Next Steps for Managing Tinnitus: Seeking Relief from Ear Noise

Q: Next Steps for Managing Tinnitus: Seeking Relief from Ear Noise

Hello： In response to your question, hearing loss caused by noise or underlying blood flow issues is not uncommon. <br>What is concerning is that it may be accompanied by persistent tinnitus and vertigo. <br>The general approach should still be based on sudden sensorineural heari

What should be the next step?

Dear Doctor,
I have been working in a textile factory for nearly 20 years in a supervisory role, but I still need to stay for several hours each day.
I usually wear earplugs, and I have recently been transferred to an office.
At the end of April this year, after inspecting the site and leaving the factory, I noticed persistent tinnitus in my left ear, which has been quite distressing.
I first visited a local clinic, where the doctor prescribed medication to promote blood circulation and vitamin B12.
However, after taking it for two days, there was no improvement.
I then went to a teaching hospital for a hearing test, which revealed a significant drop in high-frequency hearing above 4K Hz in my left ear.
I also underwent a NABER test, and the doctor indicated that the nerve conduction was normal, leading to a diagnosis of auditory nerve damage.
The doctor prescribed the same medications for blood circulation and vitamin B12, along with a tranquilizer, but after two weeks, there was still no improvement.
The tinnitus has severely affected my sleep and mood, bringing me to the brink of collapse.

I then consulted another teaching hospital, where the doctor initiated a direct steroid treatment and referred me to a psychiatrist for emotional management.
Unfortunately, there has been no improvement in my tinnitus, and I have now been prescribed additional medication for Meniere's disease.
A friend suggested trying traditional Chinese medicine, so I am currently taking Chinese herbal medicine in the morning and evening, while continuing to take Western medication three times a day (with intervals between the two).
I am aware that this may not be good for my other organs, but I feel I cannot just sit and wait for things to get worse.
The sound of tinnitus is relentless, and I fear that prolonged exposure will weaken my mental state.
I am at a loss for what to do next.
Are there any similar patients who can share their coping methods? My tinnitus has persisted for nearly two months now (without any dizziness), and I have visited several major hospitals.
I have researched online and found methods such as desensitization or masking, but I wonder if these could harm low-frequency hearing with long-term use.
I also came across a low-level laser therapy (introduced at a certain clinic) that claims to promote the recovery of damaged nerves using low-energy laser light.
I am curious if other hospitals in the country offer similar therapies and whether they would be effective for my condition, which is caused by noise-induced high-frequency nerve damage.

Thank you for your guidance!
A Desperate Patient

Yi ge juewang de bingyou, 40~49 year old female. Ask Date: 2006/06/19

Dr. Xu Jiazhen reply Otolaryngology

Hello: In response to your question, hearing loss caused by noise or underlying blood flow issues is not uncommon.
What is concerning is that it may be accompanied by persistent tinnitus and vertigo.
The general approach should still be based on sudden sensorineural hearing loss, but for long-term tinnitus, it is important to consider whether there are other underlying causes.
Regardless of the treatment method used, there should be a theoretical basis for the therapy.
I recommend seeking treatment from a specialized physician regularly, as this will make it easier to monitor the progression of your condition.

Reply Date: 2006/06/19

More Info

Managing tinnitus, especially when it has a significant impact on your quality of life, can be a challenging journey. Given your background in a textile factory and the recent onset of tinnitus, it’s understandable that you are seeking effective relief. Tinnitus, often described as a ringing, buzzing, or humming sound in the ears, can be caused by various factors, including noise exposure, which seems to be relevant in your case.

Firstly, it’s important to recognize that tinnitus can sometimes be linked to hearing loss, particularly in specific frequency ranges, as you have experienced with the drop in high frequencies. The fact that your hearing tests indicated normal nerve conduction suggests that the auditory pathways are functioning correctly, but there may be damage to the hair cells in the cochlea, which are responsible for translating sound vibrations into neural signals.

You mentioned that you have tried several treatments, including medications aimed at improving blood circulation and vitamin B12 supplementation, but without significant improvement. It’s not uncommon for tinnitus to be resistant to initial treatments, and finding the right approach can take time. The use of steroids, while sometimes effective in reducing inflammation, may not always yield the desired results for tinnitus.

Your situation is further complicated by the emotional toll that tinnitus has taken on your sleep and mental health. It’s crucial to address these aspects as well. Cognitive Behavioral Therapy (CBT) has been shown to be effective in helping individuals cope with the distress caused by tinnitus. This therapeutic approach can help you develop strategies to manage your emotional response to the sound, potentially reducing its perceived intensity.

Regarding your inquiry about alternative treatments, such as Traditional Chinese Medicine (TCM) and low-level laser therapy (LLLT), these can be considered as adjunctive therapies. TCM may offer some benefits through herbal remedies and acupuncture, which some patients report as helpful for managing symptoms. However, scientific evidence supporting these treatments is still limited, and results can vary widely among individuals.

Low-level laser therapy is another area of interest in tinnitus management. While some studies suggest that it may promote healing in damaged tissues and improve symptoms, more research is needed to establish its efficacy specifically for noise-induced tinnitus. If you are considering this treatment, it would be wise to consult with a healthcare provider who is knowledgeable about both conventional and alternative therapies to ensure a comprehensive approach.

As for the concern about using masking or habituation techniques, these methods can be beneficial for many individuals with tinnitus. They involve using background noise or sound therapy to help distract from the tinnitus, which can reduce its prominence in your daily life. However, it’s essential to use these techniques judiciously and under the guidance of a professional to avoid potential negative impacts on your hearing.

In summary, managing tinnitus effectively often requires a multifaceted approach. Here are some steps you might consider:
1. Consult a Specialist: If you haven’t already, consider seeing an audiologist or an ear, nose, and throat (ENT) specialist who specializes in tinnitus management. They can provide tailored advice and treatment options.

2. Cognitive Behavioral Therapy: Explore CBT or other forms of counseling to help manage the emotional aspects of tinnitus.

3. Sound Therapy: Investigate sound masking devices or apps that can provide soothing background noise to help reduce the perception of tinnitus.

4. Lifestyle Modifications: Maintain a healthy lifestyle, including regular exercise, a balanced diet, and good sleep hygiene, which can all contribute to overall well-being.

5. Monitor Your Treatments: Keep track of any medications or therapies you are trying, and communicate openly with your healthcare providers about what is or isn’t working.

6. Stay Informed: Continue to educate yourself about tinnitus and potential treatments, but be cautious of unverified claims.

It’s understandable to feel overwhelmed, but remember that many people with tinnitus find ways to cope and lead fulfilling lives. Seeking support from tinnitus support groups or forums can also provide encouragement and shared experiences from others who understand what you’re going through.

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