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Had chronic tinnitus. Developed acute ear pain after exposure to loud noise. Diagnosed hyperacusis. Tinnitus retraining therapies?

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Dear Doctor,

I am a 33 yr old military pilot. I have had chronic tinnitus for last 8 years. It never used to bother me much.
In the last 20 days after exposure to loud bore well drilling noise I have developed acute pain in my left ear. My hearing is normal and no damage to tympani membrane. (I had the local GP look into it). He says it may be a case of hyperacusis, and its all in my mind.
I feel i have no tolerance to some sounds at all, particular sounds like a bus horn, TV and babies. I feel very annoyed , irritated and angry, some noises are extremely painful.
Now my tinnitus has become very loud and disturbs me all the time. My local doctor says there is no objective testing for tinnitus and nothing can be done about it. He says i may have to consult a psychologist for behavioral therapies.
I have heard of tinnitus retraining therapies on net, are they conducted in India? am I likely to return to a normal life? my work involves exposure to loud sounds and I love my job in your opinion can a person be completely cured of tinnitus/hyperacusis?
Thanks
Posted Sun, 23 Jun 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for your query.

1. If there is a damage to the hair cells in the inner ear (cochlea) due to the exposure to the loud bore well drilling sound. you may be experiencing a common phenomenon known as Recruitment. There is an abnormal increase intensity of loud or high frequency sounds corresponding to the inner ear hair cell loss.

2. Hyperacusis may co-exist with Recruitment depending upon how severe the damage to the inner ear hair cells is.

3. Tinnitus Retraining Therapy is conducted by Audiologists.

4. There is no cure for tinnitus, as the exact cause is unknown. However it may be controlled.

5. There is evidence of hearing loss and tinnitus appearing a decade earlier in the armed forces as compared to the civilian population.

6. Common tinnitus therapy includes multi-vitamins, anti-oxidants and gingko biloba.

7. In Cochlear synaptic tinnitus, Caroverine (Tinnex, Tinnicar) injection and capsules, Trans-tympanic steroids may help.

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

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had chronic tinnitus. Developed acute ear pain after exposure to loud noise. Diagnosed hyperacusis. Tinnitus retraining therapies? 2 days later
Doctor,

1. Is there a cure for recruitment? I cannot withstand some frequencies of sound after a certain threshold, for eg Bus brakes, Horns, whistles etc.

2. Should I use an ear plug? or ear defender? Some websites say that they can cause further problens.

3. I feel a lot of fullness in my ear is this also a symptom associated with tinnitus/hyperacusis or recruitment?

4. Some times if i hear a loud sound I feel a lot of nausea is this also because of recruitment/hypercausis? (I have NO vertigo)

5. As a child I was given Sodium valporate tablets twice a day for 5 years (8 to 14 years) could medication taken 20 years back have an effect on me now?

6. Some times when i close my jaw while chewing I hear a click sound, it doesnt pain at all only tires out the jaw muscles, could it have any impact on my problem?

7. Is hyperacusis also cured by tinnitus retraining therapy? do patients make a full recovery?
can they work in profession like me (Jet pilot in air force) which involves high noise.

Regards
 
 
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for writing back.

1. There is no cure for recruitment. Use of digital hearing aids may help if you have a hearing loss. Your PTA (Pure Tone Audiogram) is important here.

2. Use of ear plugs will only muffle the hearing and make you more aware of the tinnitus.

3. Fullness in the ear is a symptom that is sometimes associated with tinnitus. You must get a Tympanometry (Impedance Audiogram) done to rule out middle ear pressure differential or fluid build-up.

4. Nausea due to loud sound may be due to the hyperacusis.

5. Medication taken 20 years back is unlikely to have an effect on you now.

6. The clicking sound in the jaw is related to the Temporo-Mandibular Joint (TMJ). Get a dental check-up done. A silicon splint may help relax the jaw muscles.

7. Hyperacusis is also treated by Tinnitus Retraining Therapy. Up to 50% of patients improve with treatment.

8. Continued exposure to loud noises is likely to further increase your problems. There is no medication to protect the ears from damage due to loud noise.

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

Regards.
Above answer was peer-reviewed by
 
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