Some brutal ear ringing

[DocVikingo]

Hi francousteau,

Just thinking about an intratympanic injection of any sort makes me wince, but it is good that the condition seems to be resolving to some degree.

The placement of a steroid (e.g., dexamethasone) into the middle ear space would be expected to reduce inflammation in the area and promote drainage of any trapped fluids, and this in turn could improve hearing and possibly reduce tinnitus. However, the literature with which I am familiar indicates that it isn't an especially effective treatment for tinnitus resulting from inner ear damage, such as that caused by inner ear barotrauma.

BTW, the hole from the injection typically closes very quickly, but pain at the injection site could continue for some days. An injection was administered on Tue and a second is scheduled for Thu, and repeated injections over a relatively brief period would be expected to have a cumulative effect as regards discomfort.

I am unsure what a "fishker test" might be, but sometimes a device called "Frenzel glasses" are used to evaluate possible inner ear disorder, although the patient's primary presenting complaints usually are dizziness or vertigo, rather than just tinnitus in isolation.

In any event, by end of the course of the injected steroid it should be much clearer how much improvement can be anticipated. While it is too soon to say with certainty, some tinnitus may remain.

BTW, although it would be routine in a case such as this for an ENT to closely question the patient regarding medications, "shakeybrainsurgeon" raises a point worthy of a brief visit. There are a staggering number of drugs that may (or may not) cause or contribute to tinnitus. If one is taking a nonsteroidal anti-inflammatory (NSAID) (e.g., aspirin, Advil, Aleve or Motrin), a loop diuretic (e.g., Lasix) or certain antibiotics (e.g., streptomycin), the ENT should be aware of this.

Please do keep us posted--it's how we learn.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[francousteau]

One question: did the ENT tell you to steer clear of NSAIDS like aspirin, Advil, Aleve, Motrin, Lodine, Mobic, etc? Non-steroidals, particularly in high doses, can cause tinnitus or make it worse. You had a cold and many cold remedies (like alka selzer) have aspirin in them. Did the ringing worsen during the cold? Were you taking NSAIDS while diving?

Brainy,
No the ENT didn't say anything about NSAIDS, but I've seen various sites on the I-net that said to stay away from them. Actually, the tinntitus was much worse while I had the cold and started to subside as the cold went away. After it didn't go completely away, after the worse part of the cold, I really got concerned and hence the ENT visit. And YES, I was taking some NSAIDS while diving.

Doc,
I'm now having 2nd thoughts about the additional shots. My ear hurts pretty much from it and it didn't seem to have any effect.
The "fishker test" that I referred to was a test where the audiologist put some object into my ear that was connected to a machine. The ear piece blew air into my ear and the machine measured and graphed the results. I know that I don't have the name of the test right, but hey, I'm only the patient.

Also, I've been trying some Ginko Biloba . . . no effect and I want to try some B-12. Any thoughts on natural remedies?

Thanks for the "education".

 

[DocVikingo]

Hi francousteau,

It takes a bit of time for the steroid to act and the injection was only yesterday. It's too soon to gauge its potential effect.

It's entirely reasonable to report post-injection ear pain to the ENT and he may have some ideas for managing it.

The test to which you are referring is called tympanometry, a procedure that I touched upon briefly in my original reply. It produces graph called a tympanogram that shows the amount of eardrum movement in response to air pressure as well as the pressure at which the drum moves best.

Regarding supplementation with "Ginkgo biloba" and vitamin B-12, scientific evidence for the effectiveness of the former on tinnitus is very meager, while the B-12 is unlikely to help unless the individual has a deficiency of this vitamin.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[DandyDon]

Be careful about "natural drugs" suggested as alternate treatment. Nicotine is a natural drug, but seldom a good idea. You're getting excellent care there and discussion here from professionals - and you can't beat DocV.