Modulation of Tinnitus Loudness through Pinna Lifting and Ear Canal Obstruction

Abstract

Objective: To study the effect on tinnitus loudness on lifting the pinna and obstructing the ear canal. Study Design: Consecutive, prospective case series Setting: Private practice (secondary referral centre) Patients: Patients presenting with tinnitus who hear their tinnitus at the time of the examination: 37patients with mean age 50.8. Intervention(s): Positioning the index finger in the entrance of the acoustic meatus and pulling theskin on the superior part of the entrance outward and upward, so as to exert a lifting effect on the crus helicis; and obstructing the ear canal with the index finger. Main Outcome Measure(s): Subjective evaluation of increase or decrease in tinnitus loudness during the manoeuvre. Results: On pulling the skin outward tinnitus loudness decreased in 11/37 patients to 61% on average; obstructing the ear canal led to a decrease in tinnitus loudness in 7 patients and an increase in 4 patients. Conclusions: both lifting the pinna by pulling the skin of the ear canal as well as obstructing the ear canal provoke a change in tinnitus loudness in many patients. The pathway through which these manoeuvres exert their effect is unclear; a somatosensory mechanism or an influence on middle ear acoustics might be involved.