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Suggest Treatment For Constant Tinnitus And Hearing Loss
Question: I had sudden hearing loss a few weeks ago and a hearing test revealed mild to moderate hearing loss. I now have constant tinnitus CT did not reveal any cause, bones and pressure in middle ear normal. I had an MRI yesterday. No reason for hearing loss was revealed but a round 12mm mass in the check next to the masseter muscle showed. Report said it could be a necrotic lymph node or could be something else. I am scheduled for a biopsy. I had breast cancer seven years ago followed with chemo and radiation and am nervous I could be looking at cancer again. I have developed some discomfort in my face and ear. I do not have face swelling and cannot feel the mass when I examine my cheek.
Brief Answer:
Tinnitus is due to the ISSNHL. First get a USG guided FNAC, then biopsy.
Detailed Answer:
Hi,
Thank you for your query.
1. The tinnitus is due to ISSNHL (Idiopathic Sudden Sensori-Neural Hearing Loss) is defined by a hearing loss of more than 20-30 dB in at least three contiguous hearing frequencies which develops either immediately or over 48-72 hours. Usually, it happens in one ear, usually the left ear. The reasons for this and the overall cause is often unknown, hence it is known as 'idiopathic'. ISSNHL is a medical emergency. Ideally the treatment should be started within 4 weeks. It is important to note that about half the patients get some spontaneous recovery in the first few weeks.
2. The mainstay of treatment of ISSNHL (Idiopathiic Sudden Sensori-Neural Hearing Loss) in a non diabetic patient is high dose steroids. Other medication includes anti-virals, blood thinning agents, rheologic or blood flow improvement medications, neural tonics, Carbogen (vasodilator) and Hyperbaric Oxygen Therapy (HBOT), if available. The CT/MRI study of the ears is usually within normal limits.
3. For those who cannot tolerate the above medication or for salvage treatment, TTS (Trans-Tympanic Steroids) and HBOT is strongly recommended.
4. Upload a PTA (Pure Tone Audiogram), CT / MRI images.
5. At 12 mm, if the mass in the cheek turns out to be a lymph node, it may not be very significant. Up to 8 to 10 mm, lymph nodes are considered reactive. However, as it appears necrotic, get a USG guided FNAC (Fine Needle Aspiration Cytology) done before a biopsy.
6. These investigations will settle the diagnosis and treatment can commence.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Tinnitus is due to the ISSNHL. First get a USG guided FNAC, then biopsy.
Detailed Answer:
Hi,
Thank you for your query.
1. The tinnitus is due to ISSNHL (Idiopathic Sudden Sensori-Neural Hearing Loss) is defined by a hearing loss of more than 20-30 dB in at least three contiguous hearing frequencies which develops either immediately or over 48-72 hours. Usually, it happens in one ear, usually the left ear. The reasons for this and the overall cause is often unknown, hence it is known as 'idiopathic'. ISSNHL is a medical emergency. Ideally the treatment should be started within 4 weeks. It is important to note that about half the patients get some spontaneous recovery in the first few weeks.
2. The mainstay of treatment of ISSNHL (Idiopathiic Sudden Sensori-Neural Hearing Loss) in a non diabetic patient is high dose steroids. Other medication includes anti-virals, blood thinning agents, rheologic or blood flow improvement medications, neural tonics, Carbogen (vasodilator) and Hyperbaric Oxygen Therapy (HBOT), if available. The CT/MRI study of the ears is usually within normal limits.
3. For those who cannot tolerate the above medication or for salvage treatment, TTS (Trans-Tympanic Steroids) and HBOT is strongly recommended.
4. Upload a PTA (Pure Tone Audiogram), CT / MRI images.
5. At 12 mm, if the mass in the cheek turns out to be a lymph node, it may not be very significant. Up to 8 to 10 mm, lymph nodes are considered reactive. However, as it appears necrotic, get a USG guided FNAC (Fine Needle Aspiration Cytology) done before a biopsy.
6. These investigations will settle the diagnosis and treatment can commence.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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