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Tinnitus in One Ear Only

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Known as unilateral or single-sided tinnitus, it’s possible to experience tinnitus in one ear. There are various causes of unilateral tinnitus and we are going to look at some of them here. Some are really common such as a build-up of earwax, and others may be rare, less obvious and require medical attention. An audiologist is a great person to see first regarding tinnitus as they can test your hearing as well as visually inspect your ear.

Earwax

Earwax protects the ear by trapping bacteria, dead skin and dirt in the ear canal and the natural skin migration of the ear canal will carry the wax out. However, earwax can sometimes accumulate and prevent normal hearing, disturb the eardrum, and cause unilateral tinnitus.

If you suspect you have unilateral hearing loss or tinnitus due to earwax, we recommend booking an appointment with an audiologist to confirm the cause and have it removed professionally. All Tinnitus UK Advice & Treatment Centres have an in-house earwax removal service without you having to see a GP or you can find an Ear Wax Clinic near you.

Infections

Middle and outer ear infections known as chronic otitis media and chronic otitis externa can also cause unilateral tinnitus, especially among young children. Common symptoms of ear infections may include:

  • Fever
  • Ear pain
  • Poor appetite or feeding
  • Disturbed sleep
  • Vomiting

Rarer consequences that require medical assistance, other than tinnitus, include:

  • Hearing loss
  • Balance dysfunction

If you or your child is experiencing any of the above then you should make an appointment to see your GP.


Ménière’s Disease

Ménière’s disease is a disorder of the inner ear and unilateral tinnitus is a very common symptom. Fluid builds up in the inner ear which often feels like a fullness in the ear. This can lead to dizzy spells (vertigo) and hearing loss. In most cases, the symptoms of Ménière’s disease start in one ear.

 

Ménière’s disease can occur at any age, but it usually starts between young and middle-aged adulthood. The recurring episodes of vertigo can be debilitating. The spinning sensation can last between 20 minutes and several hours but never more than 24 hours. Nausea and vomiting are common. Various treatments can help relieve symptoms and minimize the long-term impact on your life.

 

If you think you have Ménière’s then you should see an audiologist who will help in the diagnosis process and then a GP to refer you to ENT for treatment of the condition. You may then be required to return to the audiologist for help with any hearing loss and tinnitus issues.

Eardrum Perforation

A perforated or burst eardrum is a hole in the eardrum. A small hole will usually heal within a few weeks and probably won't require any treatment. Larger holes may need surgery. However, you should see your GP if you think your eardrum has burst. Perforations commonly result from:

  • Bangs to the head
  • Sudden loud noises
  • Middle ear infections

The perforated eardrum itself can cause unilateral tinnitus and so can the commonly associated ear infections. This is often due to a build up of fluid in the middle ear trying to escape or the ear becoming infected following the perforation. Any discharge will probably need to be medically treated.

Signs of a perforated eardrum or ear infection include:

  • sudden hearing loss – this may be total or just be slightly muffled.
  • pain in your ear
  • itching in your ear
  • fluid leaking from your ear
  • a high temperature
  • ringing or buzzing in your ear (tinnitus)

The symptoms will usually pass once your eardrum has healed and any infection has been treated.

Cholesteatoma

Cholesteatomas are benign skin growths behind the eardrum in the middle ear. They can stem from birth defects but are more often triggered by ear infections, which can cause hearing loss and tinnitus in the affected ear. If left untreated, the cholesteatoma can erode the middle ear tissues and bones, affecting hearing, balance and the function of facial muscles. Standard treatment for cholesteatoma is a simple procedure to remove the growth. If left untreated, a cholesteatoma will increase in size and cause mild to very severe complications including:

  • chronic infection of the ear
  • swelling of the inner ear
  • paralysis of the facial muscles
  • meningitis, which is a life-threatening brain infection
  • brain abscesses, or collections of pus in the brain

The symptoms of a cholesteatomoa will start out mild and become more severe as the cyst grows:

  • affected ear may have a smelly discharge
  • sense of pressure in the affected ear
  • discomfort, ache or pain in the ear
  • dizziness
  • facial muscle paralysis
  • hearing loss - which can be permanent

An audiologist can identify what may be a cholesteatoma but it will need to be fully diagnosed via a referral from your GP to ENT. A CT scan may be necessary where the cyst is difficult to see behind the eardrum. Once the cyst has been removed there may be some permanent hearing loss and tinnitus which will need to be treated by an audiologist. Balance may also be an issue but as long as the cholesteatoma is caught and removed early, complications are rare.

Acoustic Neuroma (Vestibular Schwannoma)

These are benign brain tumours in the brain that usually grow slowly over a number of years and sypmtoms include:

  • hearing loss that usually only affects 1 ear
  • tinnitus usually in one ear
  • vertigo

A large acoustic neuroma can also sometimes cause:

  • persistent headaches
  • temporary blurred or double vision
  • numbness, pain or weakness on 1 side of the face
  • problems with limb co-ordination (ataxia) on 1 side of the body
  • a hoarse voice or difficulty swallowing

Hearing loss that's worse in one ear for no known reason is not normal and should be checked especially if accompanied by tinnitus. Acoustic neuromas can be difficult to identify especially as the symptoms are similar to Ménière’s disease. A visit to an audiologist for a hearing test should prompt a referral to your GP who should send you to the hospital for an MRI or a CT scan or both.

 

Most tumours are left and monitored as they are usually very slow growing. Brain surgery and radiosurgery are usually a last resort due to the risks involved.

Multiple Sclerosis

Multiple sclerosis is a neurological disorder where the immune system attacks the protective sheath (myelin) of nerve fibres, causing communication problems inside and outside of the brain. Unilateral tinnitus can occur in MS4. There are many treatments, such as anti-inflammatory steroids, that can slow down the progression of neurological symptoms of MS.