The experience of hearing a noise in the ear when blinking is a specific symptom of somatic tinnitus. This phenomenon is considered “objective tinnitus” because the sound is sometimes loud enough to be heard by a clinician using a specialized stethoscope. The temporary noise, often described as a clicking, buzzing, or thumping sound, results from an abnormal interaction between the muscles controlling the eye and those residing within the middle ear.
The Anatomical Link Between Blinking and Hearing
The connection between eye movement and ear sound is rooted in shared nerve pathways and muscle proximity within the skull. Blinking is controlled by the orbicularis oculi muscle, innervated by the Facial Nerve (Cranial Nerve VII). This same nerve also supplies the stapedius muscle, a tiny structure in the middle ear space. The tensor tympani muscle, also involved in dampening sound, is innervated by the Trigeminal Nerve (Cranial Nerve V).
In cases of blinking-related sound, the cause is often an aberrant spread of the nerve signal. The impulse meant for the orbicularis oculi muscle appears to cross over or “short-circuit” to the nearby stapedius muscle. This simultaneous firing causes the stapedius muscle to contract rhythmically with every blink. The contraction pulls on the stapes bone, causing the eardrum to move in and out and creating the transient acoustic perception. This physical movement can be objectively measured using impedance audiometry, which registers a saw-tooth pattern synchronized with eye closure.
Common Causes Related to Muscle Function
The most frequent explanation for a blinking-induced noise involves involuntary muscle spasms, known as Middle Ear Myoclonus (MEM). When the sound is a rapid clicking or tapping, it is attributed to the stapedius or tensor tympani muscle contracting spasmodically. This spasm is not always continuous but can be triggered by voluntary actions like blinking, chewing, or speaking.
Another possibility is Patulous Eustachian Tube (PET), where the Eustachian tube remains abnormally open. Blinking involves subtle movement in surrounding facial and palatal muscles, which can transiently affect the tube’s tension. In PET cases, this motion can temporarily alter the sensation in the ear, making internal sounds of breathing or speaking more pronounced.
Vascular and Pressure-Related Explanations
In some instances, the noise heard with blinking is a rhythmic whooshing or throbbing sound, a form of pulsatile tinnitus that synchronizes with the heartbeat. This type of noise warrants investigation, as it is caused by turbulent blood flow in vessels near the ear, such as the carotid artery or jugular vein. Blinking can slightly alter the surrounding pressure, making the pre-existing pulsatile sound more noticeable.
One significant pressure-related cause is Idiopathic Intracranial Hypertension (IIH), where the cerebrospinal fluid pressure surrounding the brain is abnormally high. This increased pressure is often transmitted to the inner ear structures. The slight muscular effort and pressure change from blinking may be enough to trigger the perception of the pulsatile noise, similar to how IIH is exacerbated by bending over or straining.
Other Vascular Abnormalities
Less common causes include vascular abnormalities, such as narrowing of the large veins draining the brain (venous sinus stenosis) or an abnormally placed jugular bulb.
When Professional Medical Evaluation is Necessary
While many blinking-related ear noises stem from benign muscle spasms, a professional medical evaluation is necessary to rule out more serious underlying conditions. A primary care physician will likely refer the patient to an Otolaryngologist (ENT specialist) or a Neurologist. The specialist will perform a thorough physical examination, including an otoscopic check and a full hearing assessment.
Red Flag Symptoms
Specific symptoms require immediate medical attention if they accompany the ear noise. These include a noise that consistently pulses with the heartbeat, sudden unexplained hearing loss, a new onset of severe vertigo or dizziness, or facial weakness or numbness on the same side as the noise.
Diagnostic Procedures
Diagnostic procedures typically begin with a comprehensive audiogram and may include specialized tympanometry to measure eardrum movement during blinking, confirming a muscular cause. If a vascular or neurological cause is suspected, the doctor may order imaging tests, such as a Magnetic Resonance Imaging (MRI) scan or a Computed Tomography (CT) scan. These advanced scans are essential for visualizing the blood vessels and ruling out conditions like vascular malformations, tumors, or signs of elevated intracranial pressure.