The Case of the Curious Clicking Noise

Constant noise in a patient's ears were thought to be caused by nerve damage. Dr. Konstantina Stankovic of Mass Eye and Ear diagnosed a broken bone instead.

Director of otology Konstantina Stankovic, of Massachusetts Eye and Ear. / Photo by Ken Richardson

It all started with an itch. Five years ago, Maryjane was cruising along the road with her windows down after a day of swimming at a lake when she felt a sudden flutter deep inside her ear canal, like a bug had flown in. Hoping to make it stop, she pressed on her ear several times—but instead of getting relief, she felt her hearing diminish instantly.

When Maryjane still couldn’t hear well 10 days later, the Indianapolis-based mother of two saw a parade of ear, nose, and throat (ENT) specialists, who diagnosed her with sensorineural hearing loss, which is caused by nerve damage. They prescribed a variety of remedies, including nasal spray, antibiotics, and a series of inner-ear steroid injections, hoping something would help, but Maryjane’s hearing continued to worsen. In the meantime, she became increasingly bothered by a loud, relentless clicking in her ear—like “someone crunching up a newspaper,” she explains. The sound affected her every moment, frequently waking her out of a deep sleep and making conversations difficult. “I thought I was losing my mind,” she says.

Knowing she was scheduled to fly to Boston for her daughter’s audition at the New England Conservatory, Maryjane went online and read the bios of every ENT doctor at Massachusetts Eye and Ear, desperately hoping someone there might be able to help figure out what was plaguing her. Konstantina Stankovic, the hospital’s chief of otology and neurotology and a PhD-trained auditory neuroscientist, immediately caught her eye. “Her résumé was unbelievable,” Maryjane says of Stankovic, who’s received numerous awards over her career. “If anyone was going to know, she would.”

After taking a hearing test, Maryjane met face to face with the doctor, who inquired about the first time she noticed her hearing loss. Just minutes into Maryjane’s story about her family’s outing to the lake, Stankovic stopped her and said she thought she knew what was wrong. First, she showed Maryjane the results of the test, which revealed that the other doctors had all been wrong about what was causing her hearing loss: Most likely, it was the result of an injury, not nerve damage. In this case, Stankovic posited, when Maryjane pressed on her wet ear to relieve the itch after swimming, she created negative pressure in her ear canal as she took the finger away, which broke a bone in the eardrum and caused the sudden loss of hearing. Those incessant clicking and crunching sounds? They were actually two fragments of bone vibrating out of sync in response to sound.

After surgery to cement the bone, Maryjane still has some hearing loss, but she’s elated that the noises in her head are finally gone. All it took, she says without a sense of irony, was someone willing to “listen to my history and figure it out.”

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