by Neil Bauman, Ph.D.
© December, 2011
A musician explained,
I suddenly began experiencing a strange phenomenon with my hearing. I now hear music through my right ear at the correct pitch, while, at the same time, I hear the same music a semitone higher in my left ear. This is frustrating and scary. I can no longer perform my music. A major part of my life has suddenly been snatched from me. Have you ever heard of this before? Am I going crazy? What can I do to correct this condition?
Another person related,
I’ve suddenly begun to experience a rather disturbing auditory phenomenon. Sounds as heard by my right ear are pitched a bit lower than the same sounds as heard by my left ear. This gives music a very frightening and eerie chorus effect that is becoming more and more disconcerting. What causes it? Does it ever go away?
I have written about people who hear music off-pitch—either certain notes, or all notes. (See “When You Hear Music in the Wrong Key” including all the comments.) In most cases, these people heard the same music off-pitch with both ears. This alone was disconcerting and destroyed their enjoyment of music.
However, it is even more frustrating when you hear the same notes at different pitches in each ear and you don’t know which ear to believe. For example, your left ear may hear a note as F while your right ear may hear the same note as F# (F sharp).
Rest assured, when this happens you are not going crazy, but something definitely has messed up the pitch perception between your ears. This condition is known as diplacusis (dip-lah-KOO-sis).
What is Diplacusis?
Diplacusis is a disconcerting condition, especially for musicians, because you hear the same note at two different pitches—often at the correct pitch in one ear and either higher (sharp) or lower (flat) in the other ear. This makes playing, singing or listening to music sound sour (sharp or flat depending on the direction of the frequency-shift). This can be devastating to a musician who has previously had perfect pitch.
The dictionary defines diplacusis as “abnormal perception of sound either in time or in pitch, such that one sound is heard as two. This fancy name comes from two Greek words “diplous”—double, and “akousis”—hearing. Thus, diplacusis is really double hearing or hearing double. (1)
Diplacusis occurs when your ears have a significant difference in frequency selectivity. This results in clashing interpretations (dissonance) of the tones you hear.
Fortunately, although many people hear tones at different pitches in each of their ears, this difference is normally slight. In fact, when the difference in pitch is less than about one semitone (halftone), the average person typically does not notice it. This difference in pitch normally escapes our notice because the slightly different pitches of sound from our two ears merge in our conscious perception such that we only hear one pitch of sound. (2)
Musicians, however, because of their musical training, may be considerably more sensitive to these slight pitch differences. As a result, they may be aware of, and bothered by, smaller pitch differences than even a semi-tone.
Kinds of Diplacusis
Diplacusis or “double hearing” comes in various “flavors”.
Diplacusis binauralis (by-nar-RAL-is) is where you hear the same sound differently in each of your ears. For example, you may hear a different pitch of sound in each ear, or the timing may be different in each ear.
A subset of diplacusis binauralis is diplacusis dysharmonica (dis-har-MON-ih-ka) where only the pitch is different in each ear. Some authorities use the term “Interaural Pitch Difference” (IPD) rather than diplacusis, but they both refer to the same condition. (2)
Diplacusis echoica (eh-KOE-ih-ka), as it’s name implies, is where you hear the same sound repeated—thus you hear the original sound followed by an “echo” of the original sound. This occurs when the timing of tones is slightly different in each ear. As a result, you hear the sound in one ear and a fraction of a second later in the other ear—thus you perceive this second sound as though it were an echo.
Finally, there is diplacusis monauralis (moh-nar-RAL-is). This is where you hear a single sound as two different sounds in the same ear. (1)
In my experience, by far the most common “flavor” of diplacusis is diplacusis dysharmonica. This is the annoying condition that numbers of musicians experience and the “kind” of diplacusis we will discuss here.
What Causes Diplacusis?
Diplacusis involves a shift of pitch perception. This can happen when the hearing in one ear is damaged (unilateral hearing loss), or the hearing in one ear is damaged more than it is in the other ear (asymmetrical hearing loss). However, the degree of pitch distortion does not appear to bear any simple relationship to the degree of hearing loss. (3)
Incidentally, diplacusis was first observed way back in the 1880s in people with unilateral hearing loss. (2)
If one ear has normal hearing, and the other one has sensorineural hearing loss, you can have a lot of diplacusis. Bilateral sensorineural hearing loss results in less diplacusis but there are probably pitch distortions because both ears are likely messed up in the same way. (4)
In fact, there is a high degree of correlation between the occurrence of diplacusis and damage to the inner ear. (2) Diplacusis is typically experienced as a result of sensorineural hearing loss. Onset is usually spontaneous and can occur at the time of an acoustic trauma or in the midst of an ear infection. Sufferers may experience the effect permanently, or it may go away on its own. (4)
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Fig. 1: The top row of inner hair cells shows their slightly rounded stereocilia bundles. The bottom three rows of outer hair cells show their deep |
For people who have some degree of sensorineural (inner ear) hearing loss, here is a detailed account of how diplacusis may develop. First, we need a bit of background.
The cochlea in your inner ears contains four rows of hair cells. There is one row of inner hair cells and three rows of outer hair cells. On the top of each hair cell are bundles of minute hair-like projections called stereocilia (Fig. 1.). These stereocilia sway (dance) in unison to received sound signals.
The job of the inner row of hair cells is to transmit the sound signals from the cochlea to the auditory nerve. As they sway, they open “ion-gates” that allow the sound signals to be transmitted to the auditory nerve.
If the row of inner hair cells die, you will not hear anything as there is no other way to transfer the sound signals from the cochlea to the auditory nerve. If sections of inner hair cells die or are severely damaged, you no long will hear the frequencies of sound to which those hair cells were tuned.
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Fig. 2: Close-up of a healthy stereocilia bundle perched on top of an outer hair cell. (5) |
The outer three rows of hair cells (Fig. 1.) have a different function. Their job is to filter and amplify the sounds we want to hear. If all of them were to die, we could still hear (that’s the inner hair cells job), but sounds would be unregulated as to volume and all sounds would appear to run together.
Like the inner hair cells, “each set of outer hair cells and associated stereocilia (Fig. 2.) have a favorite frequency and ‘dance’ energetically when they receive it. This ‘dance’ amplifies the signal to the inner stereocilia, which react passively and signal the brain. An array of outer and inner stereocilia operate together as a narrowband amplifier.” (5)
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Fig. 3: The black (bottom) line shows the normal operation of the sharply-tuned cochlear amplifier. When some inner hair cells die or are damaged only the volume is reduced (red [top] line) but the signal is still sharply defined. (5) |
Thus, when all is working properly, there is a sharply defined peak for a given sound (The black line in Fig 3.).
However, damage or death to some of the inner row of hair cells reduces sound sensitivity so you don’t hear as well (the red line in Fig. 3.), but if there is no corresponding damage to the outer rows of hair cells, the signal peaks are still sharply defined.
In real life this seldom happens. What typically happens is that loud sounds first damage the outer hair cells rather than the inner hair cells. In fact, you could have 50% of the stereocilia on a region of the outer hair cells damaged before you would see any change in hearing on an audiogram. A person could suffer damage to 75% of the outer hair cells before he would notice he had a hearing loss, but by that time you would expect some inner hair cells to be severely damaged too. Thus, the first consequence of noise damage is not hearing loss itself as you might expect, but fuzzy or blurred hearing.
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Fig. 4: Close-up of a damaged stereocilia bundle perched on top of an outer hair cell. Notice that many of the stereocilia are missing or flopped over and deformed. (5) (Compare with Fig. 2 above.) |
The stereocilia on top of a hair cell may be damaged (Fig. 4) and thus will not be able to do their “dance” properly. Since they do not “dance” effectively, there is less amplification of their favorite frequencies.
The result is that both the amplitude and the sharpness of the resulting signal is drastically changed. Compare the black line (healthy hair cells) in Fig. 5 with the red line (damaged hair cells).
Not only is there less volume, and fuzzy hearing, something surprising also occurs. The frequency is shifted a bit. Notice that the lowest part of the red line and the peak of the black line no longer coincide.
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Fig. 5: The black (bottom) line shows the normal operation of the sharply-tuned cochlear amplifier at one particular frequency. When some outer hair cells die or are severely damaged sound signals become softer and fuzzier (red [top] line) resulting in a shallow broad curve with no clear peak. Notice that the central frequency is also shifted slightly away from where it should be, thus giving a slightly different frequency of signal in the damaged ear resulting in diplacusis. (5) |
Since the frequencies are slightly different, the result is that you now hear the same sound at two different frequencies. The fuzzy, shifted frequency in the your more damaged year and the normal or near normal sound in your undamaged or lesser-damaged ear. This is one possible explanation for diplacusis.
Another interesting phenomenon is that when your brain receives information from damaged sections of hair cells it struggles to determine whether it is intensity (volume) or frequency that has changed. Thus, for instance, it may seem that the music you are listening to has gone sharp during a crescendo. (5)
Loud sounds do not only damage or kill a single hair cell along with its stereocilia, but loud sounds also typically damage or kill neighboring hair cells as well.
Incidentally, if a cell is badly damaged, it programs itself to die through a process known as apoptosis. Since hair cells are a specialized kind of nerve cell, when they die your body does not replace them, thus leaving you with a permanent hearing loss.
Fig. 6 shows the results of severe noise damage. Notice that most of the hair cells are missing and have been replaced by scar tissue. When this happens hearing becomes very faint and fuzzy. The result is that you will no longer hear much at all, and whatever you do hear will be so fuzzy that you will be not be able to distinguish small differences in pitch between your two ears and therefore you will never notice diplacusis.
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Fig. 6: Missing and badly-damaged hair cells. The inner row of hair cells is at the top and the 3 rows of outer hair cells are in the middle. Notice how most are dead and thus missing. Compare with Fig. 1. (5) |
Diplacusis can occur whether you have a temporary hearing loss or a permanent hearing loss. If you have a permanent hearing loss, your diplacusis may prove to be permanent as well (2) such as is the case with my wife.
Diplacusis does not just occur in people with hearing loss, however. It is also found in some people with normal hearing. The main difference between diplacusis in people with hearing loss and in people with normal hearing is that in people with hearing loss there is a pronounced intra-ear frequency shift that typically exists in a fairly broad frequency region, while in people with normal hearing the intra-ear frequency shift rarely exceeds +/-2% and is distributed in a quasi-random manner such that the mean across frequencies essentially is zero. (2)
Apart from having a sensorineural hearing loss, a number of people seem to get diplacusis after they have had a cold or ear infection. This may be because of a viral attack on the inner ear, or because of a middle ear infection and/or blocked Eustachian tube causing a conductive loss.
For example, one man explained, “I have had a cold for the past week or so. Last night I suddenly noticed that the pitch I hear in my right ear is a semitone higher than the same pitch in my left ear.”
Another person explained, “I have had this happen to me several times over the years, always in conjunction with an ear infection. Fortunately, it never affected me longer than a few days.”
Still another person explained, “I have had this happen twice in the past 15 years or so, and both times it was related to a bad cold and probable ear Infection. In my case the effects diminished gradually over several weeks, and finally disappeared.”
Finally, a singer explained, “I woke up to an ear ache in the middle of the night a week ago and couldn’t hear music properly the next morning. I went to my doctor, who said my eardrum was inflamed and that I had a sinus infection. He put me on Azithromycin and steroids and now my cold/sinus infection seems to have mostly subsided, although I am still hearing about a quarter tone higher pitch in my left ear than my right.”
Ménière’s disease also seems to result in diplacusis in some people. (6) The amount of diplacusis seems to vary in degree with the amount of hearing loss, becoming more significant when the hearing decreases and less noticeable as hearing improves. (7)
How Common is Diplacusis?
Since hearing loss (inner ear damage) affects as many as 1 in 4 people, and since hearing loss is seldom identical in both ears, diplacusis is not as rare a phenomenon as you might think. (5) However, diplacusis appears to be more common—or at least more noticeable—among musicians since they have trained their ears to discern smaller differences in pitch than people in the general public.
One study of musicians revealed that 24% experienced tinnitus, 25% experienced hyperacusis, 12% experienced distortion in their hearing, and 5% experienced diplacusis in one of its forms. Of course, many of these musicians experienced two or more of the above symptoms at the same time. (5)
Cases of diplacusis on the order of 1% to 2% can be found in many people with normal hearing, especially those that are fatigued or have been exposed to loud noise. (6)
What Can I Do About My Diplacusis?
Since diplacusis is most often associated with some degree of hearing loss, if you have some condition that reduces your hearing such as wax in your ears, middle ear infections or clogged sinuses/clogged Eustachian tubes, the obvious thing to do is to treat these conditions. As the “gunk” dissipates and your ears/sinuses clear, your hearing will improve and your diplacusis will likely fade away.
For some people, being properly fitted with hearing aids helps to reduce their diplacusis.
Unfortunately, for others, nothing seems to work. You may be left to cope with your diplacusis as best you can. In any case, the good news is that you now understand what is likely going on with your ears, and that makes it easier to deal with.
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(1) Stedman’s Medical Dictionary, 27th Edition. 2000. Lippincott Williams & Wilkins.
(2) Terhardt, Ernst. 2000. Diplacusis binauralis (IPD). http://www.mmk.ei.tum.de/persons/ter/top/diplacusis.html.
(3) Larkin, W.D. 1983. Pitch Vulnerability in Sensorineural Hearing Impairment. http://www.ncbi.nlm.nih.gov/pubmed/6651625.
(4) Diplacusis. 2011. Wikipedia. http://en.wikipedia.org/wiki/Diplacusis.
(5) A Sound Ear II. 2008. The Association of British Orchestras. https://www.smartsonicsupply.com.mx/wp-content/uploads/2017/03/SoundEar-II.pdf.
(6) A Dictionary of Hallucinations. 2009. Jan Dirk Blom. p. 144.
(7) Karino, Shotaro, et. al. 2002. Application of Binaural Beat Phenomenon to Evaluation of Diplacusis Binauralis Dysharmonica. http://www.aro.org/archives/2002/2002210.html.
This is very interesting! I am a violinist with hearing loss (corrected by hearing aids), tinnitus, and diplacusis. For decades I have noticed that pitches sound lower in my left ear–my fiddle ear– than in my right ear. (They also sound darker.) This interferes with my intonation and makes my fellow musicians think I’m playing sharp. I might also mention that I have perfect pitch.
Hope this is helpful to other musicians!
Thank you, as a musician this very helpful as I have been suffering with this for the past three weeks.
This was very helpful… Since last night i have been suffering from diplacusis echoica. I caught a cold last week and now i understand better. I got luck that it faded by the evening and now i only hear a small buzzing sound, but the worst is gone…i mean the echo.
I’ve just had a bad ear infection and noticed diplacusis dysharmonica, the affected ear hearing a semitone higher than the other. As a physicist I worked out that it might be explained if the density of the fluid in the affected ear had gone up by about 12% (i.e. twice the frequency shift). I’m hoping that eventually the fluid returns to normal (if indeed that’s what’s responsible) and the diplacusis vanishes.
Oh and I should mention – the diplacusis is just under a semitone, and is equal right across 8 octaves – so it’s not localised to just one portion of the cochlea: hence my suggestion that it’s to do with fluid density which will pervade the whole spectrum equally.
Hi Henry:
Interesting theory. But I don’t see why/how the density of the endolymph and perilymph would increase.
Cordially,
Neil
I experience fullness in my ear but not all the time and have been hearing certain sounds differently. I hear road noise louder, our air conditioning systems make a rumble and I hear music a little louder than I want it to be. The bass sound is distorted.
I should add that if I go to a retail store, I will hear a rumble from the air conditioning systems that are in the ceiling.
This is terrible!! What is wrong with me? It’s driving me crazy!!
Hi Howard:
My guess is that you have some degree of hyperacusis. Typically, you get hyperacusis from exposing your ears to loud sounds. Has this been the case with you in the past?
Cordially,
Neil
After 6 months of testing, special diets and diarectics for possible fluid in my ear, I have been given the Rx Pamelor to see if calming the nerve in my ear will help.
I had an ear infection 7 months ago then woke up with double hearing in my left ear. I do not have any hearing loss.
I am a singer and am very distressed that I can not sing anymore.
Will this new Rx do anything to help my condition? My doctor has not diagnosed my problem but I have thought all along that I gave DM.
Hi Sandy:
Nortriptyline (Pamelor) is a tricyclic antidepressant. I fail to see how it will “calm the nerves in your ear”. If you are depressed, it may help your depression. I don’t see the reasoning of how it can get rid of diplacusis.
Have your ears completely recovered from the ear infection of 7 months ago–no signs of your ear being clogged, etc?
How do you know you don’t have any hearing loss? Did your audiogram show zeros all the way across the chart? They call it normal hearing if you have up to 25 dB of hearing loss–but as a musician, you’d probably notice this. And furthermore, they only check to 8,000 Hz, but you typically hear up to 20,000 Hz. and you could have massive hearing loss up there and not know it. Yet your brain knows it.
Either of those two things might be a cause of your diplacusis.
Cordially,
Neil
Sandy–how are you and your ears now? A year later…
My double hearing started about a week and a half ago. Saw audiologist and ENT on Friday. Started prednisone this a.m.
I am a choir director, and currently directing high school production of Fiddler on the Roof–also am a singer-and work with a jazz combo-(well..pre-pandemic…)
Curious—and gathering info. I truly hope you’ve found a solution—and that you are singing again??
I woke up 4 weeks ago with this strange thing. Certain sounds, voices, music trigger a specific tone like 800hz on top of the normal sound. The pitch doesn’t change on that tone, though when it started it was much worse, sound was all screwed up, and faint sounds caused my ear to alternate between a high and a low pitch, louder sounds caused the 800hz tone. Now the tone is pretty much all that’s left though it seems like it’s gotten slowly better. I hope it does get better to the point where it’s not noticable because it’s a bit depressing.
Interesting thread. I developed a considerable drop in pitch in my right ear following a flight six years ago. It’s very noticeable when using a telephone – voices sound low, muddy, distorted and almost slowed down. At the same time I developed dizziness with acute dizzy spells. Following tests I was told I had unilateral vestibular hypofunction – caloric testing showed little response from my right ear. They said it was probably caused by damage from a virus but they couldn’t explain the pitch drop – however this thread suggests it probably has the same origin. It hasn’t improved although I have no hearing loss in that ear. Interestingly my brain seems to compensate when listening with both ears and I don’t notice it – same when listening with headphones provided the sound is the same in both ears – however for example listening on headphones to the original stereo version of Eleanor Rigby with McCartney singing in just the right ear sounds very odd!
I started hearing low pitch in my left ear 3 days ago, it’s 4th day and seems like tinnitus became more stronger. Sometimes I have a felling tgat my bad ear is full. Is my diplacusis caused by ear infection? I can’t go to the hospital because of some troubled and now I’m really worried 🙁
Hi Danil:
Do you have any reason to suspect you have an ear infection? What happened three or four days ago before you noticed you had diplacusis? Was anything different? It’s hard to say what is going on with your ears with so little information.
Cordially,
Neil
I think my cat was sleeping on the left earpod, he’s not that clean so maybe that’s why? Also I saw somewhere that
it also may appear because of nerve damage. I was pretty angry and stressed that day, then later at evening I noticed my diplacusis, but is that how it works? Apologies for poor setnence construction, my English isn’t very good
Hi Danil:
Your English is fine–as long as I can understand you we should be good.
So far, nothing stands out as an obvious cause. What is happening to your ears now? Any changes?
Cordially,
Neil
Left ear is still the same, sometimes it feels like the ear is plugged, constant beeping noise which is probably tinnitus, from time to time I feel slight discomfort but not pain, music sounds low pitched but voices are fine, sometimes I hear them echoed, like if you speak into a spinning fan. My right ear is completely fine
Hi Danil:
The constant beeping noise is tinnitus. The plugged feeling could be a psychological feeling due to hearing loss. I’m not sure that there is anything that doctors can do at this point. Let me know if there are any significant changes, otherwise give it another week and then re-evaluate it.
Cordially,
Neil
Hello Mr. Bauman. My pitch recognition is back to normal! I’m still left with slight feeling of hearing loss and tinnitus though. Will it go away with time? Because my tinnitus isn’t as bad as it was
Hi Danil:
I wouldn’t be surprised if your ears go back to normal in time. They are well on the way now and I don’t see any reason this can’t continue. Just don’t focus on your tinnitus. This gives your brain permission to let it fade away.
Cordially,
Neil
Diplacusis dysharmonica explains my situation perfect. I have been a karaoke dj for about 18 years now. about 4 years ago, I started to notice tinnitus. I since learned to ware protective headphones. I adjust my singers and put the phones on immediately after. It was a Godsend at the time because I was able to continue my career. About two weeks ago a customer yelled into my left ear (unprotected ) and I noticed something was wrong immediately after. Everything I hear now is echoed and when I sing it now sounds like someone is singing with me in a different key. I’m trying to fight back depression on this. It’s effecting every part of my life from watching TV to realizing I might never be able to attend another concert in my life. My question to you is I am having ear pain after singing or hearing sounds. Pain is never there in the morning but I think that is just because I’ve just had 8 hours of silence. Pain always comes back after starting to talk or hear things. Will this pain/discomfort ever go away? I am looking for any suggestions on how to make this situation any better.
Hi Robert:
With all the DJing you’ve done over the years (probably most without ear protection) you have damaged your ears, thus they are more sensitive to sound that they used to be. So when sounds are too loud for your ears you end up with weird things such as diplacusis.
The customer yelling in your ear sure didn’t help matters–just made things worse. It will take awhile for your ear to get over this acoustic trauma including the ear pain. It should go away over time IF you protect your ears from louder sounds while it heals. This may take several months.
You need to wear ear protectors when around louder sounds–BUT, do not overprotect your ears by wearing them a second longer than you need to or you will get hyperacusis–and you don’t want that.
The best thing is to give your ears time to heal by not exposing them to louder sounds.
Cordially,
Neil
This was something I never knew about. Yesterday my ear started to hurt like crazy as though I had an ear infection (it could’ve been from my excessive blowing out since I had a fever). Now, it doesn’t hurt, but I’m beginning to hear noises a little bit lower on the right ear, but fine on my left ear. I didn’t realize till when I woke up that I likely have Diplacusis Dysharmonica. I noticed it a lot when I hear the TV and my right ear is the one facing it. Most of the time when the Chocolate Frosted Flakes commercial comes on, it sounds low pitch on one ear. It should be noted that I can still play the Piano pretty well, but I have a fear that I might start to sing a little off now that I have this disease. Perhaps there’s something in my right ear I need to clean out that could’ve caused the ear infection.
Hi Mario:
The fever could have resulted in a virus attacking your inner ear and causing the problems you have. These symptoms may go away as your body gains control over the fever and any attacking “bugs”.
Cordially,
Neil
So I woke up one morning with the most intense pressure in both ears. By that night I started hearing double sounds in my right ear. It is perfect pitch harmony. Every sound has a harmony sound attached to it. The registers at walmart, my voice, any other voice. Church is a nightmare with doubling 300 peoples voices in my ear. When no one is speaking its a dull humming sound. It honestly feels like I have a little bird in my ear that loves to harmonize with every sound it hears. It is only in my right ear. I went to a ENT he can not figure out what is wrong with me. It has gone away only 3 times in 2 weeks and not for long. I now have intense pain in my teeth, behind my right eye, my neck (near the ear) and my jaw. The ENT put me on steroids (they did nothing but make me crazy) and a muscle relaxer because he thinks I have TMJ from clenching from the uncomfortable feeling this causes. I am going crazy and fighting depression. TV is a nightmare to watch and Church is such a challenge. But the worst part is my sons voice is almost unbearable. This makes me so sad. I want to hear normal. ENT checked me for sinus in nose throat and ears I am clear as a bell. I have not been to any recent concerts or around loud noises. I did hit my head on a shelve while doing laundry, that is the only unusual thing that has happened to me in the last month.
Also hearing test said I have lost 10% of hearing in that ear. 1 week later I gained 5% back. I go again Wednesday to check again.
Do I need to go to a hearing specialist or continue on with ENT? He wants to run more intense tests and place steroids in my ear with a needle next. I am not loving this idea….
Hi Mandy:
With the pain and pressure symptoms on your face, ear and neck, my first thought is to go to an upper cervical spine chiropractor (NOT a conventional chiropractor) and make sure that your C1 and C2 vertebrae are in proper alignment. That could be your problem–especially if you already know you have neck/TMJ problems.
I can’t see that having the intratympanic steroid injection is going to help since the steroids you already took didn’t do a thing.
Cordially,
Neil
Hi there, I have hearing loss and wear two hearing aids and have also had tinnitus in both ears but worse in the left for many years. On Saturday I believe I must have experienced acoustic trauma from being close to fireworks going off as very shortly afterwards I realised something had gone wrong in my left ear. Every syllable of every word I or others speak is experienced and felt as a kind of echo vibration in my left ear. As I already have hearing loss do you think this will be permanent? I have an appointment in 2 days time at the hospital but would appreciate your thoughts on whether this sounds like harmonica or echoes. Many thanks, Sophie
Hi Sophie:
Often diplacusis from noise trauma can be temporary. This can happen when one ear is damaged more than the other so they hear slightly differently from each other–and you hear this as somewhat out of phase in timing or pitch.
Personally, I’d just give it time and let it resolve itself.
Cordially,
Neil
Hi Sophie I had the same thing did your go way?
Such a great thread. Thanks so much for all your time and expertise Neil.
I had mild, noise-induced tinnitus for 5 years. It was stable and well habituated. Then it quite suddenly got markedly worse in one ear for no obvious reason. A few days later came what I assume is dysharmonica: higher-pitched tones, particularly female voices, sound “de-tuned” and off key. Not very nice!
My GP confirmed that impacted wax was not the issue, so i’m currently waiting for an ENT appointment and praying that it’s nothing permanent or sinister……
Good luck to everyone suffering with their ears.
Just to follow up on this, my disharmony gradually decreased and after about ten days it was gone completely.
It was a euphoric moment being able to hear properly again, good as new.
My ENT thinks my eardrum or canal was irritated or injured by me sticking cotton buds in it too often and too aggressively and removing all the wax.
I sincerely hope you all experience some relief. Don’t put anything inside your ears.
Hi there- I am a musician, woring with violin and multichannel composition and it is my whole, entire life. The last three days I have had this displacusis, after a sudden ear infection seemed to develop from a sinus infection or cold. I have had a mild tinnnitus in the affected ear for severa years, which gets very much louder with this infection. During the last couple weeks I was also on small airplanes that left my ear clogged. I have been to adoctor and gotten anti-biotics, plus a steroid nasal spray, and they said my ear drum was NOT ruptured. However, this displacusis is HORRRIBLE:I can’t play violin like this- I can’t even listen to music like this!! My life is worthless to me without music. It is all I do. Will this be permanant, if its only from an ear infection, or will it go away? What should I do? Please help.
Hi Iris:
Don’t get too upset. It doesn’t help matters. I think your hearing will return to normal and your diplacusis disappear when the cold/sinus infection goes away. Diplacusis happens sometimes when one ear gets clogged up, but not the other.
Cordially,
Neil
Hi Iris,
I am the violinist myself and suffer from diplacusis for a week already, which followed a viral cold infection and 6 airplane flights. Did you recover? How quickly? Did steroids help? Thanks. I am very frustrated and scared as you can imagine.
Hello Doctor,
I have experienced the terrible t in several different ways since a child. I have overcome them every single time by the grace of God. I’ve had even the kind when you hear a song – I had it for a few months and didn’t realize it wasn’t my next door neighbors. It did resolve.
In July I went on vacation to the beach. I got in the water one time and did not submerge my head but I’m sure I got some water in my ears. I was fine, but the next night I had the worst sinus congestion ever- I have sinus/allergy type symptoms almost all year. That time it resolved by the morning and I was completely fine with no drainage, pain or congestion. Fast forward 4 days. One evening I was getting ready for bed and I had been treating another infection not sinus related with vitamin D and some colloidal silver. This time I took a very high dose of vitamin D3 because my pain was through the roof and I was weaning down my colloidal silver intake to like one tsp a day. The pain immediately subsided with the Vitamin D3 but about 30 minutes later I got a screech in my right ear that was disturbing. Later it developed into a pulse with my hear beat and in the days following several different sounds to my heart beat. It was the worse thing ever. My ENT was very short with me and said my hearing was great- I passed the audio logical test and that there was absolutely no fluid – although her nurse said I did have some fluid in my ears. She prescribed me 7 days of prednisone- the pack where you wean to a lower dosage. I didn’t take them right away. I went to my regular GP whom told me after looking n my eyes, nose and ears and pulling and pushing on several areas that I had a sinus infection and prescribed amoxicillan. I didn’t take it. My hematologist suggested I try the prednisone. I went on a partial fast for guidance and I took the prednisone. It subsided.
Fast forward to October 2- about 3 months later. I get up to do a medical treatment that requires that I lie on a flat surface- I don’t use chemicals for the treatment and I opt for natural meds including essential oils. Been doing it for months. It has nothing to do with my sinuses or allergies etc. anyway info back to bed and about an hour later I hear a loud tone in my right ear- the same ear that was previously affected by the pulsating heartbeat sound. I try to think of what I did prior to this new development– I had a bone marrow biopsy the week prior in which it left me very dizzy but I seemed to be fine quickly after. I had been crunching some ice a few days before and I did lie in an a awquard position during the treatment an hour before. We had moved to a new building at my job and I immediately started having a tightness like pressure in my head– which I still get maybe once a week. I did some steams and it seemed to help but I took some black elderberry and that made the tightness back off but when I stopped it came right back and it doesn’t go as easily now and the noise has developed into layered tones and the right ear is clogged – it tries to pop several times a day. The left ear has now started having noise though not as loud and it has tried to pop some too. My ENT says my hearing is fine again and there is no fluid. She says that it’s something I will have to live with. Also I started to hear like a loud sound when I yawn or stretch and also the echo on the last word someone speaks at times. Not constantly. This mostly happens when I get that pressure feeling as if my head will burst or like I’m on a plane… I am due to fly in the next couple weeks, and the sound has begun to get better at night. In fact the last two nights have been mostly quiet when before Incouldnt even sleep. It’s showing up mostly in the day now. What suggestions for flying would you give? Also would you try a Neti pot? ENT says that I should do the nasal steroid instead of Neti pot.
Hi Nikki:
When you hear tinnitus it is always an unmodulated sound such as a hissing, humming, ringing, roaring, clicking, etc. sound. When you hear music or singing (modulated sounds), that is not tinnitus, but Musical Ear Syndrome. Just so you know.
When you had the infection and you used “high doses” of Vitamin D3, what do you call a high dose? 1,000 IU, 10,000 IU, 100,000 IU or what? I’ve only seen a few reports of people getting tinnitus from taking synthetic forms of Vitamin D2, but not from D3.
If you have tinnitus in time to your heartbeat, that is called pulsatile tinnitus and is caused by turbulent blood flow in the arteries in your neck near you inner ear. Often it is a sign of high blood pressure.
Do you think the tightness in your head after moving buildings in your job was due to sick building syndrome?
If your ears are clear and you still get that pressure feeling, you might want to go to a special kind of chiropractor that specializes in the upper cervical spine (UCS). These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing such as the pressure in your ears.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you. There is a lot of good information on UCS chiropractic on this page also.
This might be at the root of your problems so is worth a try.
If you are at all congested, then an hour or so before you are due to take off, take a decongestant. Do the same about an hour before you are due to land. This helps some people–but you don’t seem to be congested. Thus I think the upper cervical chiropractor may be the answer.
Cordially,
Neil
Almost four days ago now my hearing randomly became distorted in my right ear. It sounds like people are talking through a fan and it gives me awful headaches. I don’t see what a doctor could do, but it’s also giving me anxiety because I’ve heard it can be a sign of sudden hearing loss. I tested to see if the pitches were different in each ear and everything sounds flat in my right ear and completely normal in my left. Nothing has happened to cause this and I have’t had an ear infection that I know of.
Hi Lauren:
The first thing you should do is go to an audiologist and ask for a complete audiological evaluation. That should tell you whether you have a hearing loss or not, how bad it is, whether in is in one ear or both, whether it is conductive or sensorineural or both (mixed) among other things. Then you will have a much better idea of what you are dealing with.
Do you have a cold or any active virus in your body that may be the cause? Are you taking any drugs or medications? Both of these things could cause your symptoms.
Cordially,
Neil
Good day Doctor Bauman. I’ve been hearing echoes on my right ear since yesterday. Yesterday I’ve listened to my earphones but I’m only using the right earpiece. After a few hours, I’ve started hearing echoes in my ear. It was bothering because the echo is getting louder as time passes by. I’m just starting my journey as a musician with my band. I’m afraid It leads to more serious matters that can affect that one thing I love doing most in this world. I will certainly appreciate your kindness of sharing your expertise. Thank you Doctor Bauman.
Respectfully,
Julia
Hi Julia:
You can get diplacusis when one ear hears differently than the other. For example, one is damaged more than the other. I think the cause of your diplacusis was because you only wore one headphone and I suspect you had the volume up too loud. If you had listened with both ears, it probably wouldn’t have occurred, but if the volume were too high, you could have damaged both ears.
I’d give your ears time to “heal” and as that happens, I think your diplacusis will fade away. This may take a few weeks. If you are going to expose your ears to louder sounds, you should be wearing musician’s ear protectors so you don’t permanently damage your ears.
Note: you can also get diplacusis if one ear is exposed to louder sounds than your other when you are playing in your band. In one study 7% of the musicians experienced diplacusis.
Cordially,
Neil
Hi Dr bauman.
I am suffering from diplaucosis and high frequency sensory neural hearin loss and tinitus following a flight 8 days ago.i did injection of intratympanic methyl prednisone and take 1mg per kg prednisone by oral simultaniously..funny thing is that i am ENT surgeon !!do uthink i should get medicine to decrease endolymphatic pressure? To your experience fir how long do i have this chance to get remedy ? During last week it dosent get better..thank u
Yours
Hi Amir:
When people have ear problems after flying, it seems there are two typical scenarios. One is that their ears were congested and mucous, etc. (I call in gunk) clogs the Eustachian tubes and they have a temporary conductive loss. Two, is that they have or catch a virus in the confines of the airplane and this virus attacks their inner ears causing a sensorineural hearing loss.
You didn’t mention whether either scenario is likely in your case. In the second case, as you know, the common medical treatment is Prednisone. Sometimes it works and sometimes it doesn’t. My rule of thumb is that the hearing you have at the end of 30 days is what you’ll have going forward. Prednisone is most effective if given ASAP after the hearing loss and becomes less and less effective as the days go by. If there is no improvement after two weeks, chances are continuing treatment probably won’t make much difference. And after 30 days it is a waste of time in my opinion.
Another of my rules of thumb is that the sooner hearing begins returning, the greater the chance of much/all of it coming back. But if there is no improvement in the first 2 weeks, chances are, not much, if any, will come back.
Yet another of my rules of thumb is that the worse the sensorineural hearing loss, the less the chances of much hearing coming back.
You haven’t said how much hearing you lost, so I can’t tell you what I think may happen in your case.
I’ve not heard of people using diuretics in such cases as yours so I really don’t know whether it will help or not. I tend not to think it helpful, but that is just a guess on my part. Remember, I’m not a medical doctor.
Cordially,
Neil
Hi again dr
Thank u for your comments.
I listened to a movie during flight for 3 hours .i guess that is the main guilty of that .after flight i was suffering from tinintus in my right ear but i didnt notice any hearing loss.i should mention that i have had this tinitus in my right ear for past 15 years.
After 3 days i felt hearing loss.
Audiometry showed this level of hearing .20 db i. 1000 fr/30 db in 2000/40 db in 3000 aand 4000..its mild to moderate snhloss in high frequency..i did intra tymanic injection of methyl prednisolone twice,and oraly 1mg per kg simultaniously..
A little improvment i can feel .its about 10th day of my treatment.
My problem list is tinitus which makes my hearing worse than it must be.and difference in putch of my ear in which means that affected ear is hearing in lower pitch in comparison with unaffected ear.and worst thing is a kinda feeling which we call it fullness in my ear ..and another thing which is very wiered and i realy beg u to explain about it is this :: i am suffering from 20 t0 40 snhloss ,so its logic not to hear things right but at the same time i can hear my breathing sound even every tiny movement in my nose in affected ear.it realy makes me crazy.why ?? Do u have any explantation ??
Thank u for being here and helping patients.u make patients not to give in
Yours
Hi Amir:
If you listened to a movie at high volume for 3 hours, that could have given you tinnitus and maybe a temporary hearing loss. Did you have the volume way up? And was it a noisy kind of movie with explosions and other sudden loud sounds in the sound track?
If so, you could have suffered from acoustic shock. This could result in hearing loss, tinnitus, the feeling of fullness in your ear (because of the sudden hearing loss your brain makes you think your ear is blocked or else you’d hear normally–wouldn’t you?), the diplacusis (hearing pitches wrong in one ear) etc.
You can hear different pitches in both ears if one ear is damaged worse than the other, or just one ear is damaged.
Hearing your breath in the affected ear is probably caused by your Eustachian tube remaining open on that side. This is called a patulous Eustachian tube. If you bend over, it typically closes and you should hear your breathing normally then. Try it and see.
Cordially,
Neil
Thankbu for rely.
My tinitus and hearing loss is getting better after 2 weeks and 3 intratympanic injection.it was acoustic shock due to high volume.
But i had a old illness ass u calked it ,patulous eustachian tube ,,simultaniously this patuolous etube ,causes autophony and hearing my breathing ..its very severe ..and when i am lying down ,it stops due to venous engorgment ..do u know any excercise or recomendation to decrease diameter of that wide eustachian tube?
Thanks
Hi Amir:
Patulous Eustachian tubes can be caused by rapid weight loss. If that is not your problem, then I’d think outside the box–especially since you had it some time ago as well.
Your Eustachian tubes are controlled by your trigeminal nerve. If this nerve is “pinched”, it cannot work properly and thus your Eustachian tube may not open and close properly. If this is your problem, then having an upper cervical spine chiropractor precisely adjust your top cervical vertebrae may solve the problem.
These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you.
Cordially,
Neil
Thank u very much..it was smart idea to go to chiroperactician.i will give it a try
Hi Dr. Bauman,
About 2 weeks ago, I woke up with a very painful ear infection for which I went to the doctor and was prescribed antibiotics. About a week later, all of my pain was gone and the infection seemed to have gone away completely, although I was still having difficulty hearing out of that particular ear. I went back to the doctor to be safe, and they said the infection was all gone but there may be excess fluid still in my ear making it difficult to hear. At the same time, I started to notice the my left ear (the one that was infected) was hearing pitches about a half step higher than my right ear. I am a musician so this is very bothersome to me. It has been almost a week since I last went to the doctor and it has not at all improved. Do you think this condition was caused by the infection? And if so, is it likely to resolve on its own? If you could share some of your expertise, it would be greatly appreciated. Thank you so much for your time.
Vinny
Hi Vinny:
There are two obvious possibilities to me. One, the infection in your middle ear has somewhat blocked that ear and thus you hear two pitches. When all the gunk in your middle ear and Eustachian tube drains away, your pitch perception should return to normal. Depending on how thick the gunk is, this could take up to 3 months.
The second possibility is that the antibiotic you took caused the pitch change. You didn’t say which antibiotic you took so I can’t look it up to see whether it is listed as causing this. If this is the case, when the antibiotic gets out of your system, you can hope that your pitch reception will return to normal.
Cordially,
Neil
Hi Dr. Bauman,
Thank you so much for your response. I took amoxicillin twice a day for 10 days. Is this problem a side effect of this medication?
Thanks,
Vinny
Hi Vincent:
I don’t have any information to indicate that Amoxicillin can cause changes in pitch. Perhaps it can in certain people–maybe you are one–but I’ve not heard of it before, so I think it unlikely that Amoxicillin was the culprit.
Cordially,
Neil
I’ve been dealing with diplacusis monauralis for a few weeks now, after a sudden onset in my left ear, and no obvious trauma. Two mild ear infections in my right ear just before this, treated with amoxycillin, doxycycline, and azythromycin. Then a few weeks later this happened.
Especially with pure sinusoidal waves sounds (e.g. whistling), i hear the actual tone in both ears, and an additional tone a bit lower in the left ear. I used an app on my iPad to map out the second tone versus the original tone, and found it to be remarkably (almost oddly) consistent, linear, and predictable.
Plugged into Excel, the data on my second tones revealed a linear correlation, F2 = 1.071 x F1 – 303, where F1 is the tone frequency being produced in Hertz (and heard in both ears), and F2 is the other tone frequency I hear in Hertz (only in my left).
At 1000Hz, the second tone, for example, is around 768Hz. And the equation even properly predicted that at 4242Hz (a little above the highest C on a piano) the second tone *matches* the first.
I would be interested to see in anyone else can try the same thing with their diplacusis. The iPad app I used in MultiTone Generator Lite, and is perfectly suited to checking this. Pick an ear, left right or both… enter a frequency… play sounds until they match. I ran from about 400Hz up to 4000Hz to get my results. Looking for an ENT with some experience with diplacusis to help me make sense of this.
By the way, I can share the results of my testing in an Excel chart if desired… including the data points, the linear correlation, and the equation Excel calculated. Oddly enough, having some knowledge of the condition helps me cope just a little with what is otherwise a very frustrating and disheartening condition.
Thoughts, anyone?
Hi Chris:
Amoxicillin, Doxycycline and Azithromycin are all ototoxic drugs and can cause ear damage. This may be the real reason for your diplacusis.
It’s cool how you have mapped out its response. I’m curious too if anyone that reads this has similar experiences.
Cordially,
Neil
Thank you for the informative article as well as for taking time to respond to all of the comments.
A few days ago I noticed my left ear felt blocked, as if there was some water in it. The next day I started hearing muffled sounds and a mild diplacusis. The day after the diplacusis was stronger and I also started hearing ringing in my left ear. Examination by my primary care physician on the same day didn’t reveal any abnormalities in the left ear. They prescribed Sudafed and instructed me to see an ENT and consider taking steroids if I experience hearing loss.
The day after the diplacusis went away but the ringing became more pronounced. Ringing has continued another day and is accompanied by occasional mild pain sensation in the inner left ear. Prior to onset there were no notable incidents of trauma or medications. I’m planning to see an ENT and have an auditory evaluation next. But due to holidays it will be a few days until I can schedule it. In the meantime my primary physician has prescribed, at my request, Prednisone tablets.
I’m wondering if I should start taking predinsone until I can see an ENT which won’t be for a few days. In addition I’m wondering if I should be taking anti viral medications as well. I’m primarily concerned about a viral sensorineural hearing loss and hoping to take preventative measures while I wait for ENT appointment.
Hi Peter:
If you have had an active virus in your body–cold, flu, herpes, etc.–in the past two weeks, then what you have described could be a viral attack. However, if negative, then I wouldn’t expect a virus to be the culprit.
It could also be due to excessive noise exposure. You didn’t specifically say you hadn’t exposed your ears to louder music for example. That could be the culprit if so.
It’s up to you whether you want to take Prednisone or not. Personally, I wouldn’t, but that would be my choice.
How are your ears doing now?
Cordially,
Neil
Thanks for the reply. I was not exposed to high noise and only had a mild cold a month ago or so. I did listen to podcasts for ~3 hours the day before the diplacusis sensation using in-ear headphone but it was not on high volume.
I started taking prednisone, but the ringing has persisted 3 days after starting Prednisone and I now feel it in both ears. It has also changed in nature from a constant ‘ring’ to a more ‘static like’ tone that goes slightly up and down, almost like electric signals.
I managed to schedule a hearing test for tomorrow. Needless to say it’s been causing quite a lot of anxiety.
Hi Peter:
Let’s see what your audiogram looks like, but I suspect you won’t show any significant hearing loss.
You need to get your anxiety under control as this will just make things worse. Learn to ignore your ear problems as much as possible by focusing on things other than your ears and see if in a couple of weeks, whether things are slowly improving.
Cordially,
Neil
As you guessed there was no hearing loss. Saw an ENT who just said it’s Tinnitus and suggested lowering stress but also hinted it may never go away. I’ve been trying to get my anxiety under control with lorazepam and have been able to sleep a couple of nights. The ringing has not improved tho and I feel it in both ears now. Started taking ginko b as well.
Hi Peter:
In order to be effective, you need to take ginkgo biloba at the recommended dosage. According to the German E committee, that dosage is 480 mg/day standardized to have 24% flavone glycosides, 5-7% terpene lactones and 2.6-3.2% bilobalide. Unfortunately, most formulations of Ginkgo do not meet this standard and are thus basically not effective. One that does, of which I know, is Arches Tinnitus Formula. There may be others.
Cordially,
Neil
Thanks for this, I have adjusted the ginko b dosage.
My tinnitus now sounds like multiple layers of modulating extremely high pitched sounds, so high pitched that it’s hard to make out the tone. It is also very reactive to sounds I hear, people talking, music playing from speakers, running water, all seem to have a noticeable effect on the pitch and intensity of the tinnitus sounds.
Curiously, I have discovered a clue. A day before my Tinnitus started, I used in-ear headphones for 5-6 hours (2x3hr continuous blocks) to listen to podcasts on a bus ride. The earphones were test devices handed out to my company’s employees to help test before their public release next year.
Today I found out that several people have reported hearing a high pitched modulating cicada sound in one of the earphones. Apparently this was so high pitched that 8 out of 10 people to tried the earphones did not hear it, but 2 of them did.
Assuming my earphones were also producing these high pitched modulating sounds on the left during those 5 hours, and I just wasn’t hearing them, could this have been the cause of my tinnitus? If so, is it possible that whatever was damaged would regenerate and heal itself?
I’ve overcome most of the anxiety, partly by working on my mindset and partly by taking trazodone. But my sleep has been devastatingly bad. In the past 3 nights I managed to sleep a total of 3 hours, despite taking trazodone. My doctor suggested Ambien but I think that’s idiotic and am not going to take it. White noise has been hard too because of the way my tinnitus reacts to sounds. And silence doesn’t help either since it amplifies the high pitched modulations. Any ideas or suggestions regarding sleep?
🙏
Hi Peter:
Your tinnitus may be from wearing the earphones for so long, rather than from the high-pitched sound you couldn’t hear. I don’t see how a sound that you can’t hear would damage your ears. However, if you were actually hearing it, but it was so high-pitched and soft that you weren’t aware of it, that may be a different story. Your brain may have latched onto it somehow, but that is pure speculation.
Does your tinnitus react to all sounds of any volume and pitch? If not, then find a sound of a pitch and volume that doesn’t upset your tinnitus and listen to that to help you sleep. If it works for you, recorded sounds of water work for numbers of people. For example, rainfall sounds, waves lapping on the beach, creeks running, waterfall sounds, etc. See if any of them work for you.
Cordially,
Neil
Oh btw my DPOA chart on my audiogram shows a drop of DPOA signal to 0 in the highest frequency (8khz) in my left ear only, something the ENTs I saw ignored and did not comment on.
Hi Peter:
I’m no expert on DPOAs at all–so I can’t comment on that either. Sorry.
Cordially,
Neil
I’m writing on behalf of a friend (G). We’re both professional classical musicians. This weekend G started to hear two pitches about a quarter step apart in response to any sound, and his long-term tinnitus turned from a high pitch into a roar. Playing organ and hearing his singers is now painful to him, and when he plays piano he can’t tell whether he is playing the right notes (he’s been playing for 50 years). G has Menière’s disease too.
This is obviously very distressing for a musician.
Would using a noise-isolating earplug (such as made by Etymotics) in just the affected ear have any benefit? It would prevent most sound from being heard on that one side.
Thanks for your wisdom.
Hi Kirin:
The first thing I’d do, if I were G would be to go to an upper cervical spine chiropractor and get rid of the Meniere’s disease. That might get rid of the extra tinnitus, some hearing loss and any vertigo and balance problems. It could also eliminate the diplacusis. Tinnitus can change just before another Meniere’s attack. And with each attack more hearing is lost–which might account for the diplacusis.
I suggest you investigate treatment from a special kind of chiropractor that specializes in the upper cervical spine (UCS). These people are able to work wonders for certain ailments and they are very gentle–not the bone cracker kind. They focus mostly on your top two vertebra (C1 (Atlas) & C2 (Axis). If this joint is “off” then you could have some of the symptoms you are experiencing such as the ear problems and Meniere’s.
You can find a chiropractor specializing in UCS by going to the following URL and entering your location. You can also read about the things these special chiropractors can do for you at this same website. Here is the URL.
http://www.upcspine.com/
Choose the “Practitioners” link along the top to find the one closest to you.
Now to answer you question. Since diplacusis is hearing different notes in each ear, by blocking the ear that is hearing the wrong pitch, then theoretically, the other ear should be on target. So that could be a reasonable temporary work-around. I’ve never heard of anyone doing that, but it sure sounds like it should work. But don’t forget the long term solution–upper cervical adjustments. That is the real cause/solution to Meniere’s.
Cordially,
Neil
Brain MRI shows large fluid collection in posterior fossa and left cerebellar hemisphere likely due to benign arachnoid cyst.
Also shows TMJ arthritis with the TMJ discs completely invisible.
Hi Peter:
When you clench your teeth, does your tinnitus get a lot louder?
Is the arachnoid cyst big enough to be putting pressure on your brain that could then be responsible for your tinnitus?
Cordially,
Neil
When I clench the tinnitus does get louder.
Not sure about the second question. Seeing a neurologist on Monday.
This is the best explanation of the condition that I have come across and I was thankful to find it.
My diplacusis symptoms are new and concerning, especially because I’m already dealing with many years of severe hearing loss (otosclerosis in opposing ear).
The new symptoms in my “good ware” are accompanied by about a 30% loss, according to an audio gram, and the advice was to watch and wait. Hoping improvement comes.
Thank you for the information!
Thanks for putting this online. Great information to have!
One week ago when I was sleeping, I woke up to this high pain in my ear. Unsure what to do, I called a semi emergency station that told me to use paracetamol and otrivin nose spray. With this the pain got better, so I could sleep again.
Next morning I wake up, and my hearing was crazy – heard 2 different pitches, so I went to the doctor, that again told me to take Paracet and wait.
I guess the infection was caused by some water that have gotten in my ear earlier this week.
The pain left after about 2 days, but the tinnitus and diplacusis dysharmonica are still there after one week.
Should I to back to the doctor and persist on getting an full check, or should I wait longer?
What I find a noticable detail is that one year ago I got some water clugged in my ear after swimming, and this never seemed to come out. I was lying in bed one day, and the feeling was that the water went though the eardrum??
However after this, my ear have been much more sensitive to loud noises than the other. (It doesn’t sound louder, but getting uncomfortable in loud environments much quicker.)
Any thoughts / ideas?
Hi Andreas:
I think what you need is a hearing test to see the differences in hearing between your ears. It sounds like your sensitive ear has some degree of hyperacusis, likely from excessive sound, that is messing up perception of sound.
Cordially,
Neil
Hi again!
Thanks for your reply.
Now, one and a half week later the dysharmonica is significantly better though still some tinnitus left. So this looks promising at least!
I will try to get an appointment for a hearing test. And keep you updated on what they find out 🙂
Thank you for putting this great information online. I am currently experiencing diplacusis dysharmonica. I first experience it 4 days ago but yesterday all of a sudden the sounds come back to normal. But now everything sounds off pitch again but not as bad as before. And I happen to have a clogged sinuses right now. Does that mean this is the reason that I have diplacusis dysharmonica? For people that have it because of hearing loss can their hearing somehow come back to normal like I did? Once again thank you.
Hi Bryan:
Anything that blocks your hearing to any degree like clogged sinuses can, can cause diplacusis. I think this is what is happening in your case.
If you have a temporary hearing loss, your diplacusis can go away as your hearing comes back. But for most people with hearing loss have the sensorineural kind–and that tends to be permanent. The kind you get with colds and sinus problems is conductive loss–and that can go away as your cold and sinus problems clear.
Cordially,
Neil
Hello Dr. Bauman,
About 2 1/2 months ago, I noticed that my left ear was ‘hearing’ tones and songs a pitch louder than my right ear. I am a former nightclub singer (years ago) but I now work as a healthcare professional (I mix and manipulate chemotherapeutic agents) – back in 1997 I first started having Tinnitus as a light albeit annoying ‘hissing sound’ to varying degrees of loudness. This was accompanied by a Heightened sensitivity to certain sounds. Through the years, this will come and go on certain days. But the Diplacussis is new, and my doctor (ENT) put me on Prednisone temporarily. The Diplacussis has improved somewhat, although I notice the Phone dial tone is “higher pitched” in my left ear than my right. Is this so terribly unusual? I always enjoyed music but now that enjoyment is somewhat impacted (let me say I never BLASTED music and I wasn’t a rock music fan) ~ My Audiogram states that my right ear hears at about 96% while my left ear receives 88% and the Audiologist tells me I do not need a hearing aid (yet). Both my parents wore hearing aids. My tinnitus is annoying (I love silence and feel it is denied to me) but the electronic distortion I hear (sometimes as if people are speaking through Waxed paper) is stressful to me. It’s not that I can’t “hear” it’s just that sometimes music sounds “crumbly” and I just wonder, will this problem resolve itself eventually as it did when I was younger (I am not past 59 but still work full time – and Healthcare is STRESSFUL which I’m certain doesn’t help matters. Any advice you can offer would be appreciated – also, the ENT doctor put me on Elavil for Tinnitus.
Hi John:
You can get diplacusis if one ear hears differently than the other. I think this is likely what has happened in your case. Although, if you have been around certain chemicals/drugs, it could be because of that.
Your heightened sensitivity to certain sounds is a form of loudness hyperacusis. It is often caused by too much noise exposure or a sudden too-loud sound. It seems from what you say that this has gone away now.
Musicians are more prone to notice diplacusis–and you are a case in point.
As you know, anxiety and stress can cause your tinnitus to be worse, so you want to get this under control. Stress itself isn’t the problem–it is how you handle the stress that becomes a problem if you don’t deal with it the right way.
Amitriptyline (Elavil) is an anti-depressant, so doesn’t help tinnitus as such, just changes your attitude to this sound if anything. However, you want to keep the dose low because the higher the dose the louder it can make your tinnitus.
Cordially,
Neil
Thank you Dr. Neil ~ I stopped taking the Elavil, it wasn’t really helping the Tinnitus – and my sensitivity to certain sounds sort of comes and goes. If I plug up my right ear, my left ear still ‘hears’ at a slightly higher pitch, but not as bad as when I first wrote to you. I take “hearing supplements” – meh – I’m not an expert but they don’t seem to do much. I am around many different drugs, but of course we wear protection and masks and gloves – and, I’m sure some of these medications can be ototoxic – are there any other drugs that can exacerbate Tinnitus or hyperacusis ? I stopped taking Furosemide because I felt it worsened my Tinnitus. I do take one Xanax at night time to help me sleep and (supposedly) some say it helps with Tinnitus (?) I greatly appreciate your response Dr. Neil and I also appreciate the other questions and answers depicted here – Many thanks to you, John
Hi John:
Are there any other drugs that can cause/exacerbate tinnitus and hyperacusis? You’re kidding–right? The upcoming 4th edition of my book Ototoxic Drugs Exposed which I’m still working on, so far lists 872 drugs implicated in tinnitus and 245 implicated in hyperacusis, and, if you are interested, 798 implicated in hearing loss. That’s a lot of drugs that can damage our ears.
Cordially,
Neil
Dear Dr Bauman, I have read through your blog and found the information helpful so thank you. I seem to have a similar problem to some previous people. I am a musician and have recently been recording vocals with the headphone on my left ear and the right open. 2 weeks ago my right ear, the open one, began to sound like a robot/dalek. There’s even almost an octave howl to notes. It’s horrible! If I blow up my right cheek, there’s a crackle or squidgy sound under my ear. Can I ask, should I plug it up to protect it? How long can this last? What can I do about it? My gp seems a little clueless. Please help. Kind regards, David.
Hi David:
I’m not surprised your GP seems clueless. I am too at the moment. What you are describing isn’t something I’ve run across before. So I’m going to ask some questions to try to understand better what is going on with your ears. I need to know the cause of your problems before I can really suggest a good answer.
Why are you using headphone on one ear and not on both? It seems to me you want to hear balanced sound and you need both ears hearing the same sounds. If you have one ear hearing the sounds at a significantly louder or softer level that the other, then your auditory system is going to try to compensate and change the volume of one. Then when you take the headphone off, your have your ears out of sync as to volume and maybe to pitch also.
When you blow up your right cheek, you are basically pressurizing your right Eustachian tube and the crackling or other sounds you are hearing is air trying to get through a congested (to some extent) Eustachian tube and as it pushes it way through the gunk and pushes it aside, then it “snaps” back and you hear the sounds of it “snapping” apart and back again.
I’d keep your ears balance so they both hear whatever you are listening to so your ears can reset to the same page so to speak. Then you shouldn’t hear any diplacusis sounds.
As I see it, you don’t need to plug it to protect it (unless you are exposing your ear(s) to excessively loud sounds.
Cordially,
Neil
Hi Dr Bauman, thanks for the reply.
When I’m recording vocals, I tend to have the backing track in the left ear leaving the right free to pitch. You may have seen singers plug an ear with their finger or have an in ear monitor in one side leaving the other free to pitch. Many singers do it although I take your advice as it’s probably not a good idea.
Thankfully, the howling octave has pretty much gone but the robot flangy sound is still there but has subsided. Listening with both ears is now not unpleasant!
I’m still going to give the music a break as I’m scared to death of setting it off again. I guess I’ll just have to be careful of volume and equal the noise going into my ears left and right. Any other advice would be great if you have any? Kind regards. David Potts
Hi David:
Glad to hear that your ears are getting better this quickly. That’s always a good sign. Hopefully, they will get back to normal soon.
Cordially,
Neil
I finally found a name to describe this weird robotic sounds that come and go. I’ve been to my ENT and a neurologist and they were both stumped. MRI and EEG showed nothing to be concerned with. When it first happened, it was only occurring once a month. Now I’m up to 4 or 5 times a month. It lasts for about 3 hours at a time. Hoping for better answers now that I can put an actual name to it!
Hello, I’ve had tinnitus for years, Idon’t know why since I never used to listen to very loud music. White noise helps and the tinnitus is worse when ears are clogged with ear wax. I tend to produce a lot of ear wax. But recently one of my ears got clogged with ear wax and the other ear was fine but just the other day I’ve developed diplacusis on the ear that is not clogged. Sound has an echo or reminds me of how people sound when they speak into a spinning fan. Could it be that hearing loss in one ear due to ear wax causes diplacusis in the other ear or maybe the ear that I can hear from has some ear wax or fluid or inflammation. I chew a lot of gum for acid relux and I wonder if that is causing my ear wax problem and maybe creating some preassure on the ears. I don’t feel like I have an infection. I’m going to try some water irrigation on the wax clogged ear tomorrow but I’m not gonna do anything to the hearing ear that has diplacusis. I’m going to the doctor on Mon and hopefully they can look in there and tell me what they see. Thanks for any advice.
Hi J:
Apart from exposing your ears to loud sounds, the two most common causes of tinnitus are hearing loss and using ototoxic drugs.
In your case, it may be your excessive ear wax clogging your ear canals and thus giving you a degree of conductive hearing loss–and your tinnitus resulting from the hearing loss. Keeping your ear canals clean would be the obvious solution if this is the case.
Just a point of correction–you don’t get diplacusis in one ear. Diplacusis is the net difference between your two ears. So the ear that is blocked with wax could indeed result in you experiencing diplacusis.
I’ve never heard of chewing gum for acid reflux. Chewing gum CAUSES your stomach to produce MORE stomach acid to digest the “gum”. To me this would just make things worse, not better.
If your ears produce a lot of wax, you need to get on a regular schedule to get the wax removed regularly whether monthly, quarterly, semi-annually or annually depending on ho fast it builds up.
Cordially,
Neil
Thank you for your quick reply, I will attempt to clear out the ear wax at home as safely as I can, if that doesn’t work I will go to the doctor.
Thanks again
Mar. 31st, 2021
Dear Neil,
Since around 1997, I have had TINNITUS and have tried many ways to combat it including ENT doctors,
Supplements, maskers, etc. For a number of years, some of these ‘treatments’ provided some minor relief
Sporadically Here and there.
In the past year or so, I have noticed my Tinnitus is exacerbated which I attributed to my taking Furosemide
Prescribed by my Doctor (for leg swelling) – I took it for about nine or ten months – I have ceased taking it
Because I can’t stand Tinnitus which in my case is like a constant running of faucet water, or what some call
A “Violet Noise”.
The Tinnitus is bad enough but nothing new, but back in late October, I noticed that my left ear was “hearing”
Certain tones a full pitch Higher as compared to my right ear. I did some research and found out that I have
Diplacusis whereas one ear perceives sound differently in each ear. I went to an ENT doctor and she had me go
For an Audiogram which revealed that I have 94% hearing in my right ear and about 88% or so in my left ear.
A land Line telephone dial tone next to my left ear sounds considerably ‘higher’ pitched as compared to my right
Ear. Over a course of 3 months, to some degree, the condition improved, however I have it again now that it is late
March (and possibly because my allergies kick in here in Las Vegas at this time of year) – Can I assume this will forever
Come and go at random?
I am a former nightclub and studio vocalist, so I very aware and sensitive to Key changes and tone variations. I hate
Having this, but feel that maybe a short dose (one week Prednisone 20mg 2 x d) will improve it again. Is it related to
ETD and if so, wouldn’t a low dose of a corticosteroid be beneficial – I would really appreciate your thoughts.
Thanks in advance,
John
John G., CPhT
Hi John:
Furosemide can definitely cause tinnitus–no question about that. In fact, a Furosemide IV can cause tinnitus within 7 minutes.
Violet noise would be an extremely high-frequency sound with almost no lower-frequency component. Is that what you think a faucet sounds like? To me it is more like white noise.
Diplacusis can indeed be caused by having different degrees of hearing loss in both ears. It can also be due to taking certain drugs. Are you taking any drugs at this time?
It’s possible it will come and go, but only if your allergies affect each ear differently. If both ears hear at the same level (volume) then it is harder to have diplacusis than if one hears better than the other.
You can try Prednisone. I don’t know whether it will help your diplacusis or not. I guess the only way to know is to try it and see.
Cordially,
Neil
Thank you Dr. Neil – I currently take Atenolol in the morning and Nifedipine for HBP – at night I am allowed to take one small alprazolam for anxiety. Of course, throughout my day I mix a lot of different cytotoxic agents, and I am inside a Mixing preparation medication Hood that is fairly loud when it’s on (but I am in and out of it, depending on how busy the Clinic is) – Lately, the “pitch” between my ears is somewhat improved, the distortion, while still there, is marginally improved. I don’t “hear” the way I did as a very young vocalist, but of course, I realize that since both my parents wore hearing aids, that eventually this will most likely be my legacy as well. To me, the Diplacusis is more distressing that the Tinnitus (which believe me, to me, it’s annoying and intrusive enough on it’s own) I would never venture out to a noisy environment without ear plugs, but is there such a thing as ‘overprotecting’ your ears? Also, I finished taking the Prednisone, I guess being a drug in the corticosteroid family it helped a little, but I am done with it (don’t care for Prednisone) – to be honest, I take as few drugs as I can. Thank you for all your helpful information – I don’t know if I have ‘violet’ noise or ‘white noise’ but it always sounds like Bacon frying in a pan (a sizzling kind of sound) which is annoying but at least tolerable on my rare “quiet” days – thank you again Dr. Neil I look forward to finding your book – John
Hi John:
You asked, “Ii there such a thing as ‘overprotecting’ your ears?”
Most definitely. Your brain wants to hear things and when you wear ear protectors unnecessarily, it turns its internal gain up to try to hear more. Then when you take the ear protectors off, everything now sounds too loud. That can lead to loudness hyperacusis which sounds more like the gain control is stuck on high.
Thus you walk a fine line between protecting your ears and overprotecting them. The general rule is to wear ear protectors when the sound is too loud (85 dB or so) and take them off as soon as the volume drops.
Cordially,
Neil
Hello,
I’ve recently been having many issues involving facial pressure in my nose and chin area, and in my neck as well. After going through many doctors, my allergist suggested the facial pressure was a product of allergy issues. I was given some steroid spray, Flonase, and salt water spray to use multiple times a day. Meanwhile, the neck problem seemed unrelated, and I began treating it with dry needling and NSAIDs.
Yesterday (6/28), I took a fall, wherein I awkwardly landed in a position where I squeezed my shoulder tightly against my neck/ear. Didn’t feel any pain…
Then today (6/29), I woke up with Diplacusis on my left ear. It’s mostly just when I speak, I hear my voice in a weird echo. My ear also feels full.
My allergist recommended Afrin along with other sprays he already prescribed for me, saying he believes it’s from allergies.
I can believe that…but I do wonder if my fall from last night had anything to do with my current issue.
Any thoughts on this?
Hi Jessica:
Why would pressure around your chin be related to allergies? I can’t see the connection. Your allergists apparently only see allergy issues and try to treat them with allergy meds.
The full feeling in your ears can be due to allergies clogging up your Eustachian tubes that is true. However, it is just as likely that it is due to your neck vertebrae being out of proper alignment and pinching your trigeminal nerve. Your trigeminal nerve also controls parts of your face.
Whenever I hear about neck issues and pressure issues in your ears, the first thing I think of is getting checked out by an upper cervical chiropractor, NOT a conventional one. When certain nerves are “pinched” due to your neck being out of proper alignment, they can cause ear problems and face problems among other things.
Just because you fell and “wrenched your back” is not suddenly going to make your allergies cause diplacusis in your ears!
If I were in your shoes, I’d head for the nearest upper cervical chiropractor and make sure your vertebrae are in proper alignment. If they are out–even a wee bit–that can cause all sorts of ear and facial problems. These upper cervical guys are the experts in discerning this–they can measure within 1 degree how far out any vertebrae is. This minute measurements are totally missed by medical doctors. They don’t think this can cause any problems. But the truth is much different.
For example, my C1 and C2 were only out 3 degrees one way and 3 degrees another way and the result is that I was getting bouts of vertigo. Two treatments by an upper cervical chiropractor fixed that and in the number of years since then, I’ve never even had a hint of vertigo. My conventional chiropractor never caught and fixed that.
You can find one of these special chiropractors by going to http://www.upcspine.com/ and clicking on the “Practitioners” button along the top.
Once they give you the “green light” that your spine is aligned properly and is holding its proper position, then see what problems you still have left. Until you do that it’s like fixing cracks in the wall, when the real problem is a shifting foundation causing the cracks. Better to fix the foundation then you won’t have cracks anymore.
Cordially,
Neil
I saw a Chiropractor (not a UCC), and he did an x-ray, and everything came back normal for my neck and rest of my face. He still did some adjustments, though there was pain after, so I stopped going to him.
I have no idea if the ear fullness is allergies or if it was from the fall yesterday. It doesn’t feel related, but I have no idea. I’m getting kind of worried.
I already did Physical Therapy for my neck/face issues, along with Acupuncture, Dry Needling, etc.
Hi Jessica:
If it were me, I’d still want to be checked out by an experienced Upper Cervical chiropractor.
Cordially,
Neil
I need some help, I had a bad cold about 2 weeks ago, and was put on predistone for 6 days for my asthma.
I was on under a lot of stress over the past month for other medical things
Over the past week I have loud tinnitus and recently found that if I put a ear bud in my right ear everything sounds normal, if I put it in my left everything sounds off like they are singing though a cardboard tube or robot like.
I saw my GP and he could see nothing wrongs do that I should wait a month to see if it goes away.
I was sleeping with an ear bud in listening to white noise during my stressful time could it be related to that??
Or should I go back to GP and ask for steroids??
I don’t think I’ve had a lot of hearing loss, watching TV is hard because it feels like my ear is reverbing but if I cover my ear I can still understand people it’s just sounds robotic..
Hi Dave:
I think that the cold virus you had got into one of your ears and has caused this distortion you are experiencing, and likely the tinnitus too–helped along by your high level of anxiety.
As a matter of caution–you should NEVER do sound therapy (listening to white noise in your case) in only one ear. This unbalances your auditory system and thus ultimately won’t help your tinnitus. So even if you only hear tinnitus in one ear, when you listen to white noise, always wear two earbuds/headphones to keep your auditory system balanced.
I’d continue with your sound therapy–but using both ears–and hopefully things will get back to normal in time. Personally, I wouldn’t go on more Prednisone. You already took a course and it did what it could do. Now, it is time that you need. It can take time like your doctor said–maybe a month or two (or longer). And at the same time, get your stress under control. That alone should help with your tinnitus. And treat your tinnitus, not as a threat to your well-being, but as a totally unimportant background sound that it is safe to ignore–then ignore it by focusing on the loves of your life and not on your tinnitus.
Cordially,
Neil
Thanks for your help. I actually saw the dr again a couple of days later, he had another look and said my ear eustachian tube were affected by my cold as my throat was swallowen even though I felt better from the cold. I’m stress is waay down as I’ve been cleared of other things he said using nasel sprays may work and as you said it could take 2+ months to go back to normal.
He did prescribe antibiotics but I have not used them yet.
Dear Dr Bauman, I’m so pleased to have found this blog post and the comments. I’m desperately trying to learn more about diplacusis dysharmonica, as my 30 year old cellist sister has this diagnosis since about 10 years. Earlier this year she completed her Master’s degree in cello, but her diplacusis is so bad now, she’s decided to give up her musical career entirely! We’re desperate to find out if there is anything that can be done to help her, even if it can’t be cured, but at least some kind of relief. The diplacusis is most probably caused by hearing loss from loud orchestral music in her youth. Do you think a cochlear implant could be of any help? She lives in Stockholm, Sweden, and is ” treated” at Karolinska hospital. Thanking you in advance!
Meta
Hi Meta:
You don’t say how much hearing loss your sister has in each ear. But diplacusis dysharmonica can be a result of hearing differently in each ear. If hearing aids can bring the hearing to the same level in both ears, then it is possible to mitigate or eliminate the diplacusis.
I don’t think a cochlear implant will help unless her hearing in her bad ear is profound–and if that was the case, she shouldn’t have diplacusis as she would only be hearing the music in one ear anyway.
Cordially,
Neil
Any thoughts on episodic diplacusis? My chief complaint is that my left ear starts hearing a few fractions of a second slower, but it’s also bit fuzzy/gravelly and might have a slightly altered pitch. (It seemed lower but I tried to reproduce the sound in an editing program while having and episode and listening in the good ear alone and it seemed like higher in the delayed ear matched that episode better.) This will happen for 30 min to 4 hours at a time and the episodes tend to be clustered, i.e. will happen once, at some random point in the day, for most days over two weeks then will go away only to reoccur the next month with daily-ish episodes for another couple of weeks. But another time, it disappeared for 6 mo without intervention. It’s typically preceded by a feeling of fullness in that left ear.
I was diagnosed with probable Meniere’s, which also is episodic, since I’ve had spells of vertigo, but they typically don’t align with these diplacusis episodes, though a salt restrictive diet seems to have helped both (hard to tell since both might have disappeared on its own as its done prior). And obviously diplacusis is sometimes associated with Meniere’s. Anyway, it seems unrelated to loud noises or a viral infection since it comes and goes throughout a given day. I’d be curious to know if you or others have ever heard of such a pattern of diplacusis since for most it seems to be present permanently or go away after a few days, not this annoying, unpredictable (will it start at 11 pm or at 11 am during my meeting???) episode business.
Hi Emma:
Some people have tinnitus that seems to run in cycles–probably due to one of your body’s circadian rhythms. It could also be due to changes in hormones, or a combination of both.
There is no reason why diplacusis couldn’t also do the same.
Meniere’s often correlates to periods of stress. Incidentally, there is no reason to have Meniere’s. You can readily get rid of it. If you are interested, read my comprehensive article on the subject at https://hearinglosshelp.com/blog/atlas-adjustments-alleviate-menieres-disease/ . Maybe that will also get rid of your diplacusis too.
Cordially,
Neil
Hi dr Bauman,
Thank you for your blog, it gives a little hope.
Since over 1 month all of a sudden I hear robot with all sounds coming in on my right ear. Been to doctor and it seems I lost all hearing of low sounds. So what does come in is robotic and with an echo an low I don’t hear anymore. X-ray it’s all good. I have had a large amount of prednison but no results. Will my hearing come back? What are the odds? My whole life feels different, don’t like music or television anymore. It scares me this can just “happen”.
Hi Sophia:
Having sudden hearing loss in the low frequencies is definitely not common, but it does happen to some people. Since Prednisone hasn’t worked and about a month has passed since this occurred, there is no point it taking any more Prednisone. I rather doubt any hearing will come back at this late date. My rule of thumb is the hearing you have after 30 days is what you will have going forward.
You may find that getting and wearing a properly-fitted hearing aid will help with the diplacusis and the robotic sound.
These things don’t “just happen”. There is a reason–it’s just that the reason may not be obvious. What was going on in your life a month ago that might have caused this? Any ideas?
Cordially,
Neil
Thank you for your comment. That is just the thing. I did not feel stressed. A week before was the last day of a little cold, which I never really have, I thought at the time it was because of my vaccination, I delayed it for some time and then got the Janssen. I do not want to think of a correlation. I am a healthy woman, 48, sport and meditate sometimes. Is there anything else I could think about? I see the eardoctor coming Wednesday for results of blood. Is there something else that could be examined before I have to “embrace” this in my life? Thank you so much for your time.
Hi Sophia:
It sounds like your ear problems are the result of a virus getting into your inner ear since before the ear problems showed up you had “a little cold” and just before that the Janssen vaccine. So probably the vaccine ultimately was the cause of you ear problems.
Probably the virus has long since gone leaving some permanent damage in its wake. I don’t know of anything that you con do now to recover any hearing, etc.
Cordially,
Neil
Hello.
Here , from Canada. Thank you for explaining what exactly is happening nto me.
I am a guitar/singer performer. I am trying not experiment with ear monitoras so perhaps I can balance the volume and the “PAN” to my left ear which I believe is still in tune. It is difficult to sing because my guitar sounds very untuned. I don’t know which sounds to follow.
Any other advice or updates will be appreciated
Hi Dr. Bauman,
Thank you for your blog post. I reached out in another blog about a year and a half ago about some loudness hyleracusis I was having with speakers particularly and a post- increase in tinnitus. The sensitivity has since mostly resolved, however the tinnitus has largely remained. I do find that massage around the upper neck reduces the symptoms largely.
I’ve been extremely stressed at work lately – more than j even have been in my life before as it’s a new job. Two days ago, I had pressure feeling and ringing start in my left ear at work. By the time I got home, I noticed j could barely hear out of my left ear. It sounded like it was underwater. I panicked and went to do the doctor, who prescribed me Prednisone. That night, the symptoms had slowly started to resolve, with less ringing and the pressure feeling gone. I’ve had this happen twice before, the first time was also after a very stressful moment and the second I believe the doctor found some water in my ear.
I’ve taken the Prednisone for two days now. I was initially scared it was sudden hearing loss but am not sure about that because it mostly resolved in it’s own. Unfortunately now what remains is a double pitch in my left ear (the affected) that amplifies a certain frequency (it’s about 800 hz( when I hear any frequencies between the range of 500 hz – 900 hz. Beyond that range, there is another time that overlays itself on the current sound, much higher and quieter in pitch. I am freaking out because I don’t want my life to look like this moving forward.
I’ve had non stop issues with my ears since two years ago following a traumatic event (not acoustic trauma, just from relationships). Since then, I developed tinnitus, globus in the throat, patulous eustachian tube, hyleracusis, muscle tension dysphonia in the throat, a couple of episodes of that sudden deafness as I explained before, and now what I believe to be this Diplacusis monauralis in the left ear. I am more or less at peace with my tinnitus, the hyleracusis had mostly faded, and the patulous has actually mostly resolved. I am an audio engineer and musician however since the onset of all of these symptoms, never really used headphones and have been extremely adamant about protecting my ears.
Is it possible that intense amounts of stress can bring on this type of Diplacusis? It doesn’t seem likely to me that the two are connected but I’ve had my body do crazy things that don’t seem all that related these past couple of years. What happened a couple of days ago felt like an “episode” where my body just broke out in stress and manifested as the temporary hearing loss. I don’t think it’s related to noise exposure. I don’t listen to headphones or anything loud at all. It just doesnt make sense.
I woke up this night at 1am to write this – I seem to be having feverish feelings of slight of hot and cold temps and my partner was sick about a week ago. I’m not sure if there is any correlation there. I just want this change in hearing to resolve as sound and music is my life.
Do you have any suggestions or have any idea as to whether this type of Diplacusis could resolve?
Thanks for reading my story, I really appreciate it.
Hi Lee:
If massage around your neck area helps reduce your tinnitus, then you know that you have somatosensory tinnitus (at least to some degree) and thus massage and chiropractic can typically help you.
Stress and anxiety also can greatly increase your tinnitus–not to mention causing your neck/shoulder/facial muscles to tighten up and thus exacerbate your somatosensory tinnitus as well.
You need to learn how to properly deal with your stress or you’ll continue to have problems with your tinnitus. From everything you say, I think this is the key to all your ear problems. You need to learn to relax–both physically and mentally/emotionally. Taking drugs isn’t the answer.
I think your diplacusis is all part and parcel of the above.
There is nothing wrong with listening via headphones as long as you keep the volume down to a level such as you’d normally hear speech at. That won’t hurt your ears anymore than talking with people would.
Cordially,
Neil
[20yo male] Around 3 weeks ago I first encountered a bout of tinnitus primarily on my right ear. At first the tone of the ringing sounded in between A sharp and B. I did not really address it. However, the week after, I started to develop some form of ear fullness, where I am more sensitive to low frequency sounds and my ears would feel kinda clogged and full. The pitch of the ringing in my ear went up by about half a semitone and I have been worrying constantly about it. The frequency is around 1000Hz. The fullness sensation seems to have gotten better for me after a few days, but the tinnitus and pitch problem (diplacusis dysharmonica) still persist. I test my hearing using my AirPods, and when comparing my left and right ear, the left ear sounds about 0.2 semitones higher and the right ear sounds about 0.5 semitones higher than normal after developing the fullness.(pitch difference is more obvious when using AirPods but more subtle when hearing external sources, but when I listen using both ears, the brain for some reason integrates the signals so that it sounds somehow normally, considering the pitch differences aren’t really that high but I can discern them because of my absolute pitch ability). Also, sounds are slightly distorted.
Around the first week of January 2023 I started feeling mildly dizzy (not spinning type, more like a rocking boat type), along with some pressure around the sinus that comes and goes during certain times of the day.
Unfortunately I enjoy listening to loud music frequently using my AirPods everyday and I sometimes feel itchy around the ear canal and scratch the ear canal occasionally, which notes the possibility of infection/wax buildup.
I had my hearing checked last week which involved playing a sound that goes lower in volume and frequency and pressing a button if i hear that sound. I somehow passed the hearing test with flying colors for some reason. I was also prescribed clarithromycin, bilastine, and a povidone-iodine mouthwash to treat any possible bacterial infection, but have experienced no side effects or any improvements as of now.
I am praying that this situation changes for the better. It’s something I’ve been worrying a lot about it (diplacusis even more than tinnitus, since I have perfect pitch) but am trying to cope with it. At this point I do not know whether the diplacusis was caused by a sinus infection, wax buildup, or exposure to loud noises. The condition has stayed the same largely since last Monday, with only the hearing fullness/low frequency sensitivity improving.
Hi Robin:
You left out some critical pieces of information–what happened 3 weeks ago just before you noticed the tinnitus? Did you expose your ears to loud sounds? Did you have any active virus in your body back then? Did your mildly dizzy episodes occur back then at the same time?
When you had your hearing checked, was your hearing exactly the same in both ears as shown on your audiogram?
When you listen to loud music, you risk damaging your hearing and this can result in diplacusis if both ears hear slightly differently. When wearing airpods or headphones, etc. the safe/proper level is about the same level as you’d listen to a person talking. When you go higher than that, you slowly, or not so slowly, damage your ears. Some of this damage is hidden and doesn’t show up on standard audiograms–but your brain is aware of it.
I doubt your problem is wax build-up as they normally make sure your ears are clean before they do a hearing test. My best guess at this point is it is due to loud noise, but it could also be due to a viral infection that got into your ears as balance issues are often a result of viral attacks.
Once you answers all the above questions, I may have a better idea as to what really happened.
Cordially,
Neil
Hello Dr. Bauman.
Before I noticed the tinnitus, I was playing some loud music unfortunately, however I already felt the constant mild rocking dizziness and sinus pressure by then, suggesting it may have also been a viral infection. My dizziness improves whenever I am in motion such as in a car or bicycle.
I also have another tone of tinnitus that increases volume as I clench my jaws, along with some neck stiffness.
The sinus pressure and dizziness are still here.
Hi Robin:
Is your rocking dizziness a forward and backward sensation such as rocking in a rocking chair, or as though someone was pushing you from behind, or is it a rocking motion in any direction?
Just to get this straight, if you are sitting in a parked can, you feel the dizziness, but once the car is moving, this helps relieve this dizziness, correct?
If your tinnitus gets louder when you clench your teeth or turn your neck hard to the left or right, that is somatosensory tinnitus in action. It is typically indicative of your cervical vertebrae being out of proper alignment.
Cordially,
Neil
Hello Dr. Bauman,
The rocking sensation feel like rocking in any direction, and it gets better when I’m in motion. It’s similar to this condition called Mal de Debarquement syndrome (MdDS).
I just saw my ENT recently, and I am focusing on giving my ears time to heal and fixing sleep and stress. I may be prescribed a nasal spray for the sinus problem.
Hello Dr. Bauman,
Just to give an update: My diplacusis has seemed to disappear and the low tone tinnitus and other distortions have lessened after 2 months despite no medications (aside from vitamin supplements)! I can hear sounds better now. I don’t know if this was a miracle or there was conducive hearing loss that was unchecked and went away. High-pitch tinnitus and mild dizziness is still there but milder and less noticeable than before. As a result I have started to become more careful with my ears and lessened the loud sounds, and take better care of my health. Thank you for the advice that you post on this website nonetheless, I know how take better care of my hearing!
Robin
Hi Robin:
I’m glad to see your symptoms are slowly going away and your ears are returning to normal. These things can take time, but you are obviously on the right path. Just remember to protect your ears from loud sounds in the future.
Cordially,
Neil
Hi Dr. Please help me as I am in distress. I have been upset about 7 days now because of what is going on with my hearing. I went to the ent as I had beeping off an on in my right ear. I got a regular auditory hearing test- listening for beeps and the speech repeating. They said I have perfect hearing and passed. However how I am hearing is the problem. Things sound distorted and robotic? Pitches are off and don’t sound how they normally do. My primary dr said sinus pressure? And maybe some fluid in my ears but that’s it? Are my ears going to be stuck this way? I can’t watch tv or music bc it sounds funny and I am scared. I haven’t had any loud noise experiences I can think of and the don’t seem to have wax in my ears or the dr would have found it. I go back in 10 days to see the ent again.
I must add: this is day 7 and I don’t know how to put myself in which category I am: temporary or permanent. This keeps my anxiety going and keeps me scared. I just want to hear normally again. I didn’t even know this was possible and my family doesn’t understand. Please tell me I’ll be okay and that this will go away?? Will be waiting anxiously for your reply.
Also note: nothing was going on before any of This. I just kind of woke up with it last Friday.??? No previous virus or infection I can think of before this either. I was perfectly fine and 7 days ago I woke up like this…..
Hi Amber:
Your ears don’t just go “wonky” for no reason. The trick is to discover what actually happened. Once we know what happened, then it is easier to answer your questions about what happened and whether it will be temporary or not.
One thing you didn’t mention is whether you are on any drugs or medications. There are a number of drugs that can cause problems with pitch distortion.
Have you had any vaccines or boosters in the past few months?
Apart from distorted hearing, did/do you have any other symptoms such as dizziness or balance problems, tinnitus, sound sensitivity where normal sounds now sound to loud and often “sharp”?
Cordially,
Neil
Hi doc. No new medications. The only thing I take is my birth control which I’ve had for the 4 or 5 years. I haven’t had any covid shots or boosters at all- like ever. I haven’t been sick in the last few months either. Last Friday I woke up to a few beeps off an on in my right ear around 5 am. I kept listening for the beeps for a few days to see if it was still happening and couldn’t tell. I think that went away. So I sat in silence for a few days. Pressing on an off my ears listening to see what I’m hearing . Then I noticed about 4 days ago how I hear things sound funny. The radio sounds higher pitched and distorted? Like in a tunnel? With maybe some echos ? Or like they are speaking in a well? The tv, appliances sound like they have a high whistle? Or give off two sounds? When I’m outside everything sounds like it’s whistling. I went to the ENT and they did a simple hearing test, had me listening for beeps and also the speech repeating words. I passed it with great hearing. Above average they said. However it’s HOW I’m hearing it that seems to be the problem. I called them back to tell them and they disregarded me and told me there is nothing they can do. I talked to an audiologist and she said for me to come see her next week. I’m on day 7 and I’m having Anxiety because I’m scared this is permanent! I didn’t seem to have any wax In my ear or my primary dr would have saw it but he did say that I had sinus pressure and maybe my Eustachian tube seemed wonky? This is all looking through just the basic ear device the drs use. He wrote me a script for Flonase. Other than that I can’t think of anything else happening?
I will also add My parents think this is caused from my anxiety and think it might be auditory anxiety because of how anxious I’ve been but I don’t think it’s possible that anxiety can cause sounds to sound distorted and off pitch, higher noted, in a tunnel etc. I think it’s the word this article is saying and I’m scared.
Also no dizziness or problems with my balance. I can hear my own voice too if that makes sense?? People breathing…. It all has a whistle.
The wind is blowing and it’s making a blizzard noise in my ears. Something is wrong doc 😞 I can’t stop crying thinking my ears are going to be stuck this way.
How will I know if it’s going to go away? It’s been 7 days already.
Hi Amber:
You have some form of distorted hearing, that’s for sure. I still haven’t been able to figure out what caused it and thus the best way to treat it, but your anxiety certainly isn’t helping matters. You need to calm down and relax.
Only time will tell what will ultimately happen. I’m thinking that giving your ears a rest from loud sounds for the next two or three months would be a good idea–then see if the distortion has lessened or gone away.
In the meantime, don’t focus on your ears. Instead, focus on the loves of your life. And practice relaxing exercises and breathing exercises. These will help you calm down.
Let’s see what your audiologist says after your next visit.
Cordially,
Neil
Hi Dr. Bauman,
I feel relieved to have found this blog. I have been experiencing what I think is some form of diplacusis in my right ear on and off over the last two months. I have not yet seen a doctor about it yet because I just moved to a new state, but I plan to soon. I moved from a very humid climate with four seasons to a very dry climate that is hot to temperature throughout the year.
On July 18th of this year, I randomly started hearing two different pitches at the same time in my right ear – the actual pitch, and a much higher, discordant pitch with it. I didn’t have any pain or fullness in my ear that would have made me think I had an ear infection, but I suppose this is possible. I have never had an ear infection as an adult, and I’m 30 years old. I had started a new birth control pill in May, and I have been on some form of oral contraceptives for the last 15 years with just one break over about a year. I don’t take any other medications, and I take a B12 supplement a few times a week because I’m vegan and have been for the past 6 years.
The diplacusis came on suddenly and made listening to music pretty unbearable. I could also hear my own voice in my head in two pitches, almost like a robot or an alien in a movie. It mostly went away on its own after about an hour and a half. I had taken a shower during that time and thought that the steam from the shower may have helped loosen some kind of ear wax blockage, if that had been the cause. After that night, I didn’t experience diplacusis again until September 8th. It again lasted about an hour and a half and then went away. During that time I had cried a bit because I was nervous, and I blew my nose a lot, so I wondered if maybe the diplacusis was sinus-related. I haven’t gotten a cold/flu (that I know of / felt symptoms of) since I got COVID in April 2022. I also haven’t had a booster shot of the vaccine since 2022 either.
I experienced the same diplacusis in my right ear again on September 12th, September 15th, and again today (September 16th). Each time, it lasted about an hour and a half and then went away, but it has been happening much more frequently this month. I was thinking of trying an ear wax removal kit if this keeps happening over the next week, but I’m wondering if you think this may be caused by something else? I have felt like I’m clearing my throat a lot more lately (although I have no pain there), so maybe I have some kind of post-nasal drainage or sinus infection? Maybe it’s my body adjusting to the dry climate out here? Maybe it’s the birth control? Any ideas you may have would be so appreciated!
Sincerely,
Amanda
Hi Amanda:
You say your diplacusis came on suddenly one day. Thinking back to that time, were you under a lot of stress then, or were you feeling anxious. It’s possible that stress and anxiety could cause your problems.
Since your episodes last an hour and a half (approximately)–which I find unusual–it seems something is triggering them. What happens in the hour or two before each episode starts. Can you think of any commonality between them such as anxiety, eating certain foods, certain kinds of movements or exercise, being tired or upset, etc., etc. And have your right ear checked for wax or other foreign material in your ear canal that may be touching your eardrum.
I don’t really think it is a sinus problem, but I’d certainly not rule it out. I also don’t think it is the birth-control pills.
Cordially,
Neil
Hello Dr. Bauman,
I developed tinnitus after a rock concert about 2.5 months ago. However, this subsided with 3 doses of cortisone and Cinnarizine and became inaudible.
I was so stressed that Cinnarizine caused muscle twitches and sleep spurts, and the psychiatrist recommended me an antidepressant. (Sertraline 25 x 4 days, 50 x 2 days)
Right around this time, I learned that antidepressants can cause tinnitus, and overnight my tinnitus increased and became very high-pitched.
While everything was normal up to this point, I thought that this increase was due to antidepressants and took refuge in the healing power of time, I suddenly started experiencing the things I will mention below.
Sounds of flowing water,
Some ventilation sounds,
I hear a low-pitched sound like a whistle or a whistle among the white noise of cars passing in the distance on the highway.
At the same time, I hear different melodies of some of the music I have listened to before. They feel like they’re ahead. Sometimes there may be fullness or short-term pain in my ears.
Sorry for my English. What could this be, diplacusis or dycasusis?
Hi Enigma:
Listening to loud music is a sure way to get tinnitus. So is taking many kinds of drugs. The sounds you are now hearing all seem to be various tinnitus sounds. It’s not unusual to hear more than one tinnitus sound. For example, I sometimes hear two or three different intermittent sounds in addition to my constant main tinnitus sound. You may be doing the same.
You also may be experiencing audio pareidolia where you perceive white noise kind of sounds as music.
Ear fullness and ear pain can be the result of the loud concert resulting in acoustic trauma of which these are two symptoms.
If you hear the music twice–one just after the other you could also have diplacusis.
Dysacusis is just a general term for anything wrong with your hearing so I seldom use it. I’d rather zero in on exactly what the problem is.
Cordially,
Neil
Thanks for the message! :pray:
Oh, I totally forgot to mention some details. Sorry!
After the concert, my acoustic trauma was diagnosed and an audiometry test was performed. I have a 50-60db hearing loss that plateaus from 9000 to 16,000. However, my doctor claimed that this loss was very old. It may be true, I experienced tinnitus for a day as a result of a gun explosion while I was in the military.
I had my hearing test done again to see if there was an ototoxic effect after Sertraline. However, the same thing came out, there is no different situation. What about the effect of Sertraline?
I’m not sure if I could explain to you very well what I experienced.
While flushing the toilet
When the taps are flowing, I hear low/mid tone whistling or whistle sounds among these sounds. I’m sure it really has nothing to do with tinnitus, I’ve never heard anything like it in my ears.
But I’m learning that this is not diplacusis or dysacusis. I’m so confused. I can also easily say that I am very stressed and very obsessed with health. Can you give me any advice? :/
Oh, I literally found a description to describe the sound I heard: like the sound of glasses being clinked!
Exactly, I hear this from white & pink noises like the sounds of some vehicles passing in the distance when I walk on the road when water is flowing when water is being filled into the siphon.
it’s very insteresting experience but it’s not funny. 🙁
Hi Enigma:
I wonder how your doctor decided that your high frequency hearing loss was so old. Was he just assuming that without concrete evidence?
Having tinnitus for a day after shooting guns is normal. It’s good that it went away then. I assume this means you didn’t have any permanent damage from the shooting.
Sertraline can cause hearing loss, tinnitus and hyperacusis among other ototoxic side effects. But that doesn’t mean you will get these side effects. If you took a low dose or for a short time, you may not have had any ototoxic side effects.
If you hear a whistling sound piggybacked on top of regular sounds, that could be a form of reactive tinnitus.
The best advice I can give you is to calm down and not focus on your ears. The more you focus on your ears, the worse your tinnitus and hyperacusis can become. So much better to focus on the loves of your life and thus ignore your ears and hopefully your tinnitus and hyperacusis will fade away in time.
Cordially,
Neil
Hi Bauman,
I would like to say that I am very grateful for your patient answers.
My doctor only assumes that this hearing loss is old, there is no evidence. Cortisone etc. He assumed this because there was no change after the trial (which may not happen, it’s normal).
I only used Sertraline for 6 days, 25mg for the first 4 days, and 50mg for the last 2 days. Is this long enough for the tinnitus to be negatively affected?
The thing is; as soon as I saw that antidepressants could negatively affect tinnitus, I noticed that my tinnitus had increased when I went to bed in the evening. I quit immediately and I’ve been here for 1 month 🙁 This small, strange sound seems to be coming from the back of my neck. When I sleep in the evening, my tinnitus is at a level of 1/10. I don’t know whether what I’m experiencing is psychological or real. It’s really strange.
In total, my tinnitus history has been exactly 3 months. I can feel this ringing (4/10) in the office, in the car, and on the street during the day. Is it possible to ignore these?
Hi Enigma:
It’s possible that tinnitus from Sertraline can kick in that soon. Some people take 5 weeks before tinnitus kicks in, but when you increase the dose like you did for 2 days, that could have done it. It may never have affected your tinnitus if you hadn’t raised the dose. As a general rule, doubling the dose can cause tinnitus to kick in with numbers of drugs. That is why I recommend taking the lowest dose that will do the job.
You can learn to ignore your tinnitus no matter how loud it is. First you need to learn to habituate to the annoyance of your tinnitus–don’t think of your tinnitus in the negative–like it is a threat to your well-being. Rather think of it as a non-threatening, useless, background sound that is safe to ignore–then ignore it by focusing on the loves of your life. When it is just “there” with no emotions attached to it, then you will start to habituate to the volume at which you perceive your tinnitus and it will begin to fade into the background and hours will go by without your even being aware you have tinnitus.
Cordially,
Neil
Dr. Bauman, Thank you for having this resource. The last few weeks my left ear seemed stopped up and my doctor said there was fluid. That week I took azithromycin and fluconazole. The fluconazole was ordered at a higher dose (150mg daily for 3 days) On day 5 I sat down at my piano and the upper range middle C and up sounded flat all of a sudden. I played my flute and mid range down I heard a different pitch slightly lower than the one being played. I listened to the TV and there was an echo in my left ear. It was a few days before I found your site- whew! I have an appointment with ENT tomorrow. I have seen improvement the last 4 days (it has been 9 days since this started) the sound of the piano is improving and each day I can play one note lower on my flute without hearing the other pitch. I have had trouble hearing ever since I first noticed the ear was stopped up. Praying this is temporary. I will report what the clinic finds.
I am 69 years old and amateur musician (lots of piccolo time) and have had tinnitus probably 45 years. I have also been sensitive to the volume of my piano and one range in the C4-C5 that has “hurt” my ears and keep asking the piano tuner to work on the piano-now I think it has been my hearing. thank you for having information !
Hi Colleen:
Some drugs have this characteristic of causing you to hear music 1/2 to 1 step low. Two drugs that are particularly bad in this regard are Carbamazepine and Propranolol. Other beta-blockers (drugs ending in olol) that also have this property include Atenolol and Bisoprolol.
I do not have any information on Azithromycin or Fluconazole causing this pitch distortion, but that doesn’t mean they couldn’t. It could well be that you have found Fluconazole to have this same characteristic.
The good news is that the people on the drugs I mentioned almost always have their proper pitch perception restored in a few days after they go off the drug. You might want to see whether you have the same experience (although you seem to be getting better at this point).
I know what you mean about certain keys in an octave sounding so loud they hurt. In my case it was 2 notes in the octave above middle C. This could be due to recruitment (if you have a sensorineural hearing loss in those frequencies) or loudness hyperacusis. In my case it was recruitment and my hearing aids not having enough compression set for those frequencies. My new hearing aids let me enjoy music without hurting.
Cordially,
Neil
Thank you for your response. I will update you on my progress. Most sincerely
Colleen
Diplacusis after COVID. 12 days since testing positive. ENT is not bothering with systemic corticosteroids, since audiogram does not show massive hearing loss. High frequency loss in the left ear is “normal aging” even though it appears asymmetrical with the right ear. I am to wait around for 3 months. The prospect of this being permanent is terrifying.
Hi Gene:
What does your diplacusis sound like? What brought it on–do you know? You need to calm down. This is not something to get terrified from. Getting upset over ear problems just typically makes things worse.
Cordially,
Neil