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What is the cause and treatment for tinitus?

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Posted on Sat, 29 Mar 2014
Question: I have a whooshing sound in my left ear. It's not constant but only when I turn my neck to the right ( max) or I bend forward ( then very short) while I have a muscle tension (CSM).. it disappear when I go back to normal neck posture. When I wake up in the morning my ear ( sometimes ) feels heavy and like there is some pressure in it. It stops when I squeeze my scm muscle or I touch infront of bottom of the ear. Like the picture shown. ( sure in the positions mentioned above) and it turns back when release squeezing or touching. It's now there for months and sometimes it's worse sometimes is better ( worse when tired ) I have been to ENT and provided hearing test and looked. so he said I have some hearing loss because of loud voices. And my right eat is worse than the left with tennitus.. He said the hearing loss might be the reason. But I don't believe it's that because it stops when I squeeze that muscle or touch that point. I also have been to physiotherapy and he said I have some muscle spasm on my left side more than the right one. But tinnitus is still there. I went to Jaw surgeon and he made pictures of my jaw but nothing showed as a reason for tinnitus. My physiotherapist told me that it might be due to an irritation of the hearing nerve because of my last dental visit to put me a crone. Is this the reason of my tinnitus you think ? I know there can be many other scary reasons but I mean why it does stop in cases I mentioned? On Monday I have a consult at a neurologist as per my gp information and he scared me to dead as my gp was talking about possible neurinoma while my cousin who is an ETN told me that I can't be this due to the modulating the tinnitus which happens when I turn or touch the points mentioned . Can u give me your opinion please ? I'm a little scared
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Answered by Dr. Sudhir Kumar (3 hours later)
Brief Answer: Tinnitus could be related to hearing nerve problem Detailed Answer: Hi, Thank you for posting your query. I have noted your complaints and also noted various consultations (and their opinions) so far. I would like to reassure you that your symptoms do not suggest any serious neurological problem. In my opinion, the most likely cause could be hearing nerve-related, as you also have mild hearing impairment. There could be additional muscle spasm in the neck. I agree that we can not be 100% sure that it is not due to neurinoma unless we do the MRI of brain, but the chances of that are very low, in my opinion. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (38 minutes later)
Thank you very much for your quick and prompt reply. I also searched you in linked in and i could see that you have an advanced experianse in neurology. I some other questions: If it was related the hearlingloss and hearing nerve, my left ear ( with this tinnitus ) is the best one. I dont know if i can attach my test report but i will try. So this is my best ear. And if it was related to the hearing loss .. What makes it only appeat by turninh head? And stop it by normal posture or by touching under the ear? Were you able to open the picture i attached? I know and understand that you cant assure me 100% that this is not a neuronoma as only MRI can assure that 100% even by any other heathy person.. What could be the hearing nerve problem? Irritation? If so, can this last for very long? Possible causes? Forgot to mention that i have a low tennitus ( peep ) at my right ear but that is not annoing and as it is the bad ear, it can be related to the hearing loss..
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Answered by Dr. Sudhir Kumar (5 hours later)
Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for getting back. To your new queries, my replies are below: 1. There may not be a correlation between the amount of hearing loss and the severity of tinnitus. 2. Turning head, touching, and other manoeuvres may change symptoms in nerve-related problems. This may happen due to blood flow or nerve impulse conduction related issues. I could see both the attachments. 3. Nerve problem could be due to loud noise, effect of medications, lack of blood flow, nutritional deficiency, irritation, etc. It may last for a few months. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (16 minutes later)
Thanks once again doctor. I am so worried about myself. And not really worried about the tinnitus. I can live with it. But I am really nervous that it is something very serious. You say that nerve problems can be caused by a lack of blood flow, this doest make you think about any tumor at the first stage? If I would be your patient at a consult and I told you all this, would you immediately require and MRI? Or think it would be a serious issue? I dont have any medication, I am a healthy person who sports 4-5 times a week.
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Answered by Dr. Sudhir Kumar (6 minutes later)
Brief Answer: I would not consider it a serious issue. Detailed Answer: Thank you for getting back. If you were my patient and told me all these symptoms, I would not consider it a serious issue and would not order for an MRI of brain. Your symptoms do not suggest a tumor to me, as patients with tumor generally have more severe hearing loss and also have headache, imbalance while walking, slurred speech, facial weakness, etc. I hope it clarifies. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar (8 minutes later)
I wanted to close this case but I didn't want to do this without thanking you honestly for your support and answers. My cousin who is an ETN in sweden told me also that it doesnt sound like serious issue. He said it might be due to muscle spasms. Or maybe be the tensio tempany muscle in the middle ear. If you probably think the same, I would like to know. if not, please accept my apologies for making it a long discussion. I thank you again
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Answered by Dr. Sudhir Kumar (9 minutes later)
Brief Answer: Thank you for getting back. Detailed Answer: I am glad to note that my answer and explanations are helping you. As I mentioned earlier, I do not think it is a serious issue and in this regard agree with your cousin, who is an ENT doctor. Muscle spasms or tensor tympani muscle could be additionally present, however, we still need to explain tinnitus and hearing loss, for that mild involvement of hearing nerve has to be considered. So, in this regard, I partially agree with your cousin. In any case, there is no need to worry. I would be glad to be of help to you in future too. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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What is the cause and treatment for tinitus?

Brief Answer: Tinnitus could be related to hearing nerve problem Detailed Answer: Hi, Thank you for posting your query. I have noted your complaints and also noted various consultations (and their opinions) so far. I would like to reassure you that your symptoms do not suggest any serious neurological problem. In my opinion, the most likely cause could be hearing nerve-related, as you also have mild hearing impairment. There could be additional muscle spasm in the neck. I agree that we can not be 100% sure that it is not due to neurinoma unless we do the MRI of brain, but the chances of that are very low, in my opinion. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/