Brief Answer:
Tinnitus is discussed in detail below:

Detailed Answer:
Hi,

Thank you for your query.

1. If her Left Ear Tinnitus is due to the swelling caused by the Otitis Externa, it will subside after it heals. Since it is intermittent, improvement is expected.

2. Regarding the continuous Tinnitus in her Right Ear, almost all people at some point in their lives experience tinnitus. Tinnitus does not have a cure, however, it may be controlled. How severe is her tinnitus on a scale of 1 to 10 for each ear?

3. Get a PTA (Pure Tone Audiogram) done. You may also get her middle ear pressures checked (Impedance Audiometry or Tympanometry).

4. The exact cause of Tinnitus is unknown. However one of the agreed pathologies is damage to or loss of to hair cells in the inner ear. The role of the brain in the perception of Tinnitus also exists. For example, some people have been relieved of Tinnitus after a cerebral stroke, while some continue to hear it even after the Cochlear (Hearing) Nerve is cut.

5. What is her exposure to occupational noise and loud music/earphones/ XXXXXXX phones? Exposure to loud noise is also a leading cause for tinnitus.

6. If her Tinnitus increases on clenching the teeth, it may require dental bite correction or use of a nightguard (dental splint).

7. I have noticed patients who have increased Tinnitus when they are stressed, have fluctuations of blood pressure, low Hemoglobin, low blood sugar levels and so on. These conditions need to be ruled out. If the tinnitus in her Right Ear is pulsatile (matching with her heartbeat), it will not decrease with Vertin, which increases inner ear blood flow.

8. Cochlear Synaptic Tinnitus may be treated in up to 50% of people with Caroverine infusion followed by capsules for two months. Other treatments such as transtympanic steroids, Gingko Biloba, vinpocetine, multi-vitamins, and anti-oxidants may also help in reducing Tinnitus.

9. Tinnitus Retraining Therapy (TRT) after Tinnitus matching on a high-frequency audiometer can be now done with computer software and special high-frequency headphones if the Tinnitus is in the higher frequencies.

10. Kindly let me know the results of her investigations. This will help in suggesting further treatment.

11. I must emphasize that in the vast majority of patients of tinnitus, the cause is never found. However, there are further treatment options depending on the type of tinnitus.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.

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Brief Answer:
Kindly share the Audiometry Reports, Impedance Audiograms.

Detailed Answer:
Hi,

Thank you for following up.

1. Given the history of Ear problems after frequent air travel, and relieving the Left Ear pressure by opening the jaw, Eustachian Tube Dysfunction (ETD) has to be ruled out. Kindly upload an Impedance Audiogram (Tympanogram).

2. If the ETD is intermittent, get repeated Impedance Audiograms done when symptomatic.

3. Which specific points on your head do you press/ massage for the sounds to change/ temporarily stop?

4. Does the murmuring, whispering include spoken words? Or just sounds? You need to elaborate on this in detail. Hearing spoken words and hearing indistinct sounds are two different problems.

5. After clarifying these reports and symptoms, we can discuss further management.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.

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