Do you know about Tinnitus and their causes?

1. Know your tinnitus Caroverine and other therapies available for tinnitus “Treatment of tinnitus with the use of one or more types of the following therapy, along with the suggested guidance, helps to treat more than 90% patients of tinnitus.” What is Tinnitus? Tinnitus, referred as, ringing or noise in the ear, is purely, a subjective experience. In fact, there is no existence of any such sound in the environment. 60% of the inner ear diseases cause tinnitus. Symptoms may include buzzing, roaring, ringing, whistling, or hissing sounds perceived in the ear. These sounds may be intermittent, continuous, or pulsatile. Tinnitus may interfere with normal activities and sleep, and there may be an associated decrease in the ability to hear conversations or other sounds in the environment. To understand your symptom of tinnitus it is necessary to understand the mechanism of hearing. How Ear works?

2. Functionally ear is divided into three parts 1.External ear 2.Middle Ear and 3. Inner ear External ear collects the sound and directs it to Middle ear. Middle ear amplifies the sound. Inner ear converts sound signals in to the electrical signals. Normally, the inner ear generates an electric impulse, only, in response to the incoming sound signals. But if inner ear cells are damaged, it does not generate required electric signals in response to sound signals. So such patients don’t hear properly. Simultaneously some time damaged inner ear hair cells may reach to the state of ‘spontaneous depolarization’. Meaning by, it goes on generating electrical signals, continuously without any incoming signals. This is the reason such patients hear such sounds continuously in the ear / head even though there is no existence of such sound in the environment. In rare cases, such state may also appear due to damage in the neural connections between inner ear and the auditory centers of the brain. What is the cause of such inner ear damage? Inner ear is structurally very close to middle ear. So, commonest cause is diseases of the middle ear, which extend to the inner ear. Usually, an ENT surgeon can easily diagnose this. In such patients there may be a history of ear pain, ear discharge, recurrent nasal or throat infections and/or deafness.

3. In majority of the cases of tinnitus it is found that, ear drum (Tympanic membrane) and middle ear are structurally normal. These are the situations where possibilities of damage to inner ear are direct. It could be due to local cause or could be due to one or more generalized diseases or metabolic disorders. Your ENT surgeon has found out the exact cause of damage by performing certain investigations like Audiometry, Impedance audiometry, Acoustic reflexes, Reflex decay, Eustachian tube function tests, SISI test, Tinnitus matching and tinnitus grading tests. As your damage is diagnosed in the cochlea, CAROVERINE is the preferred drug for you. As per clinical trials, 63% of the patients improve with one injection of CAROVERINE infused in 100 ml of normal saline. Your ENT surgeon is well informed and well trained about the usage of CAROVERINE. Also, no serious adverse effects were noticed with the use of this drug, during the clinical trials. It is also proved that it doesn’t damage the existing hearing level.

4. To have a better effect and prevent infusion of overdose, it is necessary that you understand the Grading system of your tinnitus with the help of your ENT surgeon. Please note that it is advisable to stop infusion before your tinnitus reaches zero to avoid overdose. Overdose may increase your tinnitus temporarily. In case of no response to medication, a re-dose of Caroverine can be safely given, after three weeks. In case of successful infusion, there may be recurrence of the symptom in few patients within six months. In such a situation, reinfusion is possible after 6 weeks of recurrence. What is after Caroverine therapy? If there is successful result (A)Train yourself to ignore tinnitus- This is best for residual tinnitus after therapy or for minimal tinnitus. ( B) Prevention of tinnitus:- 1. Avoid exposure to loud sounds.

5. 2.Excessive use of headphone is harmful 3.Avoid cold drinks 4.Avoid tobacco in any form 5.Avoid coffee and chocolates and any cocoa products. 6.Avoid certain ototoxic drugs and drugs like aspirin and Bruffen 7.Early treatment of middle ear disease avoids the possibility of damage to the inner ear. 8.Avoid Chinese food Totally(glutamate content) For no result with Caroverine:- There are many more options available, and these options in combinations give better results. Optional therapies are: 1.For those with deafness –Programmable digital hearing aid will solve both problems together. It not only improves the hearing but also masks the tinnitus. Large numbers of patients are benefited this way. Proper selection and perfect programming of hearing aid are vital for this. 2.For those with normal hearing – your ENT surgeon may prescribe an alternate medication. Certain combinations are proved to give better results. 3.An alternative option is Tinnitus retraining therapy (TRT). Your audiologist may explain you better about this. In fact, it is a therapy by which your brain’s attention is diverted from tinnitus, by a specific and established method.

6. 4.Certain foods helps in reduction of tinnitus- Like Vitamin A, Vitamin D, Iron, Zinc, low salt diet, low sugar diet and Low fat foods are the usual food guidance. 5.Psychotherapy and hypnosis are recommended therapies to resistant cases. Dr. Khandhar Vinod M.S. (ENT), M.S. (Gen.Surg.)