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Posted by Lilly Langtree
http://www.vestibular.org/files/spring95.txt
TINNITUS - TYPES AND TREATMENT
A recent journal article by J. Ciocon, et
al., reviewed tinnitus.
Tinnitus is typically defined as ringing in the
ears or head, but it may also be described as buzzing, humming, or
hissing. Tinnitus often interferes with a person's ability to function.
Tinnitus may be subjective (heard only by the patient) or objective (heard
by the patient and the doctor).
Subjective tinnitus, when correlated with old age, can be caused by the
deterioration of hair cells in the cochlea and/or deterioration of
pathways between the brain and the ear. The most frequent cause of
objective tinnitus is a disorder of blood vessels such as carotid artery
narrowing, blood vessel malformations, or disease of the heart valves. It
may be present as a blowing, clicking, or roaring sound. Additionally,
other causes of tinnitus include systemic diseases, infections, or
metabolic problems, drugs, or inflammatory conditions.
The journal article stresses the importance of taking a good medical
history of the patient, including data about the onset, duration,
frequency, pitch, and pulsatile nature of the noise. Things that may help
the doctor determine the cause of the tinnitus include hearing tests, a
complete blood count, a blood chemistry work-up, thyroid tests, a check of
the sedimentation rate of the red blood cells, an electronystagmography
(ENG) test, an auditory brainstem response test, and in some cases a
magnetic resonance imaging (MRI) test.
Tinnitus can be difficult to treat. In simple cases, ear wax can be
removed or an antibiotic administered for infection. In more difficult
cases, hearing aids alone or with a sound masker can be used. Biofeedback
may help with relaxation. Medications that have been employed include
antidepressants, anticonvulsants, anesthetics, glutamic acid, calcium
channel blockers, lasix, or adrenaline. According to one study, scientists
at the Shea Clinic in Memphis used intravenous lidocaine and obtained
prompt relief of low- frequency tinnitus in patients. Other studies have
had mixed results. See Ciocon, J., et al., "Tinnitus: A Stepwise Workup to
Quiet the Noise Within," Geriatrics, Vol. 50, No. 2, February 1995, pages
18-24.
