Can Neurology Help with Persistent Tinnitus in Older Adults?

Q: Can Neurology Help with Persistent Tinnitus in Older Adults?

Hello, the possible causes of tinnitus are as follows： <br>Subjective tinnitus (rare)： The most common causes are vascular disorders (such as issues with veins, arteries, and arteriovenous malformations) and muscular disorders (such as problems with the middle ear muscles, Eustac

Could you please provide more details about the issue of tinnitus?

Hello Doctor: My mother (60 years old) has been experiencing a persistent "humming" sound in her right ear for the past three months.
She visited an otolaryngologist and underwent a hearing test.
The doctor reviewed the results and stated that her right ear tinnitus was caused by external factors (such as noise), leading to deterioration, and due to her age, her hearing would not return to its original state.
The doctor prescribed a two-week course of medication, indicating that if her tinnitus did not improve after finishing the medication, there was no need to return, as the medication would not be effective for her.
After completing the two-week course, her tinnitus did not improve and has even become slightly louder.
Occasionally, she also experiences tinnitus in her left ear, but after a while, it returns to only the right ear.
Yesterday, my mother heard that my aunt also had tinnitus, but after seeing a neurologist and taking medication, she no longer experiences any tinnitus.
I would like to ask you if seeing a neurologist would help improve my mother's condition? I apologize for bothering you, and thank you very much!

sallyfan, 30~39 year old female. Ask Date: 2008/01/24

Dr. Lin Zijing reply Neurology

Hello, the possible causes of tinnitus are as follows:
Subjective tinnitus (rare): The most common causes are vascular disorders (such as issues with veins, arteries, and arteriovenous malformations) and muscular disorders (such as problems with the middle ear muscles, Eustachian tube muscles, and throat muscles) that lead to pulsatile and spasmodic tinnitus.
Objective tinnitus (common): This is the type that most patients find distressing, and the potential causes are quite diverse, ranging from external ear disorders (earwax blockage, external auditory canal inflammation), middle ear disorders (tympanic membrane perforation, serous otitis media, otosclerosis), inner ear disorders (Meniere's disease, ototoxic medications, noise-induced damage, presbycusis), disorders of the auditory nerve and neural conduction pathways (acoustic neuroma, brainstem vascular sclerosis), to disorders of the cerebral cortex (stroke, degenerative diseases, amnesia).
If unilateral tinnitus persists, it is advisable to seek further neurological evaluation to rule out any structural abnormalities.
General treatment methods for degenerative tinnitus include:
1.
Attempting to "coexist peacefully" with the tinnitus.
2.
Eliminating unnecessary anxiety and avoiding stress.
3.
Avoiding the following:
a.
Consuming certain irritant foods, such as coffee, tea, and spicy foods.
b.
Prolonged exposure to excessively loud and noisy environments.
c.
Overexertion and staying up late; ensuring adequate sleep and rest.
d.
Using headphones or earplugs to listen to music or CDs; however, listening to soft or pleasant music while sleeping (without headphones) may help alleviate tinnitus.
4.
Medication treatment, but patience is required.
(Acute tinnitus is easier to recover from, while chronic tinnitus is more challenging to cure, and treatment can only reduce the severity of tinnitus to minimize its impact on daily life.)

Reply Date: 2008/01/24

More Info

Tinnitus, commonly referred to as "ringing in the ears," is a condition that can be particularly distressing for older adults. It can manifest as a persistent sound, such as buzzing, hissing, or ringing, and can significantly impact quality of life. In your mother's case, her tinnitus appears to have developed following exposure to loud noise, which can lead to auditory nerve damage or changes in the inner ear structures. Given her age and the nature of her symptoms, it is understandable that you are seeking further medical advice.

Neurology can indeed play a crucial role in the management of tinnitus, especially when it is persistent or worsening. While the initial evaluation by an ear, nose, and throat (ENT) specialist is essential, a neurologist can provide additional insights, particularly if there are concerns about underlying neurological conditions that may contribute to the tinnitus. For example, conditions such as vestibular schwannoma (a benign tumor on the auditory nerve), multiple sclerosis, or even certain types of migraines can present with tinnitus as a symptom.

When considering a visit to a neurologist, it is important to prepare by documenting the specifics of your mother's tinnitus, including when it started, any associated symptoms (such as hearing loss or dizziness), and any treatments she has already tried. This information will help the neurologist assess her condition more effectively.

In terms of treatment, while there is no one-size-fits-all solution for tinnitus, neurologists may recommend various approaches. These can include:
1. Sound Therapy: This involves using background noise or white noise to mask the tinnitus sounds. Many patients find relief through sound machines or apps designed for this purpose.

2. Cognitive Behavioral Therapy (CBT): This psychological approach can help patients manage the emotional distress associated with tinnitus. It teaches coping strategies and can reduce the perception of tinnitus.

3. Medications: While there are no specific medications approved solely for tinnitus, some drugs may help alleviate symptoms. Antidepressants or anti-anxiety medications may be prescribed if the tinnitus is causing significant distress.

4. Hearing Aids: If your mother has any degree of hearing loss, hearing aids can amplify external sounds, which may help mask the tinnitus.

5. Neuromodulation Techniques: Some newer treatments involve using electrical stimulation or other methods to alter the way the brain processes sound, potentially reducing the perception of tinnitus.

It is also worth noting that the effectiveness of treatments can vary widely among individuals. What works for one person may not work for another, and it may take time to find the most effective approach for your mother.

In conclusion, consulting a neurologist could provide your mother with additional options for managing her tinnitus. It is essential to approach this condition holistically, considering both medical and psychological aspects. Encourage your mother to keep an open line of communication with her healthcare providers and to express any concerns she may have about her symptoms or treatment options. With the right support and management strategies, many individuals with tinnitus can find relief and improve their quality of life.

Similar Q&A

Living with Tinnitus for Over 30 Years: A Personal Journey

Hello, Doctor. In my thirties, I participated in a five-day shooting event, and because no one reminded me to wear ear protection, I developed persistent tinnitus. A few weeks later, I went to the ENT department at Taipei Veterans General Hospital, where it was discovered that I ...

Dr. Zheng Jueyi reply Otolaryngology
Hello, if tinnitus has persisted for over 30 years, the chances of it disappearing are low. It is advisable to find a way to coexist peacefully with it. As for dizziness, it may be related to the inner ear or various other factors. If the dizziness is accompanied by worsening tin...

Understanding Tinnitus: When to Consult a Neurologist for Relief

Hello Doctor: Over the past year, I have been hearing a high-pitched ringing or hissing sound in my left ear, especially in quiet environments, which often affects my sleep. I have visited an otolaryngologist three times, and the doctors have stated that there are no significant ...

Dr. Jiang Junyi reply Neurology
Hello: Based on your description, if you are experiencing frequent tinnitus, it may be necessary to consider potential issues with the cochlea in the inner ear and the auditory nerve. This is commonly seen in individuals who work in noisy environments for extended periods, use me...

Understanding Tinnitus: Causes, Symptoms, and Treatment Options

Hello Dr. Hsu, I would like to ask you a question: I have a relative who has been experiencing insomnia for over three years due to difficulty sleeping for six months without seeking medication. Later, they began to hear a constant sound in their head similar to cicadas, which ...

Dr. Xu Jiazhen reply Otolaryngology
Hello: In response to your question... Menopause can lead to these situations, but for long-term insomnia, you should see a psychiatrist rather than a neurologist. Hsu Chia-Chen, Keelung Hospital, Department of Health, Executive Yuan.

Understanding Ear Examination Treatments for Seniors with Tinnitus

Dr. Hsu, my father is experiencing worsening tinnitus and slight unsteadiness while walking. He has already undergone hearing tests and X-rays at your hospital. Could you please explain what the next steps in his treatment will be? He is emotionally unstable and reluctant to retu...

Dr. Xu Jiazhen reply Otolaryngology
Hello: In response to your question, the examination of neurotology includes several components, which can generally be completed in 4-5 outpatient visits. You may bring the elderly gentleman to the clinic, and I will explain the subsequent examinations to you.