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Suggest Treatment For Tinnitus With Hearing Loss

Posted on Sat, 16 Aug 2014

Question: Two weeks back, i suddenly lost hearing in my left ear. Presuming it was a ear wax related problem, i picked up some ear drops from the local pharmacy together with sea water for cleaning. After 4 days, no improvement. In fact i started feeling a ringing tone in my left ear together with aural pressure (no vertigo). Consulted an ENT specialist who did a tuning fork test on me and diagnosed me for ISSNHL. He prescribed me 24mg x 2 betahistine and said i would achieve full recovery in two weeks time. Not entirely satisfied, i took second opinion from another ENT doctor. He did the tuning fork and audiometry test on me and concluded that i was suffering from mixed hearing loss, including 15-30 db of SNHL. He put me on 45mg predisolone for three days in addition to gingko biloba extract, kestine (3 times), serc8 (3 times). After two days the aural pressure somewhat subsided, and a follow up audiometry revealed about 10db of improvement in the SHNL (but no improvement in the conductive hearing loss). The doctor asked me to continue oral steroids for two more days.

My question to you is: is my treatment on the right track? 14 days since the onset and 4 days since I started oral steroids, how good is my prognosis?

In a separate (perhaps unrelated development), my CBC ESR test reveals slightly elevated WBC (10.9) and Neutrophils (84.4%) while lymphocytes are 11.8%. Peripheral film indicates normocytic, normochromic neutrophilia with left shift ? Bacterial infection.

Answered by Dr. Krunal Karade (58 minutes later)

Brief Answer:
Yes , your treatment is on the right track .

Detailed Answer:
Hi,
Thanks for the query.
I have read your query.

If I were your treating doctor, I would advice you Steam Inhalation thrice daily ,Macrolide Antibiotic azithromycin 500mg once daily, continue predisolone 45mg for 5 days then tapper thereafter , gingko biloba extract, kestine & serc8 .
Discuss this with your treating doctor .

Yes , your treatment is on the right track . Prognosis is good in your case .

Hope this information helpful to you .If you have any further questions I will be happy to help.
Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Krunal Karade (6 minutes later)

Many thanks doc. I have completed 4 days of predisolone. Are you suggesting i continue 45mg for a further 5 days then taper off. How do i taper?

How long do you think it would take to get my hearing back
?

Answered by Dr. Krunal Karade (24 minutes later)

Brief Answer:
It takes 1 to 2 month to get hearing back .

Detailed Answer:
Thanks for follow up query.

Continue predisolone 45mg for 1 more day , then 30mg for next 5 days & thereafter 15mg for next five days.

Recovery peroid varies patient to patient . In my patients , similar cases like you it takes 1 month to 2 month to get their hearing back .

Wish you good health. Take care.
Thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Krunal Karade (30 minutes later)

One final question. You mentioned Azithromycin. Is this for clearing up the bacterial infection that is showing up on the CBC ESR report. Which infection could this be, because as such I dont seem to have any clear symptoms. Thank you for all your help.

Answered by Dr. Krunal Karade (10 minutes later)

Brief Answer:
Azithromycin for clearing up bacterial infection.

Detailed Answer:
Thanks for query .
Yes , Azithromycin for clearing up the bacterial infection that is showing up on the CBC ESR report & also to prevent any secondary bacterial infection after viral infection.
It could be viral infection but chances of secondary bacterial infection increases after viral infection.

Hope this information useful.

Regards.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Krunal Karade (14 minutes later)

I am allergic to Cipro (results in instant rash on the penis)but ok with Cefixime. Would Azithromycin be alright for me?

Answered by Dr. Krunal Karade (11 minutes later)

Brief Answer:
Yes, Azithromycin will be alright for you .

Detailed Answer:
Yes, Azithromycin will be alright for you . It is from different group of antibiotic given for Ear & upper respiratory track of infection.

Thanks .

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Krunal Karade (4 minutes later)

Thanks doc.Azithromycin 500mg for how many days? Can i take a single dose of 1mg or more?

Answered by Dr. Krunal Karade (8 minutes later)

Brief Answer:
Azithromycin 500mg once daily for 3 days .

Detailed Answer:
Use Azithromycin 500mg once daily after food for 3 days . Don't use single dose of azithromycin , gastrointestinal side effect are more with single dose.

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. Vinay Bhardwaj