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Have tinnitus. Taking gingko biloba. Feeling weak and pressure on head. What is the cause of tinnitus?

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ENT Specialist
Practicing since : 1991
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I have tinnitus. I am very much worried about it. I can hear it loud even when I wake up from sleep. I went to my doctor, and had hearing test, balance test for vertigo, which are all normal and tympanometry that I have type As. I have been taking Gingko Biloba for my tinnitus, also some sinutab since he said I may have eustacian tube dysfunction. I feel pressure in my head but I am now doing some exercises to fix the type As eardrum. I do equalizing. Sometimes my tinnitus is loud and I feel weak on it and cannot concentrate. I lost some pounds already thinking about it. I have nasal sceptal deviation on my right nose I forgot to mention this to my doctor. Can nasal deviation cause my tinnitus? And Can Eustacian Tube Dysfunction Cause Tinnitus? What could have caused my tinnitus? Please Help.
Posted Thu, 18 Oct 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. There is no cause for worry. Tinnitus is not XXXXXX in over 99% cases. Your hearing and balance tests are normal. Tinnitus has a tremendous nuisance value. Almost all people at some point in their lives experience tinnitus.

2. Since your Tympanogram shows a Type As graph, a trial of medication should be taken for three to four weeks.

3. What is your exposure to occupational noise and loud music / earphones / mobile phones? Exposure to loud noise is also a leading cause for tinnitus.

4. Does your Tinnitus change when you clench your teeth? If so, a dental reference is needed.

5. Common tinnitus therapy includes ginkgo biloba, multivitamins and antioxidants. You may try Transtympanic steroids or Caroverine (Tinnex) injectable or capsules under the supervision of an ENT Specialist.

6. Ideally Caroverine (Tinnex) is for treatment of a type of Tinnitus known as Cochlear Synaptic Tinnitus. In this the middle ear should be normal.

7. A DNS causes nasal turbinate hypertrophy on the lateral walls of the nose and this in turn blocks the sinuses. Blocked sinuses are poorly ventilated and along with stasis of secretions, continuing infection and inflammation is common. This causes Eustachian Tube Dysfunction.

8. Regular steam inhalation is one of the best and simplest ways to keep the Eustachian Tubes healthy and functioning. If steam inhalation makes you uncomfortable, then your septal deviation and nasal obstruction is significant. A plain CT PNS (Para Nasal Sinuses) will definitely help understand your problem. The scan should be on a new generation multi-slice scanner with 1 mm coronal, axial and sagittal cuts.

9. Balloon Sinuplasty and radio-frequency ablation of the nasal turbinates may help avoid a septum operation. The Balloon dilatation procedure of the Eustachian tube (ET) is still in it's infancy. An anatomically patent ET may not still not work physiologically. Also the inner end is cartilage and outer end is very hard bone. The main carotid artery canal may also be dehiscent. It may be tried if all else fails.

10. Kindly let me know the results of your investigations. This will help in suggesting further treatment. I must emphasize that in a 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 queries. If you have any further questions, I will be available to answer them.

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