Severe Reactive Tinnitus After Microsuction to Remove Earwax

Hi everyone,

I came down with severe reactive tinnitus almost 4 weeks ago after a routine microsuction to remove earwax - the increased tinnitus effect was almost immediate.

I've had tinnitus for at least 20 years, although an audiologist has recently said this has probably been since birth. I'm 45 now. That tinnitus was mild and never a problem and sounded like birds chirping. I never even needed to Google the word 'tinnitus' before, although I knew what it was. I have quite strong high frequency hearing loss from anything about 850 Hz to 1 kHz, although a comparison of hearing loss before (2 years before) and after the microsuction shows no difference in hearing levels.

The tinnitus has continued to get worse and worse almost daily. The first week I'd wake up to almost silence (1/10), and then tinnitus came on during the day and spiked at night (8/10). After the first week this changed for the worse. Now every morning I wake to an immediate spike at 10/10 and it may get down to an 8/10 by mid-morning and then a 10/10 by night.

I've seen 2x GPs, 2x Audiologists and an ENT specialist. All giving very mixed suggestions from keep plugging your ears as they are still healing, to let sounds in and desensitise, to 'do what feels best, it won't make a difference!'

Yesterday, out of nowhere in a quiet room, it felt as if I'd gone completely deaf in my left ear with a huge high pitched shriek coming from it. It lasted about an hour. I was referred to A&E by a GP, and arriving at A&E I was pulled aside and told this is basically not an emergency so we can't see you, but we'll give you antibiotics for the infection (no check to see whether I even had an infection!).

The GP in A&E did check inside my ear, but it felt a little painful and tender, which she was surprised about as she said usually she can probe deeper without it usually bothering anyone. She said maybe there's an infection, or soreness due to sucking out hard troublesome wax, and has prescribed Otomize ear spray... which I've read many on here warn people away from, so haven't used.

I'm due to go to a tinnitus centre but they want to do all the tests which again people recommend staying away from, like the loudness discomfort level test and tympanometry so they can try to see what effect it may have had on my ears, the type of tinnitus I have and whether I have hyperacusis... again these tests people recommend refrain from having as they have made things worse.

Blocking out sounds seems to make it worse, bringing in sounds definitely makes it worse, and it's getting worse each day. Plus, I'm very weary of trying anything that's currently being suggested and offered

 

With my tinnitus incredibly reactive to almost all sounds, and my baseline becoming higher, I'm not sure whether sound enrichment would be a good idea?

I have been wearing earplugs quite a bit, which I understand isn't something I should do, but any type of continuous noise, whether waves, natural sounds, soft music, or any colour sound for more than 5-10 seconds spike the tinnitus like crazy.

I know I need to be building up sound tolerance, which I admit I haven't been doing well - but each time I do, the baseline increases.

I feel I should be becoming more familiar with sounds but each time seems to come with a major setback and a higher baseline - and the sounds used are incredibly low volume.

I can't have sound on a TV, or sit downstairs as the hum of the fridge spikes it like crazy - even with earplugs!

The only time I sometimes seem to be able to settle things down a little is with earplugs and earmuffs.

Does anyone have any suggestions for this type of reactive tinnitus (or hyperacusis, whichever term you want to give it, but I have only experienced pain once with sound)?

 

Protection of your baseline should be the priority. You won't build up any sound tolerance with your ears the way they are reacting just now.

Stay away from the tinnitus centre for now.

Plug up, or double plug, if you need to.

Give your ears time to recover, then reasses in a few weeks.

 

Hi Dean,

Sorry about what you’re experiencing.

Your story sounds similar to mine, I also got tinnitus after an earwax removal.

However, I’m unsure if mine was actually caused by the earwax removal itself because it appeared two days afterwards, precisely in the same moment when I unclogged my left ear with my index finger because of a feeling of fullness that I had.

Did your tinnitus appeared suddenly after the earwax removal or not?

Also, since my tinnitus is also reactive to certain frequencies, I would say that the best way to desensitize the reactivity is to get a bit exposed to normal sounds but not by that much. Your level of exposure is going to depend on the tolerance of your reactivity. Apparently I also have hyperacusis according to my audiologist, so maybe that’s why I have reactive tinnitus, thou’ my reactivity is unilateral.

I can’t say if I, myself, have seen an improvement during my 6 months of reactive tinnitus (first time having tinnitus, didn’t heard of it before) because some days my reactivity is lower than other days and vice versa, so it is sort of like a rollercoaster.

On August I got COVID-19 and my reactivity went to insane levels, it reacted to people voices and radio. It no longer reacts to people’s voices and to most of the radio. Hope this helps.

 

Hi @DeanD, so sorry to hear about your experience. How long would you say the microsuction took place in each ear?

 

Thanks for the reply.

I've had tinnitus since birth (chirping), but I noticed a louder ringing within an hour or two later of the microsuction.

I was following your advice and it was getting better but a terrible acoustic trauma happened (even whilst I was double protected) which has set me back very bad.

 

Hi @ErikaS - very quick, only about 20 seconds in each ear.

Unfortunately the audiologist irrigated after, which was very loud.

I guess my case a little unique as I am already hard of hearing since birth, and my ears were blocked with wax.

Wax was pulled out, and I could hear better than I had in years and bam, ears got microsuction gun and irrigation straight away.

I think the shock brought on hyperacusis which caused the tinnitus.

How is the neuromodulation going?

 

Ugh, I had to get microsuction done a few weeks before I caught an ear infection that gave me tinnitus. The ENT was in each ear for no more than 7 seconds (I had used homeopathic drops that didn’t clear the wax and created a membrane over my eardrums). I had some sound sensitivity and itchy ears for a day or two after, but that subsided. What infuriates me to this day is I called her office to report the sound sensitivity and itchy ears, AND the fact that I still could feel fluid in my right ear. She said “yes, you did have some fluid, but it was clear and did not look infected, keep using Afrin” and I asked her if I should start an antibiotic just in case, and she declined. 2 weeks later, I got a full blown/severe ear infection in right ear, and that’s when the tinnitus came on. I have since found out that the ear infection damaged frequencies at 11.5 kHz and higher in my right ear, which is most likely the cause of my tinnitus. No damage/hearing loss in my left ear which makes sense because the ear infection was mild in that ear. If she would have just given me an antibiotic when I asked to prevent further infection/damage, I probably wouldn’t even be on this site. But here I am, with multiple tones and reactivity. Only thing on my side is that my tinnitus is low-moderate in noise level, but its intrusiveness with reactivity is what gets me.

I have done 3 Neurofeedback sessions. The first “block” of sessions focuses on engaging the parasympathetic system to tap in more and calm down the nervous system. We are looking for things like improved sleep cycles and mood, however I told the therapist “unfortunately my mood won’t change drastically until I see some type of change with my tinnitus”. You could say I am still stubborn and accepting this situation and working through my anger Anyway, the next “block” of sessions will be tying in the actual tinnitus protocol. Then after that, we will be adding in auditory memory components, basically trying to teach my brain “it’s okay that you don’t hear what you did before, let’s rewire you so you don’t focus on that as much”. I plan to continue this for at least a few months, and I have a TRT eval in February. Hoping both can work effectively together and bring on healing.

 

I feel that audiologists and clinicians should be required to fully understand the implications of microsuction machines relating to hyperacusis and tinnitus - and be required to make full disclosure of the fact it could happen verbally before it's carried out.

Seems like they are throwing the kitchen sink at your tinnitus which is good I hope it continues to fade for you.

Did they mention how they intend to target the tinnitus using their tinnitus protocol?

Keep us updated on how you go!

Merry Christmas btw!

 

Well, I am throwing everything at it. No one is really guiding me, just my own research and my own theory/thought process of early intervention may help healing. When it comes to targeting the tinnitus, it’s a specific area of the brain (auditory cortex) and what I showed there on my brain map. It was actually quite crazy, on the right side of my temporal bone area, it was red right in the auditory cortex area. It was not nearly as bad on my left side. This supports that the “damage” and ground zero of tinnitus was with my right ear. So this area will be targeted to try to request the brainwaves that are causing this disruption.

And yes, I completely agree about the microsuction. Although I do not believe my current issues came from it, I did have sensitive ears for two days after. That did go back to normal, but still very concerning and I was never told to expect any of that. They just don’t explain or go into any detail. Meanwhile this is our AUDITORY system, we only get one so it should be handled with such delicate care and thorough information at every step.

Merry Christmas to you too I was able to attend two family gatherings today, I will see how the tinnitus is going to bed tonight and tomorrow. I thankfully do not have pain hyperacusis, sensitivity, or fear of sounds in these environments, just my sensitive winding up tinnitus.

 

First off, I'm sorry to hear you're going through this. I just wanted to ask when you say ''winding up'', do you mean it gets louder throughout the day? Does driving or exercise affect it?

 

Hey @Stayinghopeful, I have reactive or winding up tinnitus. It is very much affected by sound and even things like my heart rate increasing. If you go to my thread called “How Far to Push Reactive Tinnitus” you will see an explanation of how this happens. But yes, things like a fan running, shower, car, etc all make it heightened in a way that it goes up and becomes a louder high hiss. I also deal with sound distortions to these things.

My tinnitus started from a bad ear infection in my right ear in early September. It unfortunately seemed to have damaged/inflamed nerves in my right inner ear that affect my hearing ability at 12.5 kHz and up (not formally tested, but I realized this at home doing my own sound testing on YouTube). So one could say this virus gave me sudden hearing loss at very high frequencies in my right ear, thus causing tinnitus. It’s upsetting because the tinnitus didn’t stay in my right ear, it affects my left too.

 

No problem! Sorry to hear about your setback.

Hopefully time might be able to heal us. About one week ago, I had a week of almost reactivity free for the first month after a long time, but unfortunately I got a setback out of nowhere (three days after a flight, maybe a delayed noise setback but I’m not sure), thou’ no where near as bad as previous setbacks.

Based on the months where I have been dealing with reactive tinnitus, there’s no pattern at all and sometimes I get random setbacks but at least they tend to not be permanent.

What I have noticed is that silence and earplugs do not help me with the reactivity at all since they make me more hypersensitive. I try to avoid earplugs as much as possible unless I consider them completely necessary, but if my reactive tinnitus is screaming very loud to me after the exposure to certain frequencies, I prefer to move away from the source of sound rather than using earplugs if it is an option.

 

Sorry to hear about your setback @EternalRinging. Is this the first time you have flown since your onset?

It does seem crazy in this world that not one medical person I have seen has suggested protecting ears around loud sounds (apart from my ENT who told me to keep constantly protecting as the ears will still be healing for many weeks).

I am at that stage now where phonophobia has taken over quite badly. Not from the initial exposure, but the myriad of setbacks (5 now in 12 weeks) making it worse. Each setback pushing me further in to earplugs, then homebound.

The tinnitus was unmaskable, reactive and severe on day one, and today it is worse due to those setbacks. I don't live in earplugs but I live in very quiet and silent surroundings all day.

This may be a good thing for my ears, but I must admit to feeling in quite an isolated 'stuck' place at the moment.

 

Hi @DeanD. I'm pretty similar to you.

My life has largely been hell for the last 12 months but the pain response to sound and TTTS started to dissipate at months 6-8. During this time it was living hell with debilitating tinnitus that kept me homebound all day, to a moderate, just about tolerable day following. It is still unstable, but no pain, and the reactivity - whilst still there - has improved 20%. The loudness hyperacusis took 8-9 months to get better and now only sounds in excess of 70-80 dB seem louder.

For sleep I take 30 mg of Mirtazapine. Even with this it took 4-5 months before I consistently got 7+ hours of sleep.

I was given Diazepam, 10 mg, for the day, and immediately tapered to 7 mg, next month 5 mg, then 4 mg etc. By month 6 I was on 2 mg. Today I still take a micro amount 1-2 mg most days. I am fine with this for now.

2 months in I tried Clonazepam as it had a remarkable effect reducing the volume and sound sensitivity after 12-24 hours. I realised that it is a powerful medication and it's best used infrequently to avoid dependence and tolerance. I take it every 7-10 days and take a 48-hour break from the low dose Diazepam. This has worked for me and it has allowed it to keep working. I take 0.5-1 mg of Clonazepam for 1-2 days, then stop. You should not need Diazepam the day after as it's quite long acting.

This is what I have done.

I started wearing hearing aids set at 30% of volume due to sound sensitivity and keep it there. In the day I use a sound generator everywhere I go. The tinnitus still reacts but there is no pain. I would guess the volume of running water is 25-30 dB. A couple of weeks ago I added ALA + multivitamin and mineral from Lamberts UK to mimick a 2019 study.

I also spoke to Dr. De Ridder about the options of a low dose cocktail to start soon.

During the first 9 months of hell I read, contributed to the forum, ran and took a sauna as the gym was too loud. I walked too, even though I could easily hear the tinnitus over nature and traffic. Today it ranges from moderate to severe (4-9/10) and occasionally 3/10. It can change by the hour too.

I've had to do all this by myself as CBT is not available on the NHS in my area, with the nearest being a 3.5 hour round trip. A couple of people have had success but it's become a limited postcode lottery in a decimated health system. I tried the British Tinnitus Association, they are useless unless you are new to tinnitus or have stable mild to moderate tinnitus. Even during the Tinnitus Week they have been poor, sharing pictures and information on protecting your hearing. How does that help the 7.6 million they claim to protect?

I wish you all the best,
Nick

 

Hey @EternalRinging, I feel like you are one of the very few who go about the reactivity/spiking like I do, and you’re a little further along than me (I am between 5-6 months post right ear infection that went into middle ear and caused hearing damage/loss in very high frequencies).

So I wanted to see if you can say the way in which you went/go about it was/is of benefit to where you are now? Do you feel like it helped you from regressing to worse? Also, how do you know the cause of your tinnitus, do you have any hearing loss damage?

 

Hi @Nick47 - I was doing well on Mirtazapine for sleep and Propranolol until January when I developed severe eye pains.

It was then I - out of panic I guess after ending up at an eye hospital with bad eye pain and severe photophobia - cold turkeyed on both Mirtazapine (after just over a month) and Propranolol (just over 2 months).

It looks as if either the medication, or stopping the medication, may have triggered an autoimmune issue.

I am having constant problems with muscle spasms and aches including chest, throat, stomach and legs - plus waking up several times in the night (when I can sleep more than an hour) feeling dizzy, and needing to breathe, which has been going on nearly 4 weeks now.

Now waking up opening windows feeling like I need oxygen, and even checked the altitude of where I was. I felt that bad.

I first put it all down to side effects from the medication but it's now been a month, plus the symptoms are becoming worse and cumulative each day, not better.

I've been desperate for answers. I have been to A&E, and I have called an ambulance on more than one occasion in the past 2 weeks with chest pains, and shortness of breath. Medical system is getting bored of me now, and are putting all my issues down to the usual anxiety response the moment they see me in Peltors at the hospital due to hyperacusis and severe tinnitus.

They do their usual life or death checks like blood, ECG, blood pressure, heart rate etc, and even got a head CT Scan, but all come back fine.

We have a great reactive NHS health system for emergencies but very poor preventative system for referals and tests to stop people becoming emergencies.

Am awaiting neurologist and rheumatologist appointments next week, but with worsening breathing issues and no sleep as a result of the breathing issues for a month, with severe tinnitus (8-10/10) and hyperacusis, I am losing the will and struggling to get there.

...and yes I agree, Tinnitus UK are pretty useless. Same rehashed Twitter posts that have a handful of views. Nothing in terms of research, or finding a cure - only support and recommending TRT and CBT treatments. It's pretty pointless and serves nothing towards their mission statement and tag line.

 

Hey Erika,

I’m not completely sure of what caused my tinnitus. I took 20 mg of Adderall recreationally and a week afterwards my tinnitus started. I did this in the past with no problems at all, so I came to the conclusion that it wasn’t the cause.

I used in-ear headphones at safe levels the week before I got tinnitus and my right ear became completely blocked with hardened ear wax so I could barely hear from that ear before getting the wax removed. My left ear got a lot of wax as well but I could hear fine. I was desperate so tried Q-tips to get the wax out of my ear, no luck. Probably it made the problem worse.

ENT removed the wax on my left ear (the one in which I could hear fine), but my right ear wax was so hard that he could not remove it as hard as he tried, so gave me some ear drops for 7 days to use it on that ear. Two days later, tinnitus started suddenly on my left ear after a feeling of fullness and the right ear was fine, thou’ the ringing started in the right ear 3 months afterwards and basically, as of now, both of my ears have the same tinnitus volumes, reactivity and tones, with my left ear being slightly more reactive.

So I would say it is highly likely that my tinnitus was caused due to the earwax issue, I’m just not sure if it was the ENT’s fault or my fault for having that amount of earwax accumulated in my ears this whole time since I had never cleaned my ears before in my life.

Regarding hearing loss, my audiogram is within 10 dB from 200 Hz to 8 kHz. My audiogram is kind of atypical, since my 10 dB hearing loss is in the lower frequency range and in the high frequencies from 6 to 8 kHz, they’re at 0 dB.

Extended frequencies diagram revealed that I had 35 dB of hearing loss on both of my ears at 16 kHz, but when I did that test, my right ear didn’t had reactive tinnitus at that moment. Years before having tinnitus, I did myself a YouTube hearing test with the extended frequencies and I could recall that I already had trouble hearing 16 kHz unless I increased the volume. So I came to the conclusion that my audiogram told me nothing about my tinnitus.

In the past months I decided to stop caring about over protecting my ears and I pretty much do everything I did in the past (except when my reactivity/spike goes nuts when trying to watch TV, I basically go and take a nap to calm it lol). I feel that it definitely has helped with my reactive tinnitus, since I used to hear it every time when exposed to crowded streets and now, most of the times I no longer hear it over crowded streets. I still struggle on a daily basis and I wish it was gone but I no longer feel suicidal. As you can see based on my username and avatar, I was in a very dark place when I created the account.

Also, weirdly enough, sometimes when I got exposed to insane sounds levels in universal studios, my reactivity with the normal “eeeee” tone calmed down but my beepings (Morse code) increased temporarily. Overall, in the past two months my beeping reduced with occasional spikes, but I plan to try Carbamazepine if I keep with these beepings when I hit the 1 year mark.

So I believe that despite your tinnitus being caused by an ear infection, we both might have the same damage because when I got COVID-19, which attacks the inner ear, it affected my ears tremendously. Incredibly weird how an earwax could cause that kind of damage but it happened. We might not have regular hyperacusis, but we do have sound sensitivity for sure and it appears that sound-sensitive tinnitus/reactive tinnitus should be treated similar to hyperacusis.

Sorry to hear about your tinnitus, I hope that time heals it. I know how frustrating and hard is to have this sh*t, so feel free to ask me when you have further questions or need some support.

 

@Nick47, how are you finding the Diazepam?

I was given this yesterday as I have a very bad sleep condition (not directly related to tinnitus) at a dose of 4 mg.

I didn't like the way I felt on it, and it didn't help with the sleep issue either.

Is it safe to take just one 4 mg dose and stop, or should I taper?

 

@DeanD, Diazepam does nothing for tinnitus. If it doesn't help sleep, drop it. It will not require a taper.