My name is and I have experienced Tinnitus for about 2 years. It all started with my playing in a loud rock band....I would awake after a show the night before with severe ringing....over time the ringing was accompanied with a feeling of fullness in my ears....what would usually happen is my ears would "clear" and then a day or two later the ringing would go away....this pattern continued for several years, ringing and fullness, a clearing of the ears, and the dissipation of the tinnitus....Currently I have been unable to "clear" my ears, and as such, the tinnitus has not diminished....In a recent effort to clear my ears I had tubes placed with no benefits being realized....The tubes have only caused an agitation of the tinnitus although the feeling of fullness persists....Several times a day I will have a "big yawn" and the feeling of pressure within my ears will vanish for a brief 1/2 second or so, only to return at the end of the yawn. Please let me know your thoughts, as trivial as you may think they are as I have been searching for several years for a solution with little success....Additionally, if you have suggestions for people/places I should contact, or any possible next steps, please advise...

Best Regards,

Reply: ----------------------------

The description of your symptoms is similar to what one experiences with eustachian tube dysfunction. Often there are characteristic findings on physical examination or on audiometric examination, particularly with tympanogram testing. However, if eustachian tube dysfunction were indeed the cause of your symptoms, one would expect that if it weren't self-limited that the placement of tympanostomy tubes would alleviate or lessen the symptoms.

Two other less common causes for symptoms such as those you describe include 1) a patulous eustachian tube or 2) a variant of Meniere's syndrome known as cochlear hydrops.

With patulous eustachian tubes, one typically experiences autophonia or a heightened awareness of one's own bodily sounds and voice which may also be associated with a sensation of fullness in the ears. Usually one also experiences audible popping or snapping of the ear drum with each respiration do to unrestrained flow of air back and forth through the eustachian tubes. The latter symptom is easily dealt with in most cases by placement of a tympanostomy tube. However, the former symptom of autophonia is usually refractory to most attempts at treatment.

Cochlear endolymphatic hydrops is an uncommon variant of Meniere's disease. Meniere's disease is a condition of the inner ear whereby the normal fluids of the inner ear fail to resorb in a timely fashion while fluid continues to enter the channels of the inner ear. This leads to a build up of fluid pressure and eventually, in severe cases, rupture of internal membranes of the inner ear causing attacks of roaring tinnitus, whirling vertigo, and hearing loss. Cochlear variants of Meniere's are thought to exist whereby the fluid accumulation is isolated to the cochlear (hearing) portion of the inner ear without affecting the vestibular (balance) portion. Cochlear hydrops is thought to cause tinnitus, hearing loss, and fullness in the affected ear without dizziness. The basic treatment measures include avoidance of salt, diuretic therapy, and occasionally short term use of systemic steroids.

I would suggest you consult with an otologist. This is an ear, nose throat specialist who has additional training specific to conditions of the ear and balance and limits his practice to those areas.

--

Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis

NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.

Click here to review previous Ear, Nose and Throat Clinic consultations

Consult with the Doctor