Ear, Nose & Throat Community

Five weeks?.....it is time for you to have a consultation with an ENT specialist. You need to take your medical assessment to a higher level.

Your acoustic trauma (By the way, what was the nature of this event?) and the symptoms that followed may or may not have a connection. You may have sustained acoustic trauma, but that does not mean you cannot also acquire a disease entity that will exacerbate your symptoms.

I have tinnitus, myself. I suspect it was caused by a virus, not any acoustic event. My vertigo/balance was affected first; follow by the tinnitus about 1-2 weeks later. Your pattern of response - balance issues three weeks later -- may not be that unusual.

If you do have damage in your inner ear, it can be permanent. Fullness, however, may not always be present.

A normal blood count is just that....normal. It does not rule out a virus, especially one that may be involved in your inner ear, unfortunately.

I do not know of any crazy interaction that can be associated with an acoustic incident and allergies, but both have the potential of causing ear-related symptoms.

I have no way to predict your prognosis based solely on the information you have posted. Again, I encourage you to seek an ENT consultation.

Thank you Dr. Moser! It is reassuring to finally find someone willing to think about this with me. Here are some more details in response to your comments.

I actually did manage to see an ENT in the third week, just before the symptoms got really bad. Unfortunately, the appointment left me pretty confused. The ENT said things probably would seem back to normal after a while, and asked me to wait yet another month to see. But on the report this same ENT wrote that my condition "has already resolved." Perhaps if I knew the lingo this wouldn't seem so odd? When my new symptoms started, I called repeatedly (even sent a fax) but the receptionist assured me that the doctor does not respond to patients outside of an appointment under any circumstances. She did say she was willing to put the messages on the doctor's desk. Of course no appointments were available for weeks, and as predicted the ENT has not responded to my messages. I set out looking for a more accessible doctor and did manage to identify an ENT who actually specializes in acoustic trauma. Unfortunately, this one has no openings for another 12 weeks. It's so frustrating to me; I don't want to wait 12 weeks to find out there's something that should have been done now, but what choice do I have? I guess these folks keep pretty busy.

The event itself is painful for me to think about. At a community concert, my friend announced she was going to put her cell-phone on speaker mode so I could hear a message someone left her. I thought she was going to set it on the ground, but given that the loudness moved with me as I tried to move away from it, I suspect she was actually holding the speaker up to my ear. It didn't hurt like having a screwdriver in your ear, but it was unquestionably too loud. It was loud enough that the sound was actually distorted by my ear, an effect I have experienced few times before in my life.

I am generally extremely careful with my hearing and had previously been wearing earplugs, which my friend repeated asked me to remove. Given that even the people really close to the speakers hadn't been wearing earplugs and given that it happened to be a quieter tune, I finally agreed. When the problem occurred I did not consciously recognize the danger, partly because it did not seem all that much louder than the noisy din around me, partly because I was exhausted, and partly because I was caught off guard; it never occurred to me that this particular person might do something to put me in danger.

1) In retrospect, I suspect what were perfectly safe background noise levels for all the other people were already getting into the dangerous levels for me. Is it possible for people to have different danger threshholds like this?

2) Regarding my episodes of extreme noise sensitivity which I mentioned previously; do you suppose my ears are actually in more danger during these episodes than at other times?

3) As for your tinnitus, did your balance eventually return to its original levels?

4) Is it possible that spending extended time in quiet environments makes your ears more vulnerable to noisy environments? (Analogous to the fact that you're more likely to get sunburned if you haven't been in the sun for a long time?)

I am glad you are finding a new ENT. ENTs, in my opinion, do not really like dealing with issues that they may not be able to "fix" surgically or otherwise. This is why many medical providers, when faced with these very difficult, and sometimes - impossible - challenges, will just allow Nature to orchestrate the healing. If you get better, they take the credit. If you do not get better, they blame Nature.

Inner ear damage is complex. It is rare that medical providers can really repair or alter the natural course, whatever that might be. Some people are more sensitive to sounds, and yes, they may be more prone to acoustic injury. Being in a quiet environment most of the time, does not make you more vulnerable - it is just that others may be more tolerant to noise (like those guys with the loud stereos in their cars). Many people encounter unexpected acoustic trauma, like an explosion. Statistically, the vast majority of people do improve over time, but not everyone. It may be much to soon to consider yourself permanently injured, but there is really no way to predict when, or even if, you will be one of the one's that have a full recovery, or one that will have some residual symptoms.

I wish that I could specifically address all of your questions and concerns, but at this point, it would only be for the sake of discussion, since every person is soooooo different.

Let me know what happens with the new ENT, and I am sorry that you have to wait so long. You can always hope that you will completely recover before the appointment, and the ENT will lose the opportunity to participate in your care.

Another helpful resonse; I appreciate your good wishes too.

I admit I find it very frustrating that I cannot find more information about how to take care of myself after this kind of injury, and I do have so many questions about what is going on inside there! I suspect the answers may not be known by anyone, unfortunately.

For instance, what is the effect of wearing earplugs all the time for extreme noise sensitivity during the healing process? Maybe the ears are more vulnerable at this time of healing, in which case blocking out sounds would help. Or maybe ordinary sounds are important for effective compensation mechanisms to be built, in which case blocking out sounds would be bad! Perhaps nobody knows? I am hoping that my body knows best, so I am trying to do what is most comfortable for me.

I certainly will post about my status as time goes on.

If someone reading this thread in the future knows of other instances of delayed-onset symptoms after an acoustic trauma please let us know below! I'd love to know for certain whether that is something which happens to some people.

Thanks again.

It is all a waiting game now, my friend. Medical science has some definite limitations, especially when it involves inner ear damage. Try and remain optimistic....the body has a remarkable way of repairing itself if we are patient enough to allow it time.

I don't think you will need any earplugs for everyday use, but do your best to avoid any other acoustic traumas during this healing (hopefully) process.

I am definitely more comfortable with the earplugs in. If I take them out, the fullness starts to get worse and turns into an earache. Also, the little household sounds can be uncomfortable for me. Besides which, I can't stand the way things sound through the damaged ear! So unless I find there is some harm in doing so, the earplugs stay in (at least for now).

I have read that some people can "drown out" their tinnitus with background noise. Mine gets louder with background noise, and stays louder for several minutes afterward. (It also gets louder when I eat.) I guess there are different types of tinnitus? Lucky for me, the tinnitus does not bother me much relative to the other symptoms.

I am a patient person when it is necessary, so waiting I can do.

Check out "hyperacusis". You can do a search on Google. This is unusual sound sensitivity to everyday sounds, often associated in people with tinnitus.

Need your ideas Dr. Moser-

Yesterday when I was looking for quiet in the back yard there was an explosion. I was wearing ear plugs and ear muffs for my hyperacousis, but it shook my clothes and people in my house rushed outside and said it shook the house too. It sure seemed like it was only 50 feet away but we could not figure out what it was; no groups of people, no smoke, no damage. (It is kind of tricky to see past the hedges, though.) Could a neighbor have set off a professional firecracker and then gone back inside? We may never know.

Ten minutes after the explosion my fullness returned (it has been mostly gone for several days). Given that it was after 5, I decided not to try to reach anyone. Now this morning I have a new tinnitus tone; it is significantly lower than the first.

I am concerned and not sure what to do- Go to the emergency room? Push my doctor for steroids? Do nothing?

Just wondering if you can think of something I haven't.

This is not really a life-threatening emergency, so I don't think you are going to benefit from a trip to the ER.

Doctors don't like to be "pushed" to do anything, but if you have seen an ENT, please give them a call for patient-specific advise. Steroids may not help this anyway, but that is really up to the ENT to decide.

Doing nothing is always an option -- one that many people choose for various reasons. A new acoustic incident can trigger changes in your tinnitus, but things could settle down in a few days. Tinnitus is so variable. My own tinnitus can change for day to day, even without provocation.

I am actually more concerned about the fullness than the tinnitus. However, since neither you nor my PCP's nurse think I need to rush out and do something right away, I will feel guilt-free about doing nothing.

As for calling my ENT, recall the doctor does not speak with patients unless it is during an appointment scheduled three weeks in advance- no exceptions.

Ahhh, I remember...I call that M. Diety; the feeling that you are as important as God. I hope he is an excellent doctor. Personally, I would not tolerate that behavior in a medical provider.

Hi,

I'm sorry about your acoustic trauma. Anyhow, I suffered acoustic trauma in one of my ears after listening to my ipod in a noisy environment.

I went to see a specialist, and my eardrums were fine and not perforated. (This is very important) I read up on some scholarly publications in regards to research done on hearing in animals and vitamin e. I had tinnitus in one of my ears and any kind of noise would make it worse and I was beginning to lose sounds of treble clef in the environment in that ear.

This is how I solved my tinnitus problem: What I did was take vitamin e supplements (not A because vitamin A can cause cancer), and got a bottle of soluable vitamin e oil (10,000IU bottle that can be taken orally so that is pure), took an eyedropper, filled it with the vitamin e oil and inserted it directly into my ear canal, so that it would reach my inner ear. I left the ear facing up at night before bed.

I no longer have the tinnitus. Although my ears are still sensitive, my hearing has returned to normal.

Your ear is an organ, and it needs to heal. When the inner ear has been traumatised, it can't be exposed to noisy environments because that further deteriorates the delicate membranes and nerve endings in the ear. A lot of research has been done on the effect of vitamin e in the healing of the ear. However, I personally just took it one more step and directly inserted the vitamin e oil into my ear canal so that the delicate membranes in the inner ear can heal itself.

You should consult a specialist. I saw the best ear specialist in my area, to make certain I didn't have an ear infection or a perforated eardrum. If you were given antibiotics, I wonder if it was because you might've had an ear infection?

Anyhow, I just wanted to share with you how I solved my tinnitus problem after acoustic trauma.

Will inserting vitamin e into ear canal really get rid of the tinnitus? Are you sure? Did you tell the doctor about it before you did it? I have tinnitus right now and am trying to find a way to cure it. Please give me additional advice if you have any. My email is kimliu84@hotmail.com

Thank you.

There is NO scientific evidence that inserting vitamin E oil in the ear canal wil do cure or improve tinnitus. None.