Stapedial Myoclonus

[Brian459]

I have had popping in my ears when I swallow and move my jaw for over a month now.  I had hearing tests done and my ENT says my hearing is normal, but my left ear is "sucked in" a little like on an airplane.  If it is only the left ear, why do both pop?  I went to a concert just before this all started and am wondering if loud music could cause something called stapedial myoclonus which would explain my symptoms.  My ENT dismised the thought saying the loud music wouldn't cause the popping.  Also is there a test I could ask for to prove my theory one way or another?

[Brian459]

Have you had any patients get better after this long (2 months) on their own or is more intervention necessary?  I swear I can feel something moving or dripping in my ears after they become clogged, but my ENT says there is no fluid - what more can I do.  This is driving me crazy!

[Brian459]

You said to keep you informed of my case.  My ENT says both eardrums are slightly retracted.  I have been taking antihistimines for nearly two months, he also gave me a six day steroid dose pack.  How long do I wait before pursuing ear tubes?  

[Brian459]

I don't know if I was hallucinating or what, but last Thursday I fell asleep on the couch and when I woke up, my ears were roaring but were unclogged, everything else sounded like normal like the ear retraction was gone.  I went upstairs to bed and when I woke up the next morning, it was right back to feeling clogged or retracted like now.  How is this possible?  Is there a medical explanation for why this ear retraction would come and go and why it mutes the ringing in my ears?  It only happened that one time.

[OHNS2010]

Hi,

Be positive, lets hope for the best. Please to consume plenty of fresh fruits and vegetables and also drink plenty of warm water. Please do inform in case of any problem. Take care.

Regards
OHNS2010

[Brian459]

Will try to take your advice, it's just so much louder than it used to be.  Before it was just an annoyance at night, alone in my room.  Now I can hear it watching tv.  Hope I can still enjoy some music on my home theater system at a reasonable volume.

[OHNS2010]

Hi Brian,

Nice to know that your ear is free from fluid, except for the mild retraction of the ear drum. I would suggest you to follow the orders of your ENT specialist and if you feel, you can definitely take a second opinion. A small advise from me, just forget about the tinnitus and it stops bothering you. Anxiety is a disease which keeps on bugging your brain, try to get rid of it.

I have my own doubts regarding retraction of the ear drum due to noise damage.

Regards
OHNS2010

[Brian459]

More confused than ever after yesterday's ENT appointment.  He says he sees no fluid in either ear.  Had the pressure rechecked, now right ear is slightly worse, although he says it's so minimal that he could do it tomorrow and the left ear would be more retracted.  He thinks most people would not notice the difference, feels like golf balls in my ears to me.  He wonders if I'm used to having great ears all my life that's why this bothers me so much.  Huh?  He tried to pop my ears, but like at home only the right ear popped, he says to keep trying.
He prescribed a steroid dose pack to try and get the inflammation to where he can see it.  Also is sending me for allergy tests.  Did not order a CT - says no indication of a sinus infection.
Pressure from my nose straight across into the ears.  Blew my nose last night, felt much better - pressure building back up this morning.  Now he thinks ear retracted not due to eustachian tube dysfunction, but the noise damage . Still says he can't see why my tinnitus - called my hearing excellent.
I think he is just guessing at what may be wrong.  Says to give it another month.

[OHNS2010]

Hi Brian,

Getting a CT/MRI done is also a good option, it will definitely give you a peace of mind. Probably many more in that concert would have also experienced similar type of problems, but they will either consult their doctor or learn to live with it. Very few people will discuss this openly. Consult your ENT specialist he will help you better, than we speculating things.

Regards
OHNS2010

[Brian459]

Have an appointment with my ENT coming up.  Has not run any tests except the hearing test and physical exam.  Is there any benefit to asking for CT/MRI or allergy tests to determine cause of ear pressure which is worse, but actually reduces popping and ringing?
Everyone says this is pressure is separate from the noise induced tinnitus, if so why does it mute the volume of the ringing?  Seems like I am on a rollercoaster - worst pressure
in the morning for a few hours, then better, the worse, better at night.
One more question, why do some people develop tinnitus and most others not.  There were 18,000 people at the concert.  I think it would make headlines if they all went to doctors for tinnitus.
Again, I appreciate your time and advice.  It's been a great comfort to turn to somebody for advice.

[Brian459]

Will call for an appointment next month.  It's been a tough few weeks.

[Brian459]

Is there any treatment?  Will this fade as my ETD gets better?

Thank you again for your responses.

[OHNS2010]

Hi Brian,

Hyperacusis is an abnormal intolerance to ordinary, everyday sounds, which may develop in association with tinnitus related anxiety and distress.

Hyperacusis may develop with a number of conditions affecting the auditory pathway (including acoustic shock injury - ASI). Cause of ASI is considered to be excessive middle ear muscle contractions (stapedius and tensor tympani), in particular tensor tympani contractions, following exposure to a loud, unexpected sound. Probably, this could be the result of attending the concert.

Regards
OHNS2010

[Brian459]

Is this also true of the sensitivity to sound?  Normal everyday sounds like I mentioned earlier seem very loud.

[OHNS2010]

Hi Brian,

It will take some time for you to recover; the duration varies from individual to individual. Popping is worse in the morning, is because of the venous pooling occurs when you are in supine position.

You can consult your ENT specialist again after couple of weeks to get your ears checked again.

It is not essential that your ears need to pop every time you swallow. Fullness in the ear might be because of the secretions present in the middle ear.

Regards
OHNS2010

[Brian459]

Have started steam treatments.  Have also noticed that the popping is worse in the morning when I wake up, then seems to cycle between more and less frequent every few hours through the rest of the day.  Is this normal for ETD?  Is it a good sign my ears don't pop every time I swallow?  Is this feeling of fullness or water in the ear and sensitivity to sound part of the ETD or the tinnitus.  Question whether it will ever get better.

[OHNS2010]

Hi Brian459,

Just try doing steam inhalations 2-3 times/day. As this appears to be Eustachian tube dysfunction and you might benefit from this. Please do inform whether there was any improvement in the symptoms.

Regards
OHNS2010

[Brian459]

First, thank you for your concern.  My ENT ran several tests including the ones you mentioned.  When we went over the results the only things he mentioned is that my ears looked ok on physical examination, which would seem to rule out injury or infection, and that my hearing is fine, but my left ear was "sucked in a little".  I asked during the reflex test why there were 5 tones in my right ear but only 3 in the left and was told nothing was wrong just had quicker reflexes on the left side..  
Second, the reason I keep mentioning the connection to loud music is the timing is too coincidental.  Within a few days of the concert I suddenly develop symptoms I never had before?  I fear that until that is accounted for all these treatments are doomed to fail.  I hope I'm wrong and it is just a coincidence.
I guess I'm just tired of having my ears pop constantly.  Not every time I swallow, several minutes may go by and I think I might be headed in the right direction - then the popping starts again - usually worse in the morning or late at night.  Routine sounds also seem very loud to me, the telephone, traffic,etc.  It feels as if there is water in my ears and I am clogged from my nose across my face, under the eyes and into both ears..  My ENT put me on Flonase and says it will take a long time to build up in my system - is there anything I can do at home in the meantime to relieve these symptoms?
Again, thank you for your responses.

[OHNS2010]

Hi Brian459,

In stapedial myoclonus you will be having more of an objective tinnitus (where in even the examiner can hear the tinnitus) but not clicks as you are experiencing. I think these clicks are probably because of your Eustachian tube dysfunction and you are noticing during opening your jaw and swallowing. You can get Tympanometry and Acoustic reflex impedance testing to find out what exactly your problem is. Any more doubts you are welcome.

Regards
OHNS2010