself but my life has changed ever since tinnitus started 3 months back. I don't go to any loud places anymore. Maybe someone can give you advice on how to protect your ears from loud places. And the loud motorcycles and etc, those are unavoidable, that's just life.

 

Update, half a year later:

I am doing a lot better. Indeed, I am "cured" insofar as tinnitus no longer bothers me anymore. Also, my perception is that its volume has dramatically decreased. In the interim I have unfortunately developed another health-related problem, but when that happened it occurred to me to take stock in how I've improved elsewhere and write a message of positivity to this forum: it gets better. I was on the verge of a mental breakdown and now tinnitus is the furthest thing from my mind possible.

I think a lot of people who get better leave. So did I, but a recent unrelated health malady (which has sent me down a similar negative spiral of reading horror stories that never get better) prompted me to return to leave this final message.