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Reason for constant internal TINNITUS on my ear.

Resolved Question:

Hi there,
About 1.5 months ago, I had tinnitus on my left ear and it has subsided since. I did MRI with contrast coupled with hearing test and all turned out to be normal (by ENT). Recently I've realized if I'm in a quite room or if I focus internally (head), I hear a very subtle minute sshh sound. It sounds nothing like the tinnitus before, and it very bearable and it's almost like a body sound (somato sound). I have had this for as long as I can remember.

Can most of us hear this minute sound if we focus on it? Will this very minute pulsatilla type (blood vessel or brain frequency) type sound worsen if I attend a loud noise environment? The ENT doctor seems to feel it's just an internal sound and I shouldn't focus on it and not worry about loud sounds. He feels it's normal and I should move on not worrying it will worsen. I've attended a few loud environments and haven't seen it worsen.

Please advise. Thanks

Category: Ophthalmologist

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Category: Ophthalmologist
Dr. Manish Malhotra is online now

Expert:  Dr. Manish Malhotra replied 4 Days.


Thank you for using DoctorSpring

I can understand your problem. You are suffering from tinnitus since one and half months and very mild tinnitus is still present, otherwise resolved.

Tinnitus can be due to various reasons but most are ruled out in your case as your MRI brain and audiogram are normal. Most probably this mild tinnitus is due to sound of blood flow in blood vessel. It will not worsen with loud sound and will not progress with time.

Some time tinnitus can occur with out a special reason.

Whatever it is we can start following medication -

Tab. Bilovas two times daily for one month

Hope this helps. Feel free to ask further query.

Best regards

Patient replied :

Hi Dr,
Thank you for the reply. I am attaching my audiogram result from 2013. The ENT guy seems to suggest that since I have a dip in the 4KHz, he says that I have some hearing loss and the tinnitus is due to it. I did tell him my tinnitus doesn't sound like a noise induced tinnitus, as mine is very wavy pitched and so much in the background (like a blood stream or brain frequency). And as far as I can remember, I've had this for some time. He rules out pulsatile tinnitus as my MRI doesn't seem to suggest so. I am on Gingko tabs already and still on it.
I also have some neck strain for some time now after an accident 4 years ago and I'm not sure if that can be a cause. It's more like a muscle pull type strain and managable.
The ENT's diagnosis have feared me more on noise induced environment now and I am freaked out. Do help.

Expert:  Dr. Manish Malhotra replied 3 Days.


Thank you for writing to us again.

Your audiogram shows dip at 4 kHz, means noise induce hearing loss only. Tinnitus may be related to this.
As your MRI is normal, vascular cause is ruled out.so your tinnitus is due to nerve deafness. nerve deafness is most likely due to noise trauma.
Noise induced hearing loss will not worsen with time if you are not exposed to loud noise for long time.
Normal noise will not worsen, but avoid very loud music, factory noise.

Other wise you need not to worry about normal surrounding noise.

You can continute-

Tab. Bilovas two times daily

Hope this helps. Feel free to ask further query.

Best regards

Dr. Manish Malhotra
Category: Ophthalmologist
Fellowship: L. V. Prasad Eye Institute, Hyderabad
Fellow Pediatric Ophthalmology & Squint (L.V. Prasad Eye Institute, Hyderabad)
Medical School, Residency: MBBS, DOMS, FLVPEI, Nagpur university, 1995
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