Tinnitus and Dizziness: Symptoms and Treatment Options

Tinnitus and dizziness?

Dear Dr.
Hsu,
I hope this message finds you well.
I apologize for the interruption.
Here is my situation: Since around October of last year, I have been working in an office for about nine to ten hours a day.
The work environment is quite simple, and I usually go to bed around midnight and wake up around eight in the morning.
My sleep quality seems to be acceptable.

About three weeks ago, I woke up one morning with mild tinnitus in my left ear.
A few days later, I experienced the following:
1.
While at work, I suddenly felt dizzy, so I took a leave of absence to rest in my dormitory.
After sleeping, the dizziness improved, but the tinnitus did not.
2.
Last Friday (March 11), around ten in the morning, I experienced a similar situation and had to return to my dormitory to rest.
After two hours of sleep, the dizziness significantly improved, but the tinnitus remained unchanged.
3.
On Saturday evening, while driving around eight o'clock, I was able to converse normally with a friend.
However, when I suddenly turned my head to the right and then back to the front, I felt a wave of dizziness.
I immediately let my friend take over driving.
After resting for over an hour, the dizziness disappeared, but the tinnitus did not improve.

Today, Monday, around five in the afternoon, the dizziness occurred again, and I am really worried.
Could you please advise me on how to handle this situation? Will I need to take medication long-term? Should I undergo further examinations? How can I improve the tinnitus? What dietary changes should I consider?
During this time, I visited an ENT department at a large hospital for an examination.
The results indicated that my hearing in the low-frequency range for both ears is normal, but there is a decline in hearing in the high-frequency range (approximately above 6000 Hz) for both ears, with the right ear showing a more significant decline than the left.
Thank you very much for your assistance!

Xiao C, 20~29 year old female. Ask Date: 2011/03/14

Dr. Xu Jiazhen reply Otolaryngology

From your description, it seems that this is undoubtedly an episode of vertigo; however, the accompanying tinnitus is likely causing you greater distress.
In fact, these issues are commonly related to problems within the vestibular system.
The clinical symptoms you mentioned indicate that the hearing test you underwent is merely a preliminary assessment.
It is essential to clarify the underlying issues further, so you should return to the hospital for additional evaluation and provide your attending physician with a detailed account of the duration and nature of your symptoms.
I believe this will be most beneficial for you.
Typically, for patients in my clinic, if symptoms persist or change rapidly, I recommend a comprehensive vestibular assessment.
This approach facilitates a better understanding of the condition and can help avoid the consequences of delayed treatment for rare but serious diseases.

Reply Date: 2011/03/14

More Info

Dear patient,
Thank you for reaching out and sharing your concerns regarding your symptoms of tinnitus and dizziness. It sounds like you have been experiencing a challenging situation, and I appreciate your detailed description of your condition. Let's break down your symptoms and explore potential treatment options.

Understanding Tinnitus and Dizziness
Tinnitus, often described as a ringing, buzzing, or hissing sound in the ears, can be caused by various factors, including exposure to loud noises, ear infections, age-related hearing loss, and even stress. Dizziness, on the other hand, can stem from issues related to the inner ear, vestibular system, or even neurological conditions. Given your symptoms of dizziness occurring alongside tinnitus, it is crucial to consider both conditions together.

Possible Causes
1. Inner Ear Issues: Conditions such as Meniere's disease, vestibular neuritis, or benign paroxysmal positional vertigo (BPPV) can lead to both tinnitus and dizziness. These conditions often affect balance and hearing due to disturbances in the inner ear.

2. Hearing Loss: Your recent audiometric tests indicate a decline in high-frequency hearing, which can be associated with tinnitus. Hearing loss can exacerbate the perception of tinnitus and may also contribute to feelings of dizziness.

3. Stress and Fatigue: Your work environment and sleep patterns may also play a role. Chronic stress and fatigue can lead to increased muscle tension and exacerbate symptoms of both tinnitus and dizziness.

Recommended Actions
1. Follow-Up with an ENT Specialist: Since you have already consulted an ENT specialist, it may be beneficial to seek a second opinion or further evaluation, especially if your symptoms persist. A thorough examination may include balance tests, imaging studies, or additional audiometric evaluations.

2. Vestibular Rehabilitation Therapy (VRT): If your dizziness is related to vestibular dysfunction, VRT can help improve balance and reduce dizziness through specific exercises designed to retrain your brain's response to balance signals.

3. Sound Therapy: For tinnitus management, sound therapy can be effective. This involves using background noise or white noise to mask the tinnitus sounds, making them less noticeable.

4. Cognitive Behavioral Therapy (CBT): If your tinnitus is causing significant distress, CBT can help you develop coping strategies and reduce the emotional impact of tinnitus.

5. Lifestyle Modifications: Consider making changes to your diet and lifestyle. Reducing caffeine and alcohol intake, managing stress through relaxation techniques, and ensuring adequate sleep can all contribute to symptom relief.

6. Medication: While there is no specific medication for tinnitus, some patients find relief with medications that address underlying conditions, such as anxiety or depression. Discuss with your healthcare provider whether this might be appropriate for you.

Conclusion
In summary, your symptoms of tinnitus and dizziness warrant a comprehensive approach to diagnosis and treatment. It is essential to continue working closely with your healthcare providers to explore all potential causes and treatment options. Keep track of your symptoms, including any triggers or patterns, and communicate these to your doctor during follow-up visits.

If your symptoms persist or worsen, do not hesitate to seek immediate medical attention. Your health and well-being are paramount, and there are various avenues to explore for relief and management of your symptoms.

Wishing you the best in your journey toward recovery.

Sincerely,
Doctor Q&A Teams

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