Changes in hearing and inner ear pressure can negatively impact day-to-day quality of life. From a range of auditory symptoms to dizziness, imbalance, and difficulty visually focusing and concentrating cognitively.
The symptoms above are sometimes caused by a rare but treatable inner ear syndrome, the third mobile window syndrome. For most, non-surgical options are explored. If non-surgical options do not restore clarity of hearing and quality of life, surgery may be required.
What Is Third Mobile Window Syndrome?
Third window syndrome refers to a group of auditory conditions. The most common of these is semicircular canal dehiscence (SSCD). SSCD occurs when there is a thinning or rupture in the bone or tissues of the ear. This thinning or rupture is known as a dehiscence.
The ear naturally contains two holes or pathways referred to as “windows”. When a dehiscence forms, it creates a third pathway. This third pathway disrupts the ear’s ability to regulate internal pressure, causing symptoms that interfere with hearing and daily life.
When a syndrome of the inner ear develops, it can create a ripple effect of auditory problems. Due to the close proximity third windows form to the cochlea the likelihood of developing tinnitus increases. Since the cochlea plays a vital role in hearing by translating sound waves into distinguishable sounds, third window’s symptoms can be accompanied by ringing and buzzing. An additional hole disrupts how sound waves are interpreted.
What Causes Third Window Syndrome?
How this inner ear syndrome presents itself is clear, however, what causes it is unclear. Although rare, an ear infection, injury, or damage during surgery can create a third window. However, the cause of most third windows remains a mystery.
This syndrome affects between 1% and 2% of the population. It impacts men and women equally, typically forming after the age of 40.
Studies find that children as young as 4 years old who are diagnosed with unilateral hearing loss, are more likely to develop a third window.
What Are Third Mobile Window Syndrome Symptoms?
Third window syndrome can present a variety of symptoms. Some patients experience a few symptoms, while other patients experience multiple symptoms.
This includes:
- Trouble focusing eyes or concentrating cognitively during physical activity due to auditory hypersensitivity.
- Dizziness triggered by loud noises, certain sound frequencies, and sneezing.
- Dizziness triggered by changes in air pressure when flying or when at high altitudes.
- The sensation that ears are stuffy or full of pressure and need to “pop”.
- Vertigo or an increase in balance issues with or without dizziness.
- Autophony, the sensation of hearing one’s heartbeat, eye movements, or other typically “silent” sounds.
- Hearing one’s own voice more loudly than usual, either consistently or inconsistently.
- Hyperacusis, having a sensitivity to all noise or to select sound frequencies.
In addition to the symptoms above, developing a third hole in the inner ear can increase the likelihood of tinnitus or pulsatile tinnitus. Tinnitus is a constant ringing or buzzing in the ears. Pulsatile tinnitus is the presence of sounds, clicks, and other acoustic effects in one or both ears.
How Is Third Window Syndrome Diagnosed?
Diagnosing this inner ear disorder typically requires more than one test. The symptoms above could be due to a variety of auditory conditions. Testing is likely to begin with a standard range of hearing and auditory testing.
- Auditory testing measures hearing sensitivity across a range of frequencies.
- Balance testing measures how sound frequencies impact balance.
- Tympanometry testing measures ear pressure and eardrum movement.
- Hennebert’s sign testing measures the presence of dizziness or vertigo triggered by ear pressure changes.
- An audiometry test evaluates the function of the middle ear and eustachian tube.
- Vestibular Evoked Myogenic Potential (VEMP) testing measures the inner ear muscle response.
- A CT scan shows a detailed view of the bones of the inner ear.
- An MRI provides a comprehensive view of the soft tissue of the inner ear.
How Is Third Mobile Window Syndrome Treated?
Third mobile window syndrome will not heal itself without medical or surgical intervention. Approximately one-third of patients choose surgery.
- If symptoms are mild, minimizing exposure to triggers may be enough to improve quality of life.
- If minimizing triggers is not sufficient, inserting an ear tube (tympanostomy tube) is an option for some patients.
- If symptoms are severe, surgery to plug or resurface the dehiscence may be the best option.
Experiencing Auditory Issues?
If you live in or around Staten Island or New Jersey and are experiencing the symptoms above, schedule an appointment with Dr. Stella Fulman of Audiology Island. Dr. Fulman is a Doctor of Audiology who specializes in diagnosing this rare inner ear syndrome.