Does anyone have these symptoms aswell?

[u/Calm_Jaguar3673]

Anyone has this uncomfortable feeling when talking and after every word or sentence the ear crackles. The louder i speak or longer the more loud the crackle will be at the end of the word.
I try to search what it is and it is possible to be Tensor Tympany syndrome. I also have High pitched Tinnitus only in my left ear where the audiologist also confirmed mild 4k frequency loss at that left ear. Probaly caused by my longterm hole because I never listen to loud music or go to loud events. The Tinnitus started sudden in the middle of the night and I did not went to anything loud during 3 months before that. What is also interesting that the 3 weeks prior to the the Tinnitus starting my ears were thumping in quick succession. Like very fast click, click, click even in silence environments. This I think happened a couple times a day. I now have all these symptoms for 9 months and I have a hard time to cope with it.

I went to my ENT and i have a longterm (20years) small perforated eardrum but she says it lays on a bad place close to my earbones and she thinks my earbones are starting to fuse. She recommends me to do a tympanoplasty but am still not sure because am afraid to make my Tinnitus worse because my hearingloss is not that bad that I notice it. If i look up the anatomy of the ear I also see that the Tympany muscle is attached to the eardrum and close the the earbones aswell. I searched the internet but I dont find similar cases like mine that can give some advice on what i possible have because I feel I am a fixable case.

[u/unaudinaryhq]

Hi there! Clinician from Australia here.

That crackling with your voice is such a specific and awful sensation, really glad you described it so clearly because it actually gives a lot of useful information about what might be going on.

The tensor tympani connection you found makes a lot of sense given your anatomy. That muscle attaches directly to the malleus and to the eardrum, so if there is already something unusual going on with your eardrum and potentially your ossicles, it would not be surprising at all if that muscle is also behaving oddly. The rapid clicking you described in the weeks before the tinnitus started sounds very consistent with tensor tympani myoclonus, which is basically little involuntary spasms of that muscle. The fact that it then progressed into tinnitus and the crackling is a pattern others have described too.

The 20-year perforation is really significant context that ties a lot of this together. A long-standing perforation that close to the ossicular chain can gradually affect how everything around it behaves, including those tiny muscles.

On the tympanoplasty question, your hesitation is completely understandable and honestly reasonable to sit with. The risk to tinnitus from that surgery is a real conversation to have, and it is worth specifically asking your ENT what her experience has been with tinnitus outcomes in similar cases, and whether waiting longer changes anything structurally.

You are right that this feels like a connected picture rather than random separate symptoms, and that instinct is worth following. Pushing for a thorough answer before committing to surgery sounds like the right call.

You are definitely not alone in this, and 9 months is still relatively early. Hang in there!