Fluctuating hearing and persistent clicking in right ear despite stable audiograms - has anyone experienced this?
Hi all — hoping to get some perspective from people who know ETD well, since my ENT/audiology team hasn't fully pinned down what's going on.
Some background: I'm 47, with pre-existing bilateral mild-to-moderate sensorineural hearing loss ("cookie-bite" configuration) since childhood, though I only started wearing hearing aids (mainly for work meetings) in early 2025.
Since late June/early July, I've had significant right-ear clicking/popping, along with intermittent hearing changes in that ear. The clicking has fluctuated a lot — sometimes constant, sometimes stops for a while. At one point it was clicking every few seconds specifically when I breathed lightly through my nose, and stopped as soon as I switched to mouth breathing. I don't have autophony (my own voice/breathing sound normal).
I've also had occasional fullness and some clicking in my left ear, though no hearing changes there. And early on, I had a few days of mild itching/discomfort in the right ear canal (1 or 2 on a scale of 1 to 10, nothing major).
On the hearing side: an audiogram in mid-July showed a real (if modest) drop in the right ear at a couple of high frequencies compared to my baseline from 18 months prior. Tympanometry was normal. My audiologist raised SSNHL and I did a 2-week prednisone taper. My hearing improved and stayed pretty good through most of the taper, but felt like it was getting worse — with more fullness — toward the end of it. A follow-up audiogram in August, though, showed my hearing was essentially unchanged from before, aside from a small change at one frequency. So there's been a real mismatch between how my ear feels day-to-day and what the audiogram shows.
No vertigo, no dizziness/balance issues, no tinnitus at any point.
Nasal endoscopy came back normal (no mass, structurally fine). The PA at my ENT recommended trying Flonase given the clicking pattern, since Eustachian tube dysfunction seems like a reasonable explanation, though it's not confirmed.
I have a second opinion booked with a neuro-otologist in mid-September.
Questions for this sub:
- Does the nasal-breathing/clicking pattern I described sound like a typical ETD presentation to you, or could it point toward something more specific (patulous vs. obstructive, etc.)?
- Has anyone had fluctuating hearing symptoms alongside ETD that didn't show up clearly on audiograms?
- Did Flonase (or other nasal steroids) actually help your clicking, and if so how long before you noticed a difference?
- Any other Eustachian tube function tests worth asking my ENT or the neuro-otologist about, beyond tympanometry and a scope?
Appreciate any input — trying to go into my next appointments with better questions, thanks!