A few years ago I had a very bad ear infection that left me with some ringing in my ears. For the most part it was not persistently noticable. Recently, the ringing has become louder. This started at about the same time I began taking wellbutrin and got a sore throat. The sore throat was accompanied by conjestion for a couple of days but when that cleared up, the throat was still sore and the ringing still very present. I have been on antibiotics for a couple of days now and the throat is feeling better. When I mentioned the ringing in my ears to the doctor, he looked in my ears but said everything looked okay. What might be causing this? Is there anything I can do about it?
Reply --------------------------
In many cases, the complaint of tinnitus accompanies a measurable degree of hearing loss, even though hearing loss may not be noticeable to the patient or it may not be sufficient to be a source of complaint. Often in these situations the examination of the ear drum is normal and an audiogram is required to identify the hearing abnormality. However, occasionally a complaint of tinnitus will be accompanied by perfectly normal hearing on an audiogram and there will also be a normal ear examination. Unfortunately there are no consistently reliable tests that can objectively measure the symptom of tinnitus.
There are many known possible causes of tinnitus, some of which include ear infections, eustachian tube dysfunction, presbycusis (hearing loss of aging), loud noise exposure, head trauma, and certain medications known to be potentially toxic to the inner ear. In your case, a careful physical exam of the ears, nose, and throat combined with an audiometric study of your hearing would be necessary to help identify the cause. I suspect that the chronic tinnitus you have experienced following an ear infection may be directly related to that infection which may have caused some injury to the inner ear. The recent increase in tinnitus may have been caused by eustachian tube congestion related to the sore throat. While anti- depressant medications in general may be associated with a complaint of tinnitus, I am not aware of any signficant ototoxic potential of wellbutrin.
If the recent increase in tinnitus is indeed related to eustachian tube dysfunction following a throat infection, it will most likely be a self- limited condition or it may respond to a mild decongestant. If the increase in tinnitus persists, I would recommend an ear, nose, and throat specialist examine you and measure your hearing.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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