Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Tinnitus
Question: Age 76. Have had tinnutus for 30+ yrs. Hearing is bordering an aid. 2 mths ago I got out of shower and thought rt ear felt full. Did usual and tipped head whilst little finger lightlywaggled ear to release water,so I thought. Felt a suction sound, briefly felt off balance and then a rattling sound. Hearing then also developed tinny sound when talking/listening, two tones if I whistled and severe distortion on phone whereas left ear was ok. Left ear has remained normal. ENT specialist tried prednisone for 2 weeks. No change. MRI and audio tests were all clear. Any suggestions would be greatly appreciated
Not interested in havnig injections into Cochlear as ENT specialist advises very low success rate.
Not interested in havnig injections into Cochlear as ENT specialist advises very low success rate.
Brief Answer:
Seems to be a sudden sensorineural hearing loss (SSNHL).
Detailed Answer:
Hi,
Thank you for your query.
1. Upload any previous audiograms (PTA: Pure Tone Audiogram, Impedance Audiogram) and the examination notes. Audio tests all clear? There must be some element of age related high frequency loss (Presbyacusis) or a conductive/ mixed hearing loss? It is good to hear that your MRI is normal. This rules out many other causes.
2. The diplacusis (hearing two tones) and the distortion in the hearing suggest that a sensorineural hearing loss has worsened in the right ear.
3. What is interesting is that spontaneous recovery without treatment is seen in many patients. Treatment is successful the earlier it is started and preferably within 4-6 weeks. This is the reason that one is never sure if the patients recovered on their own or because of the treatment. Controlled studies are not justified (denying some patients treatment). However patients treated late, up to three months have shown good improvement. In your case, any spontaneous recovery should have taken place by now (2 months). Have you noticed any change over the last two months?
4. In the first 4-6 weeks of a SSNHL, there is a good possibility of recovery with aggressive treatment with high doses of intravenous steroids, anti-virals, blood thinners, vasodilators, neuroprotective drugs, anti-oxidants, multi-vitamins and carbogen therapy. Up to 3 months there may be excellent results with trans-tympanic steroid injections and with HyperBaric Oxygen Therapy (HBOT).
5. Specific treatment can be discussed after you upload your reports.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Seems to be a sudden sensorineural hearing loss (SSNHL).
Detailed Answer:
Hi,
Thank you for your query.
1. Upload any previous audiograms (PTA: Pure Tone Audiogram, Impedance Audiogram) and the examination notes. Audio tests all clear? There must be some element of age related high frequency loss (Presbyacusis) or a conductive/ mixed hearing loss? It is good to hear that your MRI is normal. This rules out many other causes.
2. The diplacusis (hearing two tones) and the distortion in the hearing suggest that a sensorineural hearing loss has worsened in the right ear.
3. What is interesting is that spontaneous recovery without treatment is seen in many patients. Treatment is successful the earlier it is started and preferably within 4-6 weeks. This is the reason that one is never sure if the patients recovered on their own or because of the treatment. Controlled studies are not justified (denying some patients treatment). However patients treated late, up to three months have shown good improvement. In your case, any spontaneous recovery should have taken place by now (2 months). Have you noticed any change over the last two months?
4. In the first 4-6 weeks of a SSNHL, there is a good possibility of recovery with aggressive treatment with high doses of intravenous steroids, anti-virals, blood thinners, vasodilators, neuroprotective drugs, anti-oxidants, multi-vitamins and carbogen therapy. Up to 3 months there may be excellent results with trans-tympanic steroid injections and with HyperBaric Oxygen Therapy (HBOT).
5. Specific treatment can be discussed after you upload your reports.
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. Neel Kudchadkar
Thank you Doctor. For a condition that took one step out of a shower to suddenly occur I have been amazed at the terminologies available.
The condition is now in its 10th week and same pattern ie rattling during vibration such as a heavy step or uneven road, distortion on the phone or voices behind me and a slight muffling of radio/conversation.
All symptoms have shown sign of lessening in the last week or so and certainly less of the discomfort I felt in the early stages.
Whilst not expecting a sudden disappearance of the signs I remain aware of their instantaneous arrival. Following discussion with my ENT Specialist and if no further deterioration occurs I will let the problem work out its path for the next 2-3 months. Many thanks for your input. Best Regards. XXXXXXX XXXX
The condition is now in its 10th week and same pattern ie rattling during vibration such as a heavy step or uneven road, distortion on the phone or voices behind me and a slight muffling of radio/conversation.
All symptoms have shown sign of lessening in the last week or so and certainly less of the discomfort I felt in the early stages.
Whilst not expecting a sudden disappearance of the signs I remain aware of their instantaneous arrival. Following discussion with my ENT Specialist and if no further deterioration occurs I will let the problem work out its path for the next 2-3 months. Many thanks for your input. Best Regards. XXXXXXX XXXX
Brief Answer:
Widhing you a speedy recovery.
Detailed Answer:
Hi,
Thank you for writing back.
1. I sincerely do hope that this is a middle ear problem (Eustachian Tube Dysfunction) caused by the sudden change in temperature and humdity on stepping out of the shower.
2. In such a case, you should improve over the next few weeks.
3. I would urge you to get a repeat evaluation each month.
4. You may follow up directly at XXXX
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Widhing you a speedy recovery.
Detailed Answer:
Hi,
Thank you for writing back.
1. I sincerely do hope that this is a middle ear problem (Eustachian Tube Dysfunction) caused by the sudden change in temperature and humdity on stepping out of the shower.
2. In such a case, you should improve over the next few weeks.
3. I would urge you to get a repeat evaluation each month.
4. You may follow up directly at XXXX
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
