Tinnitus linked to undetected auditory nerve damage

Two things I learned over the years:

1. Tinnitus seems related to dopaminergic neurotransmission (or faults thereof.)

I have ADHD, but I didn't know it until I was an adult. Growing up, I would often get episodes of tinnitus. After being medicated for ADHD, these episodes became much more rare, and also exclusively now only occur at the end of the day, when my meds are half worn-off already.

I've seen many journal papers correlating tinnitus to various dopaminergic dysfunctions. For example, people who develop tinnitus in old age are apparently also more likely to develop parkinsonism, and vice-versa.

If you've noticed that you're developing tinnitus, then you might want to raise the possibility with your GP that you could have some undiagnosed problem with dopamine. Get screened for ADHD if you haven't; get tested for Parkinson's if you're the right age; etc. If it turns out that you have one of these chronic diseases and didn't know it — well, treating it on its own will probably change your life, but it'll potentially also help your tinnitus!

2. However, tinnitus also seems related to some physical process in the ear.

I've learned that, when the high-pitched ringing starts in one ear, I can instantly stop it — not just push it into the background, but literally silence it like pressing "stop" on an alarm — by using my finger to essentially plunge my ear: putting my finger into my ear canal just deeply enough and then twisting, resulting in a pressure seal like in-ear earbuds try to achieve; and then lightly — but quickly — pushing and pulling the trapped air-pressure in and out inside the ear canal, using the finger. After doing this for about 30 seconds (during which the tinnitus won't seem to change), my eardrum and ear canal both begin to feel warm. Once that happens, I then unplug the finger from my ear. At the moment I do, the tinnitus stops.

Presumably, the "plunging" action is in turn flexing my eardrum inward and outward. Basically it's acting like high-amplitude 1Hz infrasound. I'm not sure what this does that helps, but it certainly does help, consistently.

(If you're wondering: I've also had otitis media before, so I know what the sensation of my eustachian tube being blocked with fluid/crud, creating a pressure imbalance of the middle ear, feels like; and what unplugging the eustachian tube + rebalancing that pressure feels like. This isn't that! It's entirely an interaction between my finger, my eardrum, and maybe the bones of the middle ear. My ears are currently 100% clear of detritus on either side of the eardrum according to a recent ENT visit — and yet this procedure still works.)

There have been small studies regarding somatic tinnitus, see for instance

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633109/

For modifying tinnitus loudness, the most common is that it increases when clenching the jaw. In the above paper, the cerebral blood flow was measured with PET, and for people with somatic tinnitus, when clenching their jaw, in addition to the sensory-motor areas, the auditory cortex became activated as well. However, the underlying reason is unknown.

In my case, I had pretty severe hearing loss as a little child because of liquid in my middle ear. Due to that, I continuously had my mouth open so that I could hear at least a little bit through the eustachian tubes, and I guess this might have influenced the interactions between these brain regions. But who knows. In the end, my parents realized what's going on and I got tympanostomy tubes, and I'm hearing fine now. Of course I don't know if the tinnitus really comes from that, because I cannot remember (I must have been around 3 years old).