Tinnitus or Ringing in the Ears
Tinnitus is any abnormal sound heard in the ears. This is normally a high pitched whistling, ringing, or a sound similar to electrical static. Occasionally it is low pitched drumming noise, strange clicks or a sensation of hearing your own heart beat.
Mr Vik Veer is very interested in tinnitus as he has had tinnitus before and now understands what his patients are going through. A lot of people say that tinnitus is incurable, which it is in some rare cases, but on the whole most people after treatment are no longer aware of their tinnitus. Not being able to hear your tinnitus, forgetting that you have tinnitus and no longer needing treatment for tinnitus is tantamount to being cured.
Unfortunately there is no quick fix, and a lot of motivation, and determination is required for patients to be able to have relief from their tinnitus. The longer a patient has tinnitus typically the harder it is to deal with the problem.
Below are the steps that Mr Veer uses to deal with tinnitus after a consultation and hearing test.
- Examination of the ears, Eustachian tube and throat. There are many different reasons for tinnitus, and therefore a full examination is needed to make sure there is no an obvious cause for this noise. It is surprising how often a simple problem such as an infection, glue ear or arthritis can be the cause of tinnitus. Treating these problems often deals with the problem and provides the sufferer with relief relatively quickly.
- Scans. If nothing is found on examination, scans are required to rule out any pathology that may cause tinnitus. There are many problems that cannot be picked up by clinical examination, and therefore these need to checked before considering any treatment.
Improve hearing. Assuming there are no other causes identified on examination and scans, tinnitus is almost always associated with hearing loss. It might be because someone has age related hearing loss, or perhaps the hearing loss was associated with a flu-like infection or after airplane flight. Even if the hearing has returned to normal, the tinnitus can remain and cause distress. Fortunately, patients with normal hearing have the best chance of gaining control over their tinnitus.
- This is especially important if you have a pulsing heart beat noise in your ears. Some extra scans are required to rule out glomus tumours and other lesions that have a lot of blood vessels within them.
- If you are young or have a family history of immune diseases (thyroid, anaemia etc), or the tinnitus came on suddenly, then often blood tests are required as well as scans.
- Mr Vik Veer is not a neurosurgeon although he has had training in this field with regards tinnitus related brain lesions. If a brain lesion or cancer is identified, rather than attempting to deal with this himself, Mr Vik Veer will refer you to another expert who has more experience in this field. Mr Vik Veer believes in patients seeing the best person for particular problems. If he does not feel he can provide the very best care, Mr Vik Veer will introduce you to someone who can.
Treatment using the Jastreboff theory of tinnitus. This treatment worked well for Mr Vik Veer and his own tinnitus, although it is often taught badly and people do not understand why they are doing the exercises. It is based on neuronal plasticity of the brain and requires a full consultation to explain it properly.
- Occasionally hearing improvement will require an operation. This is generally a last choice option, as initially it can make the tinnitus worse. If this can be avoided, Mr Vik Veer will help you through the other options first before resorting to something as radical as surgery.
- Hearing aids are also an option if surgery is not possible. There are many different types of hearing aids, some of which are even implanted under the skin.
180 phase shift sounds. This was the technique that finally resolved the tinnitus that Mr Vik Veer suffered with. He is now in the process of developing a mobile application for this so others may have similar successes.
Mr Vik Veer believes that the use of medication is only useful for patients who have anxiety or severe distress caused by their tinnitus. In these situations he will refer you on to a specialist who is prepared to provide these drugs and is familiar with the side effect profiles. Treatment with ginkgo biloba or other remedies have been shown to not help with tinnitus. The only drug that seems to reduce tinnitus is an injection of lignocaine, however this is short lived and often causes a dangerous cardiac event.
Finally Repetitive Transcranial Magnetic Stimulation has been shown in numerous clinical studies to improve tinnitus. Excellent results have been gained, although this treatment is not effective in many of the causes of tinnitus.
Not understanding a condition often leads to failure of the treatment, especially in tinnitus management.
These are the very basics of the management of tinnitus. Obviously there are a number of modifications and subtleties that are not included here. In this situation, individualised treatment is needed, and Mr Vik Veer will explain this to you in detail.
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