instruction: hi doctor I am a 69 year old retired internist I am not taking any regular medication other than aspirin 325 my I have no known allergies and have never smoked I do not have any medical history of thyearoid disease autoimmune diseases or paget disease around four to five weeks back I noted the onset of an intermittent occasional episode of either a high pitched ringing sound in the right ear or low pitched humming in the left ear I do not recall if they occurred at the same time although they might have each episode lasted for 10 to 20 seconds before abating spontaneously there was no associated vertigo or hearing changes last evening I noted the onset of the ringing noise in the right ear remained for 20 seconds as it began to abate the lower pitched humming noise began in the left ear and has remained since this was associated with a sensation of fullness pressure and slight muffled hearing in my left ear the humming is constant and non pulsatile it is not positional and there is no vertigo I do have a history of taj disorder and it seems that when I open my jaw fully the noise increases in volume I also noted last evening when I yawned deeply the right ear ringing noise appeared for a few seconds at times the humming noise reduces in intensity spontaneously for a few seconds this morning I also noted some fullness in my right ear with a crackling noise when swallowing I recently had an acute sinusitis that resolved after five weeks although there was no ear involvement I have been under stress and have not been sleeping well I have checked my blood pressure at various times during this episode all results are quite normal I had a complete physical examination two weeks ago with full blood panels all were quite normal please help
output: hello what you are suffering from is known as tinnitus it is not a disease itself rather a symptom due to various underlying causes like age related hypertension impacted wax fluid in middle ear patulous eustachian tube tmjd temperomandibular joint disorder hyperthyearoidism etc but as you have mentioned you are not suffering from any hearing loss vertigo and your blood pressure is also within normal limit and considering the characteristics of tinnitus it is mostly due to eustachian tube defect aspirin intake also causes and aggravates tinnitus so first do not worry and do a valsalva maneuver 20 to 30 times a day the procedure of which you can get in youtube then take steam three times a day get a pta pure tone audiometry and a tympanogram pta tympanogram end eustachian tube dysfunction valsalva maneuver steam inhalation mecobalamin methylcobalamin 5 my once daily ginkgo biloba one capsule once a day revert back with the investigation reports to an ent otolaryngologist online