Hearing Loss & Valsalva Maneuver: Looking for Information

Update - June 2022, my tinnitus has lessened. Most days I do not notice it.

I had been looking for possible sources of blood pressure in or on the Cochlea that might explain why Valsalva improves my high frequency hearing so much.

Briefly, I have to reread the information I posted here, but my hearing ends around 4600 Hz and extended briefly to 7200 Hz with Valsalva. One example of hearing is of a mail box alarm (Hanna, sensor in mailbox sends radio signal to an alarm in my house.) When it sounds, about 15 feet away, it produces a sound that I often miss at first. Valsalva transforms that sound from low to loud. Why?

To me, this observation indicates that my diagnosis of "nerve damage" does not account for my high frequency hearing loss. [High frequency hearing loss is very common among older people.] (I'm 79).

1) This briefly discusses the Kim & Lee publication.
https://dizziness-and-balance.com/anatomy/ear/vascular.html
2) This publication has some information on the arteries within the ear and Cochlea.
Kim, J. S. and H. Lee (2009). "Inner ear dysfunction due to vertebrobasilar ischemic stroke." Semin Neurol 29(5): 534-540
https://www.researchgate.net/profile/Ji-Kim-4/publication/38016105_Inner_Ear_Dysfunction_Due_to_Vertebrobasilar_Ischemic_Stroke/links/00b4952d3fc25114a8000000/Inner-Ear-Dysfunction-Due-to-Vertebrobasilar-Ischemic-Stroke.pdf
I'd like to find ear & hearing researchers with interests in this subject.

@chasmayhear It's good to know that your tinnitus has lessened.

I suggest you post your questions on the Ear, Nose, and Throat (ENT) Discussion Group on Mayo Clinic Connect. You are likely to find more research information there.

@julieo4 and @chasmayhear, this discussion is posted in both the ENT group and the Hearing Loss group. 🙂

@chasmayhear ...I have a similar situation as you. My right ear has muffled hearing with reduced high frequencies. When I do the Valsava maneuver I get an instant improvement in high frequency response and better hearing on the right ear. The effect lasts about 15-20 seconds. Then high frequency response is again lost.

This short improvement occurs every time I do the Valsalva. This has been going on for over 2 years. It started with an infection in the right ear from a 30 day exposure to blowing dust from nearby wheat fields.

It seems logical that the air pressure from the Valsalva is correcting whatever my problem is for just 15 seconds. I wonder if my Eustachian tube can be opening from the Valsalva & then closing again within 15 seconds.

So far neither of 2 local ENTs have been able to help me when I've discussed this phenomena with them. They probably have little to no experience with the situation I present to them.

I am so glad to hear from you. Your description sounds very similar to mine.

Your observations and mine ARE very interesting. Mine does not last as long as yours. But once I did Valsalva during a presentation by a woman and it seemed to last through minutes. ? Some researcher, somewhere might learn something studying this.

I have a mailbox sensor (Hanna) that rings when the mailbox door opens. The sound goes from very low volume to loud when I do Valsalva.

You should get the phone app Spectroid. (There is a similar spectrum analyzer for Apple phones. ) It shows the frequency of the sounds that you are hearing. I posted on that.

The next time that I take a hearing test, after the normal test, I will try and get a measurement of how my high frequency response increases with Valsalva. I also did a crude hearing test with a sound generator. It showed the frequency where my hearing ends without Valsalva and with Valsalva. Very significant extension. See those posts.

WARNING- I have heard safety warnings about doing Valsalva. Be aware, learn about the warnings.

I'm 80 and have just learned last year that I have venous insufficiency. I now wear compression stockings. I have high blood pressure. I wonder what effects those two conditions might have. Perhaps an artery pressures a part of my ear and then when I do Valsalva (pressurizing the air in my throat and connected areas) that I move the artery or other blood vessel away from that part of my ear, like the cochlea. It would seem like a hearing test with Valsalva for us might show something interesting and maybe important. ?

Do you have any of my conditions? Are you using a hearing aid? I'm not yet but it would help. This Valsalva issue is stopping me from getting a hearing aid and simply applying sound amplification.

We need researchers and not apparently ENTs. Who does research in this field? What hospital or university is there with ear and hearing research that might be contacted?

How widespread are these pressure effects in older people?

chasmayhear....
Teaching hospitals such as Johns Hopkins and Mayo Clinic usually have the latest methods & advancements. Look for teaching hospitals in your area. I am currently searching for a doctor in S.NY. that is very experienced with the newest techniques for detecting ETD and has done a large number of Balloon Eustachian Tubplasty procedures.

I find about 2-3% of doctors I've seen are really excellent. 15% are pretty good and 80% mediocre or worse.

HI - So glad I found this. Add me to the list of people with diagnosed SSNHL (sudden sensoineural hearing loss) that experiences a return of some high frequency hearing when I do the Valsalva, leading me to think that there's something else going on either instead of, or in addition to the SSNHL - like Eustachian tube issues etc, or some . I'm seeing a neuro otologist in a month and am hoping he can see what happens while I do valsalva. I do the valsalva many times a day so I can hear better, and I am worried that I "shouldn't be" doing that, although an ENT told me that "frequent valsalva" and decongestants and nasal sprays are the way to fix eustachian tube dysfunction - so I'm both concerned and hopeful. Any additional info on this topic?

Welcome, @gcritchley. I agree that discussing the Valsalva maneuver with the ENT specialist is a good idea.

I found this reference info that may be helpful to prepare you for your consult with your ENT.
- - Valsalva Maneuver - StatPearls - NCBI Bookshelf: https://www.ncbi.nlm.nih.gov/books/NBK537248/#!po=30.0000
EXCERPT
"Valsalva maneuver is relatively safe and can be performed in all patients. Side effects reported are rare. However, since there is a rise in intraocular and intra-abdominal pressure, therefore the test must be avoided in patients with retinopathy and intraocular lens implantation. Valsalva retinopathy may result in susceptible patients.[8][9] Also, there are reports of syncope, chest pain, and arrhythmias due to the performance of VM. Therefore, caution is necessary for patients with pre-existing coronary artery disease, valvular disease, or congenital heart disease."

You may also wish to connect with other members talking about SSHL in the Hearing Loss support group here https://connect.mayoclinic.org/group/hearing-loss/

In particular, this discussion may interest you:
- Help: Sudden Sensorineural Hearing Loss (SSHL) - very scary https://connect.mayoclinic.org/discussion/help-sshl-very-scary/

Was this balloon procedure expensive?

Chas.....I also have improvement in high frequency with Valsava. No MD or audiologist can explain why. Very frustrating.