Suggest Treatment For Tinnitus

Brief Answer:
Tinnitus due to noise exposure

Detailed Answer:
Hi. Thank you for writing to HCM.

The constant ringing that you are experiencing is called as tinnitus. This occurs when the auditory nerve (cochlear nerve or nerve responsible for hearing) is damaged or irritated due to sudden noise exposure. This causes the nerve to constantly fire signals leading to the sensation of a continuous sound even if there is no external stimuli.

Tinnitus can be treatable in early stages such as in your case where it has been just two weeks since the sudden noise exposure. Oral steroids may help in reducing the inflammation to the nerve created due to the sound. However, the improvement depends significantly on the amount of damage created to the nerves.

To assess this, I would recommend that you have the following performed when you see your ENT specialist on Thursday.

1. Ear endoscopy - to see if the eardrum is intact. Sometimes loud noises can damage the eardrum
2. Pure tone audiogram - This will show based on your hearing capability at different frequencies if the auditory nerve is involved. This will be indicated with a high frequency dip in hearing. This test will also let us know if the hearing mechanism and the bony ossicles are fine.

If I were your treating ENT specialist, I would recommend the following management for tinnitus

1. Absolute avoidance of noisy environment - Continuous exposure to loud noise can damage your hearing permanently and the tinnitus that you are experiencing is an early indication of this. Use of good quality earplugs or noise maskers are indicated.

2. Oral steroids (1 week) are usually effective immediately especially if there is a hearing loss. They may be effective at this stage too if the damage is minimal.

3. Oral antioxidants ( 3 months) to reduce further nerve damage and help in healing.

4. Vitamin B12 supplements (3 months) that will help the nerve heal or regenerate.

It is common for tinnitus to disappear in one or two weeks if the damage is minimal and all necessary measures are taken to avoid noise exposure along with the above mentioned medications. However, it may take 4-6 weeks or even longer if the degree of damage is higher. White noise maskers/hearing aids are helpful if tinnitus is persistent for more than 3 months.

Hope this information helps. Do let me know if you have any further questions.

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Brief Answer:
Avoiding noise exposure will help

Detailed Answer:
Hi. Thank you for writing back.

Well, if the ear plugs don't help then it is definitely recommended that you take a break from work (for about a week). If your hearing test (pure tone audiogram) shows any signs of nerve damage then an occupation/role that does not involve exposure to loud noises may be worth considering.

Also note that Celebrex or Celecoxib is known to be an ototoxic drug which means it has the potential to damage the auditory nerve and worsen or cause tinnitus. Tramadol is also ototoxic but much lesser when compared to Celebrex. Paracetamol is a safe alternative for an anti-inflammatory agent. Lunesta is fine for sleeping.

Do let me know how your consultation with your ENT specialist turns out. Will be happy to help if you have any further questions.

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