Unilateral Tinnitus, ~80-100% Gone, 1.2kHz Pure Tone Remains with Visual Snow (VS)

Hi everyone, this is my first post here, but I've followed Tinnitus Talk since my onset late December/early January. Everything started at the end of December 2018. My ear was beginning to become impacted with wax so I scheduled my yearly lavash. The left ear went fine, but the right ear was too dry, and the procedure ended up impacting my ear even worse than it was. They gave me some earwax softening drops but I misunderstood exactly how to use them. Over the course of the next week my ear would open and close, no tinnitus, but I kept trying to use the drops to soften things more. Eventually it got so bad that I went to an urgent care around Christmas and was told that I had some type of ear infection. I was prescribed a round of Amoxicillin and also set up an appointment with a reputable ENT the following week. During this time I first noticed some lower frequency tinnitus to which I generally ignored, as I have always experienced tinnitus from my prior cerumen impactions that just simply go away after cleaning.

Before my ENT visit, I was practically deaf in the ear. The tinnitus got worse and worse until it was just constant high pitch screeching with low pitch 200-400Hz whistles. During my first ENT visit, the PA performed micro-suction and observed scattered wax around my canal and on the ear drum itself. She attempted to clean out half of it but it was too painful for me to endure so we had to postpone the rest for the next week. The screeching continued until the second visit, when she cleaned about 80% of the remaining wax out, but couldn't reach some areas of my eardrum due to having a convoluted ear canal structure. She asked how my hearing was afterwards and to my shock, it was not 'back to normal'. Sound was slightly muffled and some loud tinnitus was still present. At this point, I had

• ~ 1 kHz (half morose code half pure tone) tinnitus
  
• 1.201 kHz (pure tone) tinnitus
  
• ~2 kHz (morse code) tinnitus
  
• 4 kHz (cricket sounding) tinnitus

The screeching and others went away. The cricket sound was the worst, difficult to mask, and made concentration or much of any activity annoying.

I was given three hearing tests in 2019:

• 1/4/19 Right ear HL at -25 dB, -40 dB, -30 dB at 4 kHz, 5 kHz, 6kHz (bone was normal at 4 kHz, not tested beyond). Minimal 10 dB loss at 500 Hz, 1 kHz
• 1/14/19 Right ear HL at only 8 kHz at -20dB
• 4/8/19 No HL

Between 1/4 and 1/14 the cricket sound diminished, and it eventually disappeared by march except for mornings I would wake up and hear it loud. To this day, if I flex my tensor tympani muscle I can hear it just for the duration of doing so (and briefly thereafter sometimes).

Sometime in February, another doctor from the same clinic operated on my eardrum to remove wax that stuck to the ear like paint. He could get about 90% of it off, but did not feel as though it was worthwhile to finish and believed the rest would come off naturally (it was the most uncomfortable feeling in my life). I do think this helped because between 3/2019 and 5/2019 the 2 kHz morose code disappeared 99.9% and the 1 kHz tone diminished greatly. I started noticing a new tone however, which I think existed the whole time but was masked by the louder tones:

• 1.5-1.6 kHz pure tone tinnitus

From then on, all my tinnitus has reduced and began to plateau to some baseline that consists of just the 1.201 kHz (pure tone) tinnitus and very light, not bothersome 1.5 kHz tinnitus. The 1.2 kHz tone would be so low some days that it would appear (morse code) in amplitude, unless I listened for a while.

Flash forward to today and the baseline has still dropped, albeit very very slowly. Once in a while, I will hear silence 0% (with regards to these pure tones). Other days, the tinnitus will be super faint 1-5%, like it's struggling to ring. Other days, it will stay at baseline ~5-15% of original presence. Very occasionally it will spike, including stress induced from flexing my Tensor Tympani muscle.

Bottom line, everything is gone except for the 1.2kHz tinnitus.

Now here's the weird thing: I can make that go away completely by applying pressure to my face with my finger 1 cm away from the Tragus. Nothing hard, just a light push makes my tinnitus completely go. It did a lot for my anxiety, knowing that if tinnitus were really really bothering me, I could get some brief moments of silence.

Here's another weird thing: when I put an earplug in my ear, my tinnitus actually diminishes. I also have had mild bilateral static-hissing tinnitus since a kid that has never bothered me and I've felt to be normal. That increases when my earplug is in. Similar, if I'm around loud music (I'm careful, nothing too loud), there is no change on my tinnitus. In fact, sometimes it goes down too. If I drink, my tinnitus goes down (but do I get some moderate bilateral static tinnitus). It seems completely independent of any typical sensorial circumstances.

One more weird thing: If I experience 'fleeting' tinnitus tones in my right ear, the 1.2 kHz tone completely cuts out, even though I can still hear out of the ear. Its not until the fleeting tone goes away that the 1.2 kHz tone comes back.

Also, I faintly recall as a kid that yawning would give me a similar ringing tone, but only during the yawn and if it was a big enough yawn. I know that tone was somewhere between 1.0-1.3 kHz.

In summary I would say that my tinnitus on its own is a success story, as any outside sound masks it for the most part. The reason I don't feel as though its a success, is that along the same timeline, I developed moderate-heavy visual snow. Here is a brief timeline of my symptoms:

• 2/2019: Sensation of migraine like aura in early stage, but never develops (I have had a history of migraine with aura, but no occurrence in over 5 years)
• 2/2019: Sudden abundance of floaters, different shapes in each eye
• 3/2019: Sensation of 'fireworks' afterimage in center vision when looking at bright/white surfaces
• 4/2019: Sensation of black sparkling dots in center vision when going into a dark room after being outside or looking at a screen
• 6/2019: Onset of illusory Palinopsia in ultra-dark, high contrast area and LED lights
• 8/2019: Palinopsia becomes more intense, shows up in lesser contrast like street lights
• 9/2019: Afterimage perception increases, very hard to watch TV in a dark room.
• 11/2019: All VS symptoms except floaters get worse, floaters become less noticeable for some reason
• 1/2020-2/2020: VS symptoms begin to stabilize and find a baseline, but any light or shiny object gives me trails.

I've done an head MRI in 2/2019 and an ear CT scan in 2/2020 no issues found. I've had multiple OCTs, back retina scans, visual field tests with no defects. My vision is still 2020 and night vision seems good besides seeing static.

I have reason to believe that my tinnitus, which is not ultimately gone, is the cause for my VS, which is the main disturbing factor in my life.

Also on my hearing tests, theres a section titled : Impediance Tympanogram. Is there any signifigance to that? My right ear always has a lower number than my left ear on every hearing test. I attached my first test to this post.

 

My theory is visual snow is connected to tinnitus fading as it's literally "gaps" in the signal... probably a consequence of the brain dialing down firing of excited responses which it deems as over excited. The regions might be linked in some manner (I'm not a neuroscientist).

When my tinnitus got worse and I got "chimes" for the first time (it was quite explosive, and lessened to a single note and lowered in volume over time), at the exact same time I also noticed a huge degree of "sparkles" in my vision at night, bright twinkles of light which faded as fast as they appeared. This already rarely occured, and is back to being so.

That being said any drug blocking tinnitus in theory should make visual snow worse then.

That being said as well, maybe try some coffee?