Pulsatile Tinnitus Gone After Tenotomy of Middle Ear Muscles

Dear @Padraigh Griffin, thank you for your posts and the time you spend here sharing your knowledge. You are well informed about the problem. I'm visiting Prof. Bance next month for reflex decay and long time-based tympanometry examination. Because that it seems impossible to find anyone doing here in Czechia.

I'm still unsure whether I'm the right candidate for the surgery since my main problem is fullness/tightness (after acoustic shock). I exhibit some symptoms of Tensor Tympani - I can hear constant fluttering (like butterfly wings) when I put my finger into the ear with an intermittent crackling sound. So I presume my Tensor Tympani is in constant contraction. This article from Prof. Bance is very informative on the topic of MEM.

However, it remains unknown whether the section helps the fullness or not.

Nevertheless, I will give it a thought since the impacts are pretty high - I can not do sports (the fullness gets much higher) and work appropriately due to concentration problems and fatigue.

Please, what are your takes on the risk of the surgery? Can you do sports after? Are the sounds of chewing manageable? In your research, did you come across patients who also went through the section and had the fullness?

 

Hello @Padraigh Griffin,

Thank you for all the information you provided. I have high pitched pulsatile tinnitus, and occasionally, maybe once or twice a week, I notice the low pitch fluttering/thumping for maybe 10 minutes or so.

My question is whether you had the high pitched (pulsatile?) tinnitus from your Tensor Tympani issue and that was relieved by the surgery?

Thank you!

 

Hi, yes, I didn't have the typical whoosh. Is was sound that is hard to describe. Higher pitched definitely. I had all the tests to rule out vascular etc. It was either my Stapedius or Tensor Tympani. If I was guessing it was my Stapedius.

From your description you sound like you have MEM from my experience. Have you had a consultation with a MEM specialist... Neurotologist?

 

Hi, it really is too early for me to say what the results or impacts of my surgeries were. I am a rare case as I don't think anyone ever had the ears done 6 weeks apart. I begged the Professor to do them even though it was tough going as I wanted to be coming out the other side for summer time here in Ireland.

As for current effects. I have increased sensitivity to bass sounds and sudden sounds. My dog's barking for example. My retriever has a bass bark (loudest bark in the world at 94 dB), and my Spitz has a yap. I find both irritating but the retriever bark is a killer. I also have difficulty projecting my voice, but I have no need to so it's not a problem. Zero issues with chewing. I honestly know nothing about ear fullness apart from the fact that the Tensor Tympani affects Eustachian tube function. I had diagnosed ETD prior to the surgeries with negative ear pressures, but this has resolved completely after the surgeries. Maybe that is linked to the feeling of ear fullness.

One thing I can tell you from my research and speaking to others is that no one's MEM is the same. Everyone experiences it in a different way.

Sincerely hope that helps.

 

Hi @Padraigh Griffin.

I have been to the apparent tinnitus expert at MA Eye and Ear in Boston, but he didn't mention anything about this, and didn't have any many good suggestions. I had basic hearing tests, but I don't know/think they checked for anything regarding MEM, but I don't really know.

I see you mentioned a Dr. Santos in Boston. Is this who you mean? Have you heard good things about him?

Felipe Santos, MD

Thank you for any thoughts!

Chris

 

Hey @Padraigh Griffin,

I think I might have MEM. I don’t really have the normal pulsatile tinnitus. It’s just a thumping sound, not constant, and not synchronized with my heartbeat. It happens a few times during the day. Is this similar to what you had?

Also, what professional treats this condition?

 

Hi @Padraigh Griffin,

I know you mentioned you have some sound sensitivity after the surgery. How about normal everyday sound? Are you fine with daily sounds? Is your own voice sound different?

Thank you! I am considering the surgery too and really appreciate your answers.

Ching

 

Hi. It would be a neurotologist experienced in the surgery. Professor Bance in Cambridge to my knowledge is the best doctor in Europe and is only a short trip from Stansted airport. I don't know of any Portuguese or Spanish doctors but maybe there are some.

 

Hard to explain. Base sounds in particular or sudden sounds are irritable. Projecting my own voice is not comfortable. It is not severe but is enough to stop me from doing my job which is teaching.

 

That is the best guy on the East Coast. He trained under Dr. Rick Friedmann who has performed 100s of these procedures. You have the best doctor there. People have been very happy with his work.

 

Hi, thanks for your reply. My job is not teaching so I think if you stop teaching, the sound sensitivity is not a big issue for you. I heard the sound sensitivity may fade away as time goes by.

 

@Padraigh Griffin, yhank you for this detailed post. I am not well versed in the anatomy of the ear, but do you know, if you get these surgeries, will intratympanic injection treatments still work? Like for example intratympanic steroids or if OTO-313 ever came out? I assume this is not reversible?

 

@Padraigh Griffin, you don't happen to know of any experts in Sweden?

I got high pitch tinnitus from a lumbar puncture in February, and they think MEM as well. There is fluttering and buzzing in my ears... I got SOLU-MEDROL (Cortisone) IV about a month ago for the papillary edema that prompted the lumbar puncture to begin with, and it felt like someone turned off the fluttering/drumming in my ears and the buzzing stopped (the high pitch ringing not affected). But it has slowly come back more and more.

Doctors I've met here so far are very blasé and tells me to just wait and it will "probably" resolve on its own or I'll learn to live with it.

 

What kind of sick leave do you need from teaching after the surgery? I'm in the same field. Do they give sick leave for it?

Mine is for sure whooshing, but a vjjj vjj thing in the head as well. Sometimes it goes in a slizz fizz in the ears, head, and once in a while only one ear is affected. I really don't know if and how much of a subjective tinnitus I got, as my trigeminal nerve was irritated for weeks, from dry inflammation and from being clogged.

No acoustic reflex whatsoever in the left ear and for sure I can hear my tensor tympani spasming as well. Sometimes stapedius is involved as well, which causes a high-frequency buzzing sound.

I had a consultation with Dr. Bance but as my symptoms weren't classical, he approved Botox injection only in the muscle. I don't know how to get it done, as quarantine makes everything very hard for me, and to go there just for a Botox injection is not easy. As most of the time I have the whooshing, it was hard for him to say that it is only that and not subjective tinnitus as well.

 

Hello Padraigh, thanks for sharing your very interesting messages and journey. My pulsatile tinnitus is also linked to blinking, pressing body parts etc etc. But I do also have quieter pulsatile tinnitus generally when I do not trigger it. Was this the same for you? I suspect mine is either TTTS or a cervical problem but when I try to solve it by pushing my jaw, I seem to make it worse permanently.

Best wishes,
James

 

Padraigh Griffin is no longer active here, as he sadly has passed away.

In Loving Memory of Padraigh Griffin