I have experienced intermittent, bilateral tinnitus for about 4 years. Tests by an ENT indicate some loss of hearing in the high frequency range, but otherwise no hearing problems. Onset of the tinnitus almost always occurs at night. The tinnitus often goes away after rising. If sufficiently strong, it will stay around for a day or two. The tinnitus subsequently is very quiet for a few days, after which a new cycle begins. I have tried numerous treatments and nothing seems to work perfectly. However, the best success appears to be a combination of Hismanol and Vancenase. Although I do not have a history of strong allergies, the tinnitus seems to be the most active during windy weather and the least active after some general rains. I am not totally sure of causes and effects because the symptoms and solutions are often vague. I am active on the support groups for tinnitus and for allergies, and find that many people have similar symptoms. I will appreciate any comments that you might have.
Answer -------
Tinnitus is a symptom experienced on occasion by most, if not all, humans. Most cases of tinnitus are associated with some degree of hearing loss. Hearing loss resulting in tinnitus may be a result of acute or chronic infection, injury, inflammation from environmental allergens or irritants, congenital conditions affecting the hearing apparatus or nerve, the aging process, environmental toxins, aging, certain medications, amongst other causes. Tinnitus in the absence of measurable hearing loss may also be related to some of the afore- mentioned causes. Reversible causes of tinnitus most frequently are related to inflammation either from acute infection, toxins, or medications (such as aspirin or similar drugs). A common reversible cause of intermittent tinnitus is eustachian tube dysfunction which results in relative differences between middle ear and ambient air pressures. A commonly experienced example of this is seen during the descent of an airplane when one is traveling from low pressure in high altitude to higher pressures with lower altitudes. Eustachian dysfunction can occur because of tubal inflammation in ailments affecting the nose or sinuses, throat, or allergic conditions. Such cases of reversible tinnitus may respond to medical intervention directed at the underlying cause or the condition may be self-limited.
Some cases of tinnitus will be unassociated with hearing loss and will have no identifiable cause (known as idiopathic tinnitus). Other cases will have an associated irreversible hearing loss (typically high frequency nerve loss) yet the tinnitus is not eliminated with hearing aid amplification or the degree of hearing loss is not sufficient for a hearing aid. Still other cases will be associated with some type of injury such as noise trauma or head trauma without other measurable injuries. In all of the examples listed in this paragraph, tinnitus is frequently an isolated symptom for which the patient seeks focused medical intervention. Unfortunately, there are no consistently effective medical interventions for tinnitus as an isolated symptom. After addressing potential and known causes of tinnitus, typical recommendations involve some form of masking with broad band noise. An audiologist might be consulted to assist you with masking. There has been some limited success in relieving tinnitus with the use of a mild sedative known as Xanax. An otolaryngologist should be consulted to discuss the use of this medication for tinnitus.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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