Brief Answer:
PTA, HRCT +MRO Tempral Bones, rule out BPPV, BAHA/meds for Tinnitus.

Detailed Answer:
Hi,

Thank you for your query.

1. It would be ideal if you could upload a latest PTA (Pure Tone Audiogram). This will help suggest treatment for the Otosclerosis.

2. After these many years it is unlikely that medical management of the Otosclerosis is possible. Still an examination of the eardrums is recommended.

3. There is now an option of using a BAHA (Bone Anchored Hearing Aid) instead of the ITC Hearing Aid. For that the bone conduction hearing levels should be better than 50 dB in at least one ear.

4. An HR(High Resolution) CT and MRI Temporal bones will help look for any cochlear Otosclerosis that may have now developed.

5. The treatment of the vertigo depends upon whether it is positional (BPPV- Benign Paroxysmal Positional Vertigo) or due to progress of the Otosclerosis. Is the dizziness true vertigo (spinning of the surrounding) or only unsteadiness? How often and how long do the episodes last? Is it continuous? Are there any other associated symptoms, such as nausea, vomiting or sweating? Is the dizziness only when there is change of position (such as when you lie down or sit up)? Can you walk without support? Do you get dizzy when you turn in bed or when you look up while climbing stairs? Is your vision clear or blurred? Is there any tendency to blackout?

4. Since your Tinnitus is mostly due to the hearing loss, any improvement in hearing will lessen the perception of the Tinnitus. Transtympanic steroids, gingko biloba, multi-vitamins, anti-oxidants and caroverine are some of the medications that may also help in reducing Tinnitus.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.

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Brief Answer:
Seems to be BPPV. Confirm with a Neurotologist. Continue cardiac meds.

Detailed Answer:
Hi,

Thank you for writing back.

1. The symptoms of your vertigo seem to be those of BPPV, which is very common at your age (up to one in three people). It is important to determine the type of balance problem. The main broad division is between central (brain) and peripheral (ear) related dizziness.

2. Certain signs such as nystagmus (abnormal eye movements during vertigo), gait (difficulty in walking) cannot be evaluated on your own. Get your blood pressure checked. Hearing levels should be checked. Cervical spine problems and gastritis are also common causes for dizziness.

3. BPPV can be managed without medication. Re-positioning maneuvers speed up recovery. It is important to prevent falls due to the vertigo.

4. Your cardiac medications must continue.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.

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Brief Answer:
Neurotologist/ENT/Neurophysician.

Detailed Answer:
Hi,

Thank you for writing back.

1. An examination and testing by a Neurotologist will be ideal. If the sevices of a Neurotologist are not available, an ENT Specialist or a Neurologist will suffice.

2. These specialists can differentiate between the type of balance disorders and help treat them.

3. BPPV results from tiny calcium crystals being dislodged from their normal location in the inner ear into the semicircular canals, leading to the symptoms similar to the ones described by you.

4. Re-positioning or liberatory maneuvers are done with the help of your doctor to help re-position these tiny calcium crystals back to their original location, thereby curing the condition (and dizziness). These are time-tested maneuvers.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.

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