Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Hearing Loss And Tinnitus
Question: Dear Sir,
I am writing from Canberra, Australia with an intention to have a proper treatment from you for my significant hearing loss and continuous hissing sound coming out from my right ear.
I had a viral flu 14-15 weeks ago and I was recovered from that roughly in 10 days. During this period, I mainly had the typical ‘Cold and Flu’ medications (Paracetamol plus Caffeine) and an incomplete course of antibiotic (Blind self-treatment with Ciprofloxacin). However, according to my doctor’s opinion, while leaving me, the virus caused something in my right ear which was resulted to some sorts of humming and echoing windy sound with significant hearing loss. The doctor said it’s very normal, temporary and happened due to the associated mucus behind the ear drum and I might need to wait for about 15 weeks. Prior to the flu and during this whole period until today I have been taking Thyroxin 100 microgram one tablet per day due to my hypothyroidism.
On two recent consultations both with the Audiologist and ENT specialist, I have been diagnosed with Sudden Sensorineural Hearing Loss presented late and have had steroid tablets (50 mg per day) for 12 days.
There was no improvement during the time I have been taking steroid. I am continuously experiencing a windy/blowing sound coming out from my right ear associated with ringing and unclear cracked sound whenever am exposing to a moderate louder speech/song other sounds. The level of hearing loss is still significant. Finally, on yesterday, my ENT specialist ended up with me by suggesting a Cochlear Implant as he does not feel that hearing aid can improve that kind of severe loss.
Considering this situation, I have been tired with the lengthy treatment pattern in Canberra and am seriously thinking to come to another area/country if there is a potential chance to get recovered from my problem by avoiding any hearing aid, Cochlear Implant or so at my current age of 38.
I look forward to hear from you ASAP about the treatment options and anticipated cost.
The two reports from the Audiologists are attached herewith. Please doctor, I need concrete information about the treatment line including whether there might be some underlying reasons for my sudden hearing loss.
Kind Regards,
XXXX XXXXXXX
XXXX
M: 0000
I am writing from Canberra, Australia with an intention to have a proper treatment from you for my significant hearing loss and continuous hissing sound coming out from my right ear.
I had a viral flu 14-15 weeks ago and I was recovered from that roughly in 10 days. During this period, I mainly had the typical ‘Cold and Flu’ medications (Paracetamol plus Caffeine) and an incomplete course of antibiotic (Blind self-treatment with Ciprofloxacin). However, according to my doctor’s opinion, while leaving me, the virus caused something in my right ear which was resulted to some sorts of humming and echoing windy sound with significant hearing loss. The doctor said it’s very normal, temporary and happened due to the associated mucus behind the ear drum and I might need to wait for about 15 weeks. Prior to the flu and during this whole period until today I have been taking Thyroxin 100 microgram one tablet per day due to my hypothyroidism.
On two recent consultations both with the Audiologist and ENT specialist, I have been diagnosed with Sudden Sensorineural Hearing Loss presented late and have had steroid tablets (50 mg per day) for 12 days.
There was no improvement during the time I have been taking steroid. I am continuously experiencing a windy/blowing sound coming out from my right ear associated with ringing and unclear cracked sound whenever am exposing to a moderate louder speech/song other sounds. The level of hearing loss is still significant. Finally, on yesterday, my ENT specialist ended up with me by suggesting a Cochlear Implant as he does not feel that hearing aid can improve that kind of severe loss.
Considering this situation, I have been tired with the lengthy treatment pattern in Canberra and am seriously thinking to come to another area/country if there is a potential chance to get recovered from my problem by avoiding any hearing aid, Cochlear Implant or so at my current age of 38.
I look forward to hear from you ASAP about the treatment options and anticipated cost.
The two reports from the Audiologists are attached herewith. Please doctor, I need concrete information about the treatment line including whether there might be some underlying reasons for my sudden hearing loss.
Kind Regards,
XXXX XXXXXXX
XXXX
M: 0000
Brief Answer:
Trans-tympanic steroids, antivirals, HBOT, BAHA.
Detailed Answer:
Hi,
Thank you for your query.
1. The second audiogram shows a slight increase in the hearing loss.
2. Ideally the treatment should be within 4 to 6 weeks, but I have patients with improvement in the 3 to 6 month time period. Beyond 6 months, improvement is not expected.
3. The mainstay of treatment of ISSNHL (Idiopathiic Sudden SensoriNeural Hearing Loss) in a non diabetic is high dose steroids. Other medication includes anti-virals, blood thinning agents, rheologic or blood flow improvement medications, neural tonics, Carbogen (vasodilator) and Hyperbaric Oxygen Therapy (HBOT), if available.
4. Right now, for any salvage treatment, trans-tympanic steroids and HBOT is strongly recommended. An anti-viral added to the trans-tympanic steroid treatment is a better combination in your case.
5. If there is no improvement, you have the option of not treating it further. Hearing aids are not advised as the other ear is normal. You are also not a candidate for a cochlear implant for the same reason.
6. You are an ideal candidate for a BAHA (Bone Anchored Hearing Aid). A trial is recommended.
7. The cause of ISSHNL is rarely found. That is why it is called idiopathic.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Trans-tympanic steroids, antivirals, HBOT, BAHA.
Detailed Answer:
Hi,
Thank you for your query.
1. The second audiogram shows a slight increase in the hearing loss.
2. Ideally the treatment should be within 4 to 6 weeks, but I have patients with improvement in the 3 to 6 month time period. Beyond 6 months, improvement is not expected.
3. The mainstay of treatment of ISSNHL (Idiopathiic Sudden SensoriNeural Hearing Loss) in a non diabetic is high dose steroids. Other medication includes anti-virals, blood thinning agents, rheologic or blood flow improvement medications, neural tonics, Carbogen (vasodilator) and Hyperbaric Oxygen Therapy (HBOT), if available.
4. Right now, for any salvage treatment, trans-tympanic steroids and HBOT is strongly recommended. An anti-viral added to the trans-tympanic steroid treatment is a better combination in your case.
5. If there is no improvement, you have the option of not treating it further. Hearing aids are not advised as the other ear is normal. You are also not a candidate for a cochlear implant for the same reason.
6. You are an ideal candidate for a BAHA (Bone Anchored Hearing Aid). A trial is recommended.
7. The cause of ISSHNL is rarely found. That is why it is called idiopathic.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor. So, at this stage as it's been nearly four months since the problem occurred, do you recommend me to travel XXXXXXX XXXXXXX or so for any likely treatment that you suggested or I can try to organize those here if there is nothing exceptional that I can expect from India? Please, note, the ENT specialist in Canberra has prescribed to stop steroid as there was no improvement.
Brief Answer:
ISSHNL is not a common condition.
Detailed Answer:
Hi,
Thank you for writing back.
1. Trans-tympanic steroids will help at this stage (oral steroids can be stopped) along with HBOT.
2. You can travel to XXXXXXX XXXXXXX as I currently have a thesis topic on Trans-tympanic steroid therapy underway with one of my students. A large number of patients are currently under treatment.
3. I will add an antiviral such as gancyclovir to the steroid (such as dexamethasone).
4. If this therapy does not work, take a trial with a BAHA.
5. Discuss this line of treatment with your local doctors in Australia and check if this is possible there.
6. The incidence of iSSHNL is low (about 0.0015%) and hence there is always ambiguity regarding treatment. This simple treatment plan is the most agreed upon at present worldwide.
I hope I have answered your query. If you have any further questions I will be available to answer them.
Regards.
ISSHNL is not a common condition.
Detailed Answer:
Hi,
Thank you for writing back.
1. Trans-tympanic steroids will help at this stage (oral steroids can be stopped) along with HBOT.
2. You can travel to XXXXXXX XXXXXXX as I currently have a thesis topic on Trans-tympanic steroid therapy underway with one of my students. A large number of patients are currently under treatment.
3. I will add an antiviral such as gancyclovir to the steroid (such as dexamethasone).
4. If this therapy does not work, take a trial with a BAHA.
5. Discuss this line of treatment with your local doctors in Australia and check if this is possible there.
6. The incidence of iSSHNL is low (about 0.0015%) and hence there is always ambiguity regarding treatment. This simple treatment plan is the most agreed upon at present worldwide.
I hope I have answered your query. If you have any further questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you so much for the concrete answers in dot points. So, as I informed before, my ENT specialist in Canberra, Australia has stopped oral steroid and has finally suggested for the cochlear implant. According to your opinion, some other options are, Trans-tympanic steroids along with HBOT and may be some antiviral medications can also be applied on top of these.
How about the continuous hissing (as like a sound of internal air pressure coming from the effected ear)? Is there any separate action that I can take to get rid of it (I am not sure whether it is Tinnitus or not)? At the begging stage, I mainly experienced it while brushing in the morning and now it has been increased and constant after starting the steroid along with a much broken hearing (just like a robotic sound especially, the telephonic voice and the female voice). Also, if I shake my head left and right, I feel there is a 'Bee' inside the right ear; it feels like I have had water in the ear for ages! Theses are some significant information for you which I might have missed out!
Now, as it's been roughly four months I have been suffering from this problem. I am planning to travel Pune/India late January 2016; do you think, it's alright or I am getting late? It's actually the Christmas time and the price for the flight tickets are so high...but, whatever, the treatment lines you have indicated are definitely not easy or quicker to undergo here in Australia!
I look forward to hear from you.
Kind Regards,
XXXX XXXXXXX
XXXX
Thank you so much for the concrete answers in dot points. So, as I informed before, my ENT specialist in Canberra, Australia has stopped oral steroid and has finally suggested for the cochlear implant. According to your opinion, some other options are, Trans-tympanic steroids along with HBOT and may be some antiviral medications can also be applied on top of these.
How about the continuous hissing (as like a sound of internal air pressure coming from the effected ear)? Is there any separate action that I can take to get rid of it (I am not sure whether it is Tinnitus or not)? At the begging stage, I mainly experienced it while brushing in the morning and now it has been increased and constant after starting the steroid along with a much broken hearing (just like a robotic sound especially, the telephonic voice and the female voice). Also, if I shake my head left and right, I feel there is a 'Bee' inside the right ear; it feels like I have had water in the ear for ages! Theses are some significant information for you which I might have missed out!
Now, as it's been roughly four months I have been suffering from this problem. I am planning to travel Pune/India late January 2016; do you think, it's alright or I am getting late? It's actually the Christmas time and the price for the flight tickets are so high...but, whatever, the treatment lines you have indicated are definitely not easy or quicker to undergo here in Australia!
I look forward to hear from you.
Kind Regards,
XXXX XXXXXXX
XXXX
Brief Answer:
Tinnitus is due to the SNHL.
Detailed Answer:
Hi,
Thank you for writing back.
1. The Tinnitus is due to the SNHL (Sensori-Neural Hearing Loss)
2. The sounds that you hear are distorted in the affected right ear. This is a known problem in SNHL.
3. ISSNHL is a medical emergency. The therapeutic window is 4 to 6 weeks. However since about four months have already passed, another month will not make much of a difference. Hence late january 2016 is fine.
4. If there is no further improvement after the tans-tympanic steroids and HBOT, the Tinnitus can be treated separately. Cochlear Synaptic Tinnitus may be treated in up to 50% people with Caroverine infusion followed by capsules for two months. Other treatments such as trans-tympanic steroids, gingko biloba, multi-vitamins and anti-oxidants may also help in reducing Tinnitus.
5. You should try to initiate this treatment within 6 months at the most.
6. If there is improvement, a good hearing aid or a hybrid implant can help. Tinnitus is also treated in some patients with a cochlear implant. Otherwise a BAHA implant will be perfect in your case.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Tinnitus is due to the SNHL.
Detailed Answer:
Hi,
Thank you for writing back.
1. The Tinnitus is due to the SNHL (Sensori-Neural Hearing Loss)
2. The sounds that you hear are distorted in the affected right ear. This is a known problem in SNHL.
3. ISSNHL is a medical emergency. The therapeutic window is 4 to 6 weeks. However since about four months have already passed, another month will not make much of a difference. Hence late january 2016 is fine.
4. If there is no further improvement after the tans-tympanic steroids and HBOT, the Tinnitus can be treated separately. Cochlear Synaptic Tinnitus may be treated in up to 50% people with Caroverine infusion followed by capsules for two months. Other treatments such as trans-tympanic steroids, gingko biloba, multi-vitamins and anti-oxidants may also help in reducing Tinnitus.
5. You should try to initiate this treatment within 6 months at the most.
6. If there is improvement, a good hearing aid or a hybrid implant can help. Tinnitus is also treated in some patients with a cochlear implant. Otherwise a BAHA implant will be perfect in your case.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much Doctor. However, if I will come late January 2016 how long do you suggest me to stay in XXXXXXX India; should I book a return ticket after a month or more?
Regards,
XXXX
Regards,
XXXX
Brief Answer:
1-2 months depending upon the response to treatment.
Detailed Answer:
Hi,
Thank you for writing back.
1. Trans-tympanic steroids and HBOT treatment will take at least 10-15 days.
2. If there is improvement, a month's stay is fine including treatment for tinnitus and a BAHA trial.
3. If a BAHA implant is required another 15-20 days stay may be required.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
1-2 months depending upon the response to treatment.
Detailed Answer:
Hi,
Thank you for writing back.
1. Trans-tympanic steroids and HBOT treatment will take at least 10-15 days.
2. If there is improvement, a month's stay is fine including treatment for tinnitus and a BAHA trial.
3. If a BAHA implant is required another 15-20 days stay may be required.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
